by Joel Blackstock LICSW-S MSW PIP no. 4135C-S | Dec 15, 2025 | 0 comments

Joseph Campbell is arguably one of the most influential intellectuals of the twentieth century. If you have watched a Marvel movie or read a modern fantasy novel or sat in a screenwriter’s workshop you have encountered his fingerprints. George Lucas explicitly credited Campbell’s The Hero with a Thousand Faces as the structural backbone of Star Wars. Every major Hollywood studio has copies of his work floating around their development offices.

Even filmmakers who actively deconstruct his monomyth model still have to be in conversation with Campbell to do so. You cannot escape him if you are telling stories in the Western tradition.

But here is the thing about Joseph Campbell that we need to hold in our minds when we think about what psychology has become. He was a showman. He was a legitimate scholar but also someone who understood that the truth sometimes needs a little theatrical assistance.

One of Campbell’s favorite presentation techniques involved showing an image of ancient bear bones that were perhaps two million years old and discovered in a cave. The bones had been arranged in a particular way with pieces shoved back into the bear’s mouth.

Campbell would present this with his characteristic gravitas and explain that the ancients understood that nature must eat of itself. They knew that to take life is to participate in a cyclical loop of giving and receiving. The bear consuming itself was a ritual recognition that we are all food for something else.

It is a beautiful interpretation. It is probably even partially true. We know through depth psychology and early anthropology that prehistoric humans were almost certainly trying to make meaning of existential realities. Ritual practices around death and consumption are well documented across cultures. Campbell was not fabricating this from nothing.

But also come on Campbell. These are two million year old bones shoved in a hole. Maybe the jaw just collapsed that way. Maybe soil shifted. Maybe an animal disturbed them centuries after burial. He did not know. He could not know. And yet he presented it with the confidence of revealed truth.

Here is why this matters. Campbell’s influence is incalculable despite his methodological looseness. He told a story that resonated so deeply with something in the human psyche that it became the invisible architecture of our entire entertainment industry. He was not objectively right about those bear bones but he was pointing at something real about how humans make meaning. The story he told about that meaning making was more powerful than any peer reviewed paper could have been.

We need to remember this when we think about psychotherapy and what it has become.

When I first entered the field of psychotherapy I had a fantasy. I thought I was going to be Joseph Campbell. I was going to find my way to someplace like Berkeley and immerse myself in the grand conversation between psychology and mythology and anthropology and philosophy. I imagined something like the Esalen Institute in the 1970s where Fritz Perls developed Gestalt therapy and where researchers and mystics and clinicians sat together in hot springs and argued about the nature of consciousness.

Those places barely exist anymore.

What I found instead was a competitive model built on H-indexes and impact factors. I found academic departments that had been siloed into increasingly narrow specializations. Each department defended its territorial boundaries against incursion from neighboring disciplines. The institute model where a psychologist might spend an afternoon talking to an anthropologist about ritual has been systematically dismantled.

What we have instead are specialists who do not read outside their sub specialty and researchers whose entire careers depend on defending one narrow hypothesis. We have an incentive structure that actively punishes the kind of cross pollination that leads to genuine discovery.

This is not just an academic inconvenience. It is a catastrophe for the human sciences and for the actual treatment of patients.

There is a reason Freud stuck around. It is not because psychoanalysis was rigorously validated through randomized controlled trials. It is because as the science writer John Horgan observed old paradigms die only when better paradigms replace them. Freud lives on because science has not produced a theory of and therapy for the mind potent enough to render psychoanalysis obsolete once and for all.

The biomedical model promised us a better story. It told us that humans are biological machines and that suffering is just a mechanical malfunction. It promised that if we could just find the right neurotransmitter or the right gene we could fix the machine.

But look at what that looks like in practice.

It looks like the 15 minute medication management appointment. A person comes in with their life falling apart. They are grieving a divorce or wrestling with the trauma of their childhood or facing a crisis of meaning. And the doctor looks at a checklist. They ask about sleep. They ask about appetite. They ask about energy levels. They treat the symptoms like check engine lights on a dashboard. They prescribe a pill to dim the lights and they send the person away.

It looks like manualized Cognitive Behavioral Therapy. This is the gold standard of evidence based treatment. But in the vacuum of a manual it becomes absurd. A patient might be crying about the loss of a child and a therapist who is strictly adhering to the protocol has to redirect them to the agenda for Module 3 which is identifying cognitive distortions. The model has no room for the tragedy of the situation. It only has room for the erroneous thought that the patient is having about the tragedy.

The result is that by most measures we are not actually helping people more effectively than we were fifty years ago. To understand the depth of this failure, we must look at the “smoking gun” of the psychiatric establishment: the STAR*D study.

For nearly two decades, this massive, taxpayer-funded study was held up as the irrefutable proof that the “medication merry-go-round” worked. It cost $35 million and was cited thousands of times to justify the idea that if a patient didn’t get better on one antidepressant, you simply switched them to another, and then another. The study claimed a “cumulative remission rate” of 67%. It told us that two-thirds of people would be cured if they just complied with the protocol.

This was a lie built on methodological quicksand. A forensic re-analysis of the data (Pigott et al., 2023) revealed that the researchers had inflated their success rates through a series of stunning methodological sleights of hand. The original design called for the Hamilton Rating Scale for Depression (HRSD) to be the primary outcome measure. But when that scale wasn’t showing the numbers they wanted, investigators switched to a secondary, unblinded, self-report questionnaire (the QIDS-SR) which painted a rosier picture.

Furthermore, the re-analysis exposed that hundreds of patients who dropped out due to side effects were excluded from the failure count, effectively scrubbing the negative data. Even worse, over 900 patients who didn’t even meet the minimum severity for depression were included to boost the numbers. When the data was re-analyzed using the study’s original criteria and including all participants, the cumulative remission rate plummeted from 67% to 35%.

But the most damning statistic is the sustained recovery rate. Of the 4,041 patients who entered the trial, only a tiny fraction achieved remission and actually stayed well. When accounting for dropouts and relapses over the one-year follow-up period, a mere 108 patients achieved remission and stayed well without relapsing. That is a sustained recovery rate of 2.7%.

If a heart surgery or cancer treatment had a failure rate of 97.3%, it would be abandoned. Yet, this study was championed by investigators with deep financial ties to the pharmaceutical industry, and the results were codified into clinical guidelines that still rule the profession today. This is the indictment: we have built an entire system of care on a statistical fabrication, prioritizing the protection of the model over the healing of the human.

I have big problems with Freud. I have big problems with classical psychoanalysis. I am more of a Jungian. But here is what the depth psychologists understood that the biomedical model forgot. Humans are not just biological machines. We are meaning making creatures who navigate the world through story. When you take away our stories you do not make us more rational. You make us lost.

This separation of science from narrative has hurt the researchers too. In his book The Ghost Lab journalist Matt Hongoltz-Hetling uses the flock of dodos metaphor to describe this phenomenon. He argues that specialized creatures that are perfectly adapted to narrow environments become extinct when conditions change.

Academic science has become a flock of dodos. A neuroscientist studies one particular brain region. A psychologist studies one particular therapeutic intervention. An anthropologist studies one particular culture.

Nobody is allowed to step back and ask what all of this means together. When you silo information into separate academic disciplines instead of organizing it into a holistic understanding you kill the narratives that are already there. You cannot see the story until you step back far enough to recognize the pattern.

One of the primary functions of a subjective narrative in an objective field like psychotherapy is that it lets us start with things we consider self evident. These are things that do not need evidence because they are the ground upon which evidence stands.

Things like humanity is important. Things like we contain multiplicities and conflicting parts. Things like consciousness is a mystery.

The biomedical model has no way to accommodate these self evident truths because they are not measurable. You cannot run a randomized controlled trial on human dignity.

Martin Heidegger understood this trajectory. He warned that science and technology were becoming self justifying systems that asked only whether something could be done and never whether it should be done.

We are watching this play out right now with Large Language Models and Artificial Intelligence. The tech industry is boiling seawater and consuming enormous amounts of our remaining resources to build ever larger systems. As Ed Zitron has documented the current AI boom is likely a bubble that will crash and burn. It may leave us with a Google monopoly on Gemini that will not actually help anybody.

Should we be doing this? Should we be fundamentally restructuring our economy around technology whose benefits are speculative at best?

The Heideggerian answer is that we are not even capable of asking these questions properly because we have lost the narrative framework within which “should” makes sense. When everything is reduced to capability and efficiency the concept of values disappears.

Can we just recognize that having a livable planet is probably a self evidencing goal? Can we recognize that having a psychotherapy willing to engage with perennial philosophy might be more valuable than another meta analysis demonstrating small effect sizes for manualized interventions?

This is what I mean by reintroducing narrative. I do not mean replacing evidence with myth. I mean recognizing that the facts do not speak for themselves. Data requires interpretation. Interpretation requires a framework. And frameworks are stories about what matters.

The story science forgot is the story of science itself. It is the story of how inquiry emerged from human communities trying to understand their world. We can recover this story. We can rebuild the connections that the academic silos have severed.

The path is there. It always has been. We just need to be brave enough to walk it.

If academic science has become a flock of dodos clinical practice has become something arguably worse. It has become a reenactment of the Milgram experiment where the system plays the role of the authority figure and the patient plays the victim.

We often remember Stanley Milgram’s famous 1961 study as a lesson about the capacity for evil but its deeper lesson was about the capacity for distance. When the subject had to physically touch the victim compliance with the order to harm them dropped to 30 percent. The White Coat only retained its authority when it created a buffer between the human actions and their consequences.

Modern psychotherapy has built a massive administrative White Coat that separates the healer from the healed. This is not just a metaphor. It is a structural reality that is actively driving patients out of the profession and into the arms of pseudoscience.

For a patient in crisis the Evidence Based system often functions as a machine of exclusion. A study on healthcare administrative burdens reveals that the psychological cost of navigating billing and insurance denials and intake forms acts as a friction that hits the most vulnerable the hardest. We ask trauma survivors to retell their stories to three different intake coordinators before they ever see a therapist. This process is itself retraumatizing.

When they finally reach a provider they are often met with the biomedical gaze which is a checklist driven assessment that reduces their complex narrative of suffering to a code for billing. As the Australian Psychological Society has noted the chemical imbalance theory and the medicalization of distress have failed to reduce stigma and have instead left patients feeling defective and unheard.

The result is a profound Low Trust environment. Theodore Porter in his book Trust in Numbers argues that we only rely on strict mechanical numbers when we do not trust people. We use the DSM and manualized protocols because insurers do not trust clinicians to judge and clinicians do not trust themselves to deviate.

This creates a fundamental schism that explains why the profession feels like it is cracking in half. On one side you have the academic researchers who are incentivized by grant funding and publication metrics. To get these rewards they must isolate variables and create reproducible manualized protocols. This means they must strip away the very thing that makes therapy work which is the messy and unrepeatable human relationship.

On the other side you have the clinicians who are incentivized by patient outcomes. They are in the room with the messiness. They see that the manualized protocol fails the complex trauma patient so they improvise. They integrate. They use intuition.

The academic looks at the clinician and sees a cowboy who ignores the data. The clinician looks at the academic and sees a bureaucrat who has never treated a suicidal patient. This is why the research is no longer informing the practice. We have created two different languages. The researcher speaks in p-values and population averages while the clinician speaks in case studies and individual breakthroughs.

This low trust environment creates a vacuum that wellness influencers are all too happy to fill. We often mock the public for turning to unverified supplements and TikTok diagnosticians and quantum mysticism. But we have to ask what these influencers are providing that we are not.

They are providing narrative. They are providing connection. They are providing a. parasocial yes but still, High Trust experience.

A recent analysis suggests that wellness fads thrive not because people are stupid but because the influencers offer a feeling of personal validation that the medical system denies. Even AI chatbots are now being described by users as more humane than doctors because the AI listens to the whole story without looking at a watch or a checklist.

When a patient is told by a doctor that their pain is idiopathic or psychosomatic because it does not show up on a lab test and then an influencer tells them I see you and I believe you and here is a story about why this is happening the patient will choose the influencer every time. The trust gap drives them away from care that might actually help and toward solutions that feel good but do nothing.

This leaves the ethical psychotherapist in a state of moral injury. We are forced to participate in a system that we know is alienating the very people we are trying to help. We are trained to value the therapeutic alliance or the bond of trust above all else yet we work in a system designed to sever it with paperwork and time limits and standardized protocols.

We have to put down the White Coat of administrative distance. We have to stop hiding behind the Evidence Based label when that label is being used to deny the reality of the person in front of us.

If we want to stop this exodus and heal the split we need specific structural changes. We cannot just hope for better insurance reimbursement. We need to change what we consider valid science.

First we must re-legitimize the systematic case study. For a century the detailed narrative of a single patient was the gold standard of learning. We replaced it with the aggregate data of the randomized controlled trial. We need to bring it back. We need journals that publish rigorous detailed accounts of what actually happens in the room when a patient gets better.

Second we need to build open source repositories for clinical observation. Currently the wisdom of the field is locked behind for profit paywalls or lost in the private notes of isolated therapists. We need a Wikipedia of Clinical Practice where thousands of clinicians can document what they are seeing in real time. If ten thousand therapists report that somatic processing helps complex trauma that is a data set that rivals any RCT.

Third we need to teach philosophy and narrative in graduate school again. We are training technicians when we should be training healers. A therapist who knows how to read a spreadsheet but does not know how to understand a story is useless to a human being in crisis.

If we do not offer a therapy that is human and narrative and deeply relational we will continue to lose our patients to those who do even if what they are offering is a lie.

We often treat mathematics as if it were the bedrock of reality itself. We act as though a p-value is a piece of the universe, like a rock or a proton. But we must remember that math is not the thing itself. It is a representation of the thing. It is a map, not the territory. It is a mirror, not the face.

Theodore Porter’s work in Trust in Numbers reminds us that we reach for these mirrors when we do not trust our own eyes. But the mirror is useless without someone to look into it and interpret the reflection. Data by itself is pointless. It is a pile of bricks without an architect. It requires interpretation to become meaning, and interpretation is fundamentally a narrative act.

When we try our best to make a purely objective study, we are still telling a story. We are saying, “These numbers represent this phenomenon.” Then another researcher comes along, looks at the same numbers, and tells a different story: “No, they represent that.” This conflict isn’t a failure of science; it is science.

The greatest breakthroughs in history did not come from people who just crunched numbers. They came from people who could see the story the numbers were trying to tell. These stories are really damn interesting, often stranger and more beautiful than fiction.

Consider August Kekulé. He didn’t discover the structure of the benzene molecule by staring at a spreadsheet. He discovered it by dreaming of a snake eating its own tail—the Ouroboros. His subjective, narrative brain provided the image that unlocked the objective chemical reality. The data was there, but it needed a myth to make it intelligible.

Look at Quantum Physics. The raw math of quantum mechanics is cold and abstract. But when physicists like Erwin Schrödinger or Werner Heisenberg looked at that data, they saw a story about uncertainty, about cats that are both alive and dead, about a universe that only decides what it is when it is observed. They didn’t just calculate; they interpreted. They told a story about reality that was so radical it changed how we understand existence.

Even in psychology, the data of the “talking cure” was messy and anecdotal until Freud and Jung gave us the language of the Unconscious and the Archetype. Were they objectively “right” in every detail? No. But they gave us a framework—a story—that allowed us to navigate the chaos of the human mind. They provided the map that allowed us to enter the territory.

We have spent the last fifty years trying to strip this storytelling capacity out of our profession in a misguided attempt to be taken seriously by the “hard” sciences. In doing so, we have thrown away our most powerful tool. The brain is a story-processing machine. To treat it with checklists and spreadsheets is to deny its fundamental nature.

We need to be brave enough to pick up the mirror again. We need to be brave enough to look at the data—whether it’s the 2.7% recovery rate of STAR*D or the trembling pupil of a trauma patient—and ask, “What is the story here?”

The path forward isn’t about choosing between science and narrative. It is about realizing that science is a narrative. It is the grandest, most complex, most rigorous story we have ever tried to tell. And it is time we started telling it properly again.

More @ Get Therapy in Hoover, Alabama.