Innovation, Controversy, and Consensus in Traumatology

David V. Baldwin
Author Note
David V. Baldwin, PhD, independent practice in Eugene, Oregon (formerly, Adjunct Professor in the Department of Psychology, Southern Oregon State College, Ashland and courtesy faculty appointment at the Psychology Department at University of Oregon).

The author gratefully acknowledges members of the traumatic-stress mailing list for their passionate and thoughtful exchanges on topics covered in this article over the past two years, and Terry Bristol of the Institute for Science, Engineering, and Public Policy for interesting discussions regarding recent work by Larry Laudan and others in the philosophy of science. Helpful critical comments on a draft of this article were contributed by several anonymous reviewers on the Traumatology editorial board.

Correspondence concerning this article should be addressed to the author via email dvb@trauma-pages.com or to PO Box 11143, Eugene, OR 97440-3343.

Note: Draft "pre-print" version of this article, with minor edits in June 2013; please do not quote. The final article, as published in Traumatology in March 1997, is still available on the web.  See: http://tmt.sagepub.com/content/3/1.toc

Abstract

Controversy follows innovation and threats to the status quo in many social domains, including the sciences. This article briefly summarizes information from the philosophy of science and data from studies of conflict in diverse fields. It then introduces two independent contemporary controversies in traumatology -- a new clinical method called EMDR and the Final Report of the APA Working Group on memories of childhood abuse -- and considers them within a broader context of the historical rift between psychological research and practice. The aim is to step outside the frame of specific conflicts and identify differences in philosophical orientation and values that contribute to communication difficulties and associated conflict between partisans. Approaches are offered toward building consensus within the field.

How is it that controversy invades domains such as psychology and allied sciences, where the rational pursuit of knowledge should seemingly minimize emotional friction?

This article suggests that controversy in traumatology, following a pattern seen in other sciences, reflects different philosophical assumptions between opposing partisans. The article reviews controversy within the context of philosophy of science and history of psychology, and then considers the social psychology literature on social conflict. Scientific controversies provide opportunities to study and explicate those underlying values distinguishing partisans. Two specific controversies, illustrating aspects of social conflict, are discussed with respect to their common features. One example involves adoption of EMDR (Shapiro, 1995), a relatively new clinical method for resolving traumatic experiences. The second draws from the APA Working Group Final Report on memories for childhood sexual abuse (Alpert, Brown, Ceci, Courtois, Loftus & Ornstein, 1996). These contemporary controversies appear consistent with a rift between research and practice that has plagued psychology for decades. While this historical rift is well known (Hitt, 1969), its pertinence to contemporary debates in traumatology has not been explored. The article concludes with preliminary suggestions for building consensus in the field.

Considerations Concerning Social Conflict

Controversy and conflict flourish in most domains of human interaction, and many factors perpetuate them; examples include labor negotiations, and societal issues such as abortion or gun control. Likewise, the professional literature on social conflict spans diverse disciplines including business administration, education, social psychology, and sociology. Commonalties gleaned from diverse examples of social conflict can reveal parallels and inform discussion of controversy in general. Below, a brief summary of this literature highlights principles emerging from conflict studies in varied fields which appear relevant to the two controversies discussed here.

Controversies in science may stem from differing philosophical views and values.

Proponents of different theories are, I have claimed, like native speakers of different languages. Communication between them goes on by translation, and it raises all translations familiar difficulties.... Some words in the basic as well as in the theoretical vocabularies of the two theories ... function differently. (Kuhn, 1977, pp. 338)

Historically, controversy follows innovation in science, and has commanded attention from philosophers of science. According to Kuhn, every paradigm has its own rules for the importance of problems and for judging problem solution. Where standards are shared across paradigms, their interpretations are likely to differ (Kuhn, 1977). Two extreme schools in the philosophy of science have been termed positivism and relativism (see Laudan, 1990). Positivism holds that science must strive for a unity of method, within which all members agree on the epistemic standards of knowledge, and by which all theories can be objectively compared. In contrast, Feyerabend (1988) argued there can be no single method, that new ideas must emerge from a field of chaos. Strong forms of relativism maintain that the standards for evaluating theories are merely conventions, that virtually any theory can be rationally maintained in the face of any conceivable evidence, that a given conceptual framework cannot be made intelligible in the language of a rival world view, and that scientists choose among theories on the basis of personal beliefs or professional interests. Although relativism is not accepted by most philosophers of science, positivism no longer holds the dominant philosophical position in science. Various pragmatic and realistic combinative positions have attempted to bridge the gulf between these opposing perspectives (Laudan, 1990).

Psychology emerged as a discipline from a union of philosophy and physiology, including selected ideas and assumptions from each. It patterned itself after the natural sciences, which then held a positivist philosophical position (Buss, 1975). Sherif (1987) argues that experimental, statistics, and assessment areas in psychology fit most closely within the positivist position, while applied areas such as developmental and clinical psychology fit poorly. [In traumatology, both Walter Cannon and Hans Selye argued against reductionism.] These latter areas were less accepted by a discipline then striving for acceptance as an academic science. Methodological preconceptions, patterned after the natural sciences, led to other beliefs about how to pursue knowledge. For example, behaviorism's avoidance of subjective experience followed from positivism's focus on objective measurement and verification. Like a lens, premises accentuate some qualities while blurring others: by selectively determining choices regarding what to study and what to ignore, they constrain the knowledge that can be obtained from research and influence how this knowledge is evaluated (Moulton, 1983). Psychology has also wrestled with historically evolving definitions of acceptable research standards, reflecting changing social values and interests (Danziger, 1990). As scientific fields have grown more heterogeneous in recent decades, an influx of perspectives diversify the available world views within them. Currently, feminism represents one emerging, holistic value system in science (Tuana, 1989) relevant to the scientific vs. clinical debates in traumatology. Chaos theory (Robertson & Combs, 1995) and quantum mechanics (Stapp, 1993) may represent other relevant perspectives. Diverse views yield to progress through debate and may exacerbate social conflict.

Multiple coexistent world views imply divergent underlying values and evaluative standards. This may be especially apparent within sciences concerned with social behaviors -- where historical, cultural, and personal factors influence the elaboration and acceptance of theories (Danziger, 1990). Controversy within psychology today may echo fundamental contradictions within its historical roots, including unresolved debates surrounding the mind-body problem or mechanistic/reductionistic vs. holistic approaches. Meehl (e.g., 1973) has written extensively on the conflicts between clinical and actuarial -- or "muddleheaded and simpleminded" -- methods in psychology. Kimble (1984) identified five specific value dimensions discriminating `scientific' vs. `humanist' cultures among psychologists: These groups differed on scholarly values (scientific vs. humanistic), basic source of knowledge (objectivism vs. intuitionism), appropriate setting for discovery (laboratory vs. field), generality of laws (nomothetic vs. ideographic), and appropriate level of analysis (elementism vs. holism). Similar issues, of course, resonate in medical practice as well (Engel, 1977; Jewson, 1976). For example, cultural differences sway acceptance of medical interventions across nations (e.g., Payer, 1988).

If science progresses as successive theories solve more problems than their predecessors (Laudan, 1996), then individuals with differing concerns -- including those more troubled by current theory limitations -- will respond to new theories differently, depending on how well their issues are satisfied. Laudan has proposed that where a scientific discipline includes divergent epistemic standards, emerging theories are likely to satisfy the standards of some scientists but not the standards of others. Epistemic standards relate to knowledge or the conditions for acquiring it. Obviously, satisfied individuals are most likely to adopt the new theory. This suggests that "early adopters" of a new theory subscribe to different standards than those who accept it much later, if at all. It follows that the arguments of early advocates often rely on differing theories of evidence and inductive support than those cited by subsequent converts (Laudan, 1996). In fact, subjective and non- scientific considerations may play an indirect role whenever scientific decisions (such as theory choice) are underdetermined by incomplete or ambiguous empirical data (Shapin, 1982).

Distortions in social perception encourage negative stereotypes and maintain conflict.

Social perception is selective and involves categorization. Distortions in social perception can exacerbate conflicts that may appear to be moral- ideological when they actually stem from differing interpretations of the underlying facts -- or misunderstandings (Ichheiser, 1970). As escalating controversy engenders conflict, negative attitudes and perceptions (e.g., stereotypes) of the opposing side may develop or increase. Here, stereotypes mean categorically-based generalizations by partisans toward their own or opposing group members.

Stereotypes are probably inevitable adaptations, invaluable in reducing the complexity of social interaction. Like caricatures, stereotypes simplify by emphasizing some attributes and neglecting others. They may categorize the values as well as the traits of opposing members (Esses, Haddock & Zanna, 1993), particularly in scientific controversies. Though stereotypes may be positive or negative, accurate or inaccurate, conflictual contexts tend to produce categorizations (of the opposing side) that are inaccurate and negative. Emotional factors accompanying controversy may influence selection of information and cognitive processing strategies, maintaining stereotyped views (Schaller, 1992). For example, stereotyped opposing groups and their members are seen as more similar and less variable than members of the same side, or, indeed, than they are (Judd, Ryan, & Park, 1991; Vonk, 1995). Language use reflects these beliefs: language for stereotypical generalizations is more abstract, while language describing exceptions more concrete (Maass, Solvi, Arcuri & Semin, 1989). Further, information about a stereotyped group is better remembered if it is consistent with stereotyped beliefs than if it is inconsistent (Cano, 1991). Taken together, these processes reinforce either positive or negative a priori impressions. Stereotyped expectancies can become self-fulfilling prophesies.

Conflation of such non-scientific factors with fundamental issues between groups obscures the latter differences and contributes emotional heat as controversy escalates into conflict. A general model of conflict focuses on alternating structural changes in opposing groups (Pruitt & Rosen, 1986). Polarization of groups is one example of structural change, both contributing to and a consequence of escalation. Polarization directly reinforces escalation while eroding safeguards against it. Over time, conflict may widen to new and broader issues, increasing distrust and possibly inducing desire to punish or defeat the opposing side.

In situations where one group supports the status quo and an opposing group advocates change, group status becomes an important dimension. Those advocating the orthodox view may feel more anxiety at the prospect of change (Stephen & Stephen, 1985). Robinson and colleagues found that members supporting the status quo (i.e., pro-abortion partisans, and traditionalists in the English literature Western Canon debate) were more prone to bias, and were more accurately judged, than members of the opposition (Robinson, Keltner, Ward, & Ross, 1995; Robinson & Keltner, 1996). Their results suggest that each side misperceives the opponents' beliefs in a way that exaggerates differences between groups. Also, the side advocating change, being less well known, is typically judged less accurately. Complicating this, multiple positions in some controversies may share a mixture of orthodox and change elements within multifaceted disagreements. This implies alternating aggressor-defender roles, creating a spiraling conflict (Pruitt & Rosen, 1986). Escalating conflict and multiple positions characterize controversy in our selected examples.

Contemporary Controversies

Two examples were chosen to emphasize commonalties of controversy that may appear less salient if examined separately, and also for technical reasons (primarily, availability of sufficient data on both sides). The EMDR controversy focuses specifically on determining the efficacy and operative mechanisms of a single clinical method. The Final Report of the APA Working Group focuses, within a single discipline (psychology), on the controversy concerning memory for childhood sexual abuse. Both examples pit practitioners against researchers, yet it is well to recognize that neither of these positions are as pure as presented here. Some individuals, for example, are both practitioners and researchers; these and other partisans may float between camps on specific issues.

EMDR. Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1995) was selected as an example because this clinical method is relatively well known, and has garnered more empirical research than other new trauma therapies. Other innovative approaches for trauma work have emerged recently, including Traumatic Incident Reduction (TIR) and Thought Field Therapy (TFT). Critical Incident Stress Debriefing (CISD), and its variations, are psycho-educational approaches for groups exposed to traumatic incidents. These approaches have attracted clinical attention as powerful methods for work with traumatized persons. All are controversial, and appear to evoke deep passion in supporters and critics alike. Discovered or developed by clinicians, they share limited empirical support or accepted theoretical foundations at present. Some individuals, primarily trauma therapists, embrace one or more of these methods as useful tools in their work with PTSD patients. Others, primarily researchers, remain skeptical of these methods' efficacy and pedigree. Responses to these methods can fairly be characterized as polarized, and communication between opposing groups is often difficult and contentious. Although EMDR illustrates this example here, a similar process may apply with other clinical (or educational) innovations that challenge orthodox assumptions.

APA Working Group. Within the field of psychology, controversy has grown around aspects of memories for childhood abuse. Although this issue has spread to other mental health fields as well, in this article the example is illustrated with reference to the final report of a working group of six prominent psychologists, formed to address this issue for the American Psychological Association (Alpert et al., 1996). This focus clarifies that value differences do not necessarily involve communication across scientific disciplines. [All page numbers in the following section refer to Alpert et al.]

APA Working Group Final Report

Compare the preceding quote from Thomas Kuhn (1977) with these excerpts from Alpert et al.'s (1996) final conclusions:

We frequently do not speak the same professional language or define phenomena in the same manner; we read different journals and books, and attend different specialty meetings; and each group finds useful and compelling studies that the other group sees as problematic and questionable. Many of the difficulties that we have encountered in attempting to achieve consensus reflect these profound epistemological differences.... (p 2)

These contrasting conceptions ... have lead to debate concerning: ...(d) the relevance of the basic memory and developmental literatures for understanding the recall of stressful events; [and] (e) the rules of evidence by which we can test hypotheses about the consequences of trauma and the nature of remembering. (pp. 1-2)

For two and a half years, the Working Group remained split in two camps: "practitioners" and "researchers". Despite some shared agreements, many issues were left unresolved. Both sides agreed that the current state of research on memory does not adequately account for traumatic amnesia or distortions (pp. 141-142). Additionally, both accepted that memory is sometimes fallible and sometimes not, that sometimes we remember salient life experiences without periods of amnesia while at other times awareness of such experiences emerges in response to environmental cues, and that certain therapeutic practices pose reliability risks for false reporting (p. 235). Both camps also agreed that the other side displayed a confirmatory bias: failed to consider findings counter to cherished beliefs (p. 221).

Their Final Report highlights differences in values and interests between sides -- these "hidden" aspects surface most clearly in the document's reply and response segments. Important specific differences are presented below, in a collage summarizing internal assumptions and perceptions about the opposing side.

Representative Practitioner assumptions: Practitioners value naturalistic, observational and correlational data (p. 138), and see serious limits to the inferences that can be made from currently available experimental data (p. 148). They believe that memory for traumatic events may differ from memory for usual events (p. 137). While recognizing a variety of sexually abusive acts, practitioners believe all are disruptive and hold the potential to be traumatizing (p. 146) through changes in the adult-child relationship (pp. 146-147). They believe any problems with criticized psychotherapeutic techniques (viz., hypnotism) lie in how they are used (p. 136), and that telling the trauma story (thus integrating trauma memory into a coherent narrative) is helpful and effective therapy (pp. 134-135).

Representative Researcher assumptions: Researchers value experimental data over naturalistic, correlational, and observational data (p. 138). These experimental data do not provide sufficient evidence to believe that memory for traumatic experiences differs from other memory processes (p. 137). From their objective perspective, childhood sexual abuse can be seen as a decontextualized event, and may not always be traumatic to children (p. 145). For example, a determining factor is the child's understanding of the event when it occurred: some sexual events (e.g., fondling) might not be experienced by an infant as abusive (pp. 234-235). Similarly, the best [scientific] evidence available suggests it is possible to taint a report about stressful events (p. 234). Specific therapeutic practices can lead to report inaccuracies (p. 232), but they do not ineluctably do so (p. 233). Researchers worry that telling the trauma story may be iatrogenic and harmful (p. 135; pp. 187-188).

How Each Camp Perceives the Other: According to practitioners, researchers hold a seriously flawed image of what happens in therapy: they assume that some psychotherapeutic techniques are innately suggestive and distorting and are only used for eliciting memories (p. 136). According to researchers, practitioners equate anecdotal evidence with the results of controlled empirical studies: they endorsed feelings and impressions over controlled studies (p. 228); they claim that memories for trauma are `special' (p. 109); and they assume that research low in ecological validity (e.g., with respect to the social nature of a therapy context) cannot generalize to that context (pp. 227-228). Thus, practitioners misunderstand how scientific reasoning proceeds (pp. 221-222).

Discussion

Reviewing summarized values of the Working Group's researcher and practitioner camps dispassionately, it seems apparent there is a fundamental difference in the emphasis placed on controlled experimental research vs. anecdotal evidence. Further, both groups may perceive the other's folly as violating their own accepted values. Practitioners may see researchers as not considering certain data (e.g., observation and anecdote) and thereby missing the broader picture. Researchers may see practitioners' over-reliance on correlational information as an invitation to subjectivity and error. In short, these groups differ in what they mean by acceptable empirical data. This difference captures each of Kimble's (1984) significant value dimensions: scholarly values, basic source of knowledge, appropriate setting for discovery, generality of laws, and appropriate level of analysis. (Kimble's clinical and experimental groups also differed on a methodological strategy dimension, but it was not included in his final factor.)

Stemming from underlying epistemic differences surrounding what kinds of data each camp chooses to accept, additional disagreements around memory processes and clinical practice issues appear secondary and inevitable. In two respects, these differences may stem from dissimilar demands within two distinct career paths (they may also predict divergent specializations). First, researchers must value experimental data (which they produce), and recognize dangers in anecdotal evidence. Similarly, practitioners rely on their own feelings and observations because quick decisions are often required and actuarial data may not address specific circumstances in their clinical work (Meehl, 1973). Second, these specializations accrete different experiences and kinds of data. Practitioners generally see only those victims of childhood sexual abuse who manifest emotional distress or symptoms warranting clinical intervention. Researchers seldom knowingly come across individuals who have been sexually abused or sought therapy. Prolonged exposure to these distinct environments may produce differing preconceptions about the incidence and consequences of childhood sexual abuse. Likewise, the rift between early adopters of EMDR (and other new trauma approaches), and skeptics critical of these methods, also hints at divergent standards. While both would agree on some measure of efficacy, we might expect disagreement over just how this is best assessed. Practitioners probably emphasize pragmatic factors (e.g., attrition rates) when considering a clinical method for adoption, while researchers might favor theoretical congruence. Researchers' skepticism may also reflect, through personal experiences, how often new theories fail.

Miscommunication and misunderstanding (both inherent in controversy) provide fertile ground for the development of negative perceptions. Both researchers and practitioners may form inaccurate stereotypes of the opposing groups, based on a long history of perceived differences, lack of information, and frustration with the opposing side. For practitioners, this frustration may include the perceived irrelevance of much clinical group data for their own individual clients, perceived attacks by academic colleagues (e.g., Dawes, 1995; Ofshe & Watters, 1994), and by the scarcity and intrusions forced by various marketplace changes (Fox, 1995). For researchers, frustration may include concerns over perceived pseudoscience, the proliferation of competing professional schools (Caddy, 1981), and dwindling resources devoted to basic vs. applied research. For example, practitioners call for research into phenomena of clinical interest, including efficacy of new clinical interventions. They support these demands with the claim that X deserves further study because understanding X is important for competent clinical practice with clients who manifest X (see Alpert et al., 1996, p. 141). For researchers, this may smack of an intrusion into their turf -- a violation of their expectation that purely theoretical grounds should guide research decisions. To the extent both groups see themselves as different, and identify with others like themselves in opposition to the outside group, negative stereotypes may be a predictable consequence (Ichheiser, 1970). Comparing the reasonableness of each group's internal assumptions with their characterizations of the opposing side's beliefs (e.g., in the Working Group report), suggests tendencies to misperceive and impute exaggerated differences to the opposition.

Practitioners. Focused on healing patients suffering from persistent intrusive symptoms of PTSD, it is in practitioners' interest to seek out methods purporting to assist resolution of their patients' pain. The risk of accepting a bogus procedure is relatively low, since its implementation occurs in the clinician's office, generally in front of a single client. If a procedure fails (or proves harmful), it can be discarded with little embarrassment. On the other hand, the incentive to adopt effective new clinical methods involves both emotional and economic values.

In the developmental course of exploring claims for any new clinical procedure, word of mouth communication among colleagues is typically followed by case study presentations, then publications, and finally by controlled clinical trials of growing sophistication. As seen in Alpert et al. (1996), practitioners weigh their own feelings and observations highly. They are also more familiar with the initial evidence: thus, those closer to early anecdotal data are more willing and able to test for themselves reports concerning a new clinical method. In contrast, researchers will tend to emphasize congruence with known theories, and will only learn of these methods as described in published reports -- independent of their effectiveness. Considering empirical support for EMDR in relation to other clinical procedures and its potential utility, many practitioners see this method as relatively well supported, despite inconclusive evidence regarding exactly how it works. They may underestimate both the diverse sources of resistance to successful new theories by scientists (Barber, 1961), and the decades sometimes needed for empirical verification of new ideas.

Researchers. Valuing theory and empiricism as the wellsprings of scientific knowledge, researchers stand unimpressed (and perhaps even suspicious) at the serendipitous discovery of EMDR (e.g., Rosen, 1995) or other clinical methods not tightly grounded in accepted psychological processes. The risk of publicly endorsing a bogus procedure is relatively high, because it entails almost certain derision from colleagues if the method is subsequently shown to be less than advertised. Moreover, these risks include not only endorsement of an ineffective procedure, but one subsequently shown effective due to known mechanisms (e.g., suggestion). Difficulties and costs of clinical research generally, and with assessing long-term clinical outcome among PTSD populations in particular, further muddy the empirical waters and may also contribute to skepticism.

For researchers, the value of explaining how an existing clinical procedure works is considerably less than predicting a novel procedure based on theoretical considerations. Judging empirical support for EMDR in relation to other experimentally established psychological phenomena, many researchers see this support as questionable. Indeed, the idea that a new and surprisingly effective clinical method was discovered serendipitously by a non-scientist and marketed to clinicians before scientific acceptance contradicts the view that theoretical advances should drive research, and that research findings should guide clinical practice (Dawes, 1995): this does not further scientific interests.

Building Consensus

There are certainly cases where reaching consensus simply involves complete dissemination of existing facts. Where two groups share epistemic values but hold different information, they may temporarily disagree until information is fully shared. Greenwald (1996) discusses opposing views about EMDR in these terms, but this appears to be only one aspect of a more complex process in our examples. Where epistemic standards differ between groups, it is not just the facts that separate, but differing interpretations of these facts. When differing epistemic standards are involved, controversy is predictable; this encourages negative stereotypes and escalating social conflict. In such cases scientific disagreements all too easily progress to cultural or political arguments. For example, O'Donohue and Thorp's (1996) view of EMDR as "marginal science" is unintentionally descriptive: in any field, those questioning orthodox views are (or become) marginalized and tend to see things from a different perspective (Weinreich-Haste, 1986). Consensus formation in such instances is a complex process because the opposing value structures are neither trivial issues nor false dichotomies.

Forging consensus in traumatology will require resolving disagreements about epistemic standards. However, since such disagreements are not always resolvable, this is only a partial solution. It is helpful to realize that differing standards emerge from specific contexts to evaluate differing kinds of data and ideas. In these cases, Laudan (1996) proposes that a given theory becomes dominant in a field where that theory is superior to all rival theories by every differing set of standards in that field. The goal is to explicate epistemic values as fully as possible, while recognizing that internalized values are never easily identified or declared (Nisbett & Ross, 1977). Laudan's proposal has strong implications for traumatology. He emphasizes that differences in epistemic standards do not necessarily prevent agreement about the superiority of a given theory, provided one theory is eventually capable of satisfying more standards (or solving more problems) than its rivals. This suggests that we identify differences in values, standards, and definitions across opposing groups, and seek reconciliation. The process of identifying underlying epistemic standards and agreeing on definitions of terms will not be simple, but it may bridge the rift between opponents. Arguments that do not directly address these differences are likely to be futile, because they ignore the fundamental (and often unacknowledged) values over which partisans disagree.

Cooperation on issues independent of the controversy may, over time, break down antagonism and build alliances across opposing sides, providing partisans have equivalent status and develop meaningful relationships. Superordinate goals, exemplified by emergence of a common enemy or common opportunities for gain (Sherif & Sherif, 1966), effectively weaken prior group boundaries and foster positive attitudes among former adversaries (Pruitt & Rubin, 1987). For example, cooperative groups of researchers and practitioners might investigate new clinical methods collaboratively (e.g., Carbonell & Figley, 1996). As another example, a common recognition may emerge that the motivations of some for-profit managed care corporations -- e.g., regarding assessment, confidentiality, or quality of care -- are antithetical to shared values concerning patient welfare held by psychologist researchers and practitioners.

In fact, there is much to be gained when researchers and practitioners combine their knowledge and insights. The simple recognition that one is involved in a conflict spiral can itself reduce contentious behaviors and increase conciliation. This thought provided a major purpose in writing this article. Meanwhile, communication difficulties, though exasperating, may be inevitable: in Kuhn's (1977) words, "differences are unexpected and will be discovered and localized, if at all, only by repeated experience of communication breakdown" (p. 338). Yet these difficulties represent opportunities to explain positions, and eventually increase understanding of the other side's perceptions. To the extent that fundamental value differences are acknowledged and explored, partisans' discussions become more cooperative (Druckman, Broome & Korper,1988). Intuitive skills that clinicians find useful for uncovering unknown values or assumptions, and in dealing with irrational hostility, may be particularly helpful in this process. Similarly, the logical skills researchers use in avoiding pitfalls of anecdotal subjectivity, and data-based actuarial knowledge (e.g., of social conflict dynamics), should also prove valuable in reaching an integrative solution. Finally, it is well to recognize that these long-standing value differences will undoubtedly re-emerge in future conflicts long after our present controversies have been resolved. Controversy and conflict, at some times more convincingly than others, can reflect strength and growth in any scientific endeavor.

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