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The Nine Lives of the Attuned Clinical Ear: The Future of an Illusion

My colleagues and I (Joiner, Brown, Perez, Sethuraman, & Sallee, 2005) referenced self-ratings and clinician ratings of childhood anxiety to a third, relatively objective data source—neuroendocrine responses to a biological challenge—and found that self-ratings had considerable probative value. Ours is a reasonably interesting finding (thus its appearance in the journal): The result that self-report sometimes is at least as good as—maybe better than—clinician ratings affirms other such results (e.g., Eddins & Jobes, 1994) and runs counter to a prevailing Zeitgeist (at least in some circles) reifying clinician ratings. In his commentary, Shedler (2006/this issue) suggests that Joiner et al. misunderstood the “illusion of mental health” concept. Shedler, Mayman, and Manis (1993) believed the illusion resides in patients’ or should-be patients’ minds— Joiner et al. understood this, and it is a plausible view. It is just that it is not the only possible view, as the Joiner et al. title’s phrasing (“In the Mind of Which Beholder?”) suggests. A statement from Shedler’s (2006/this issue) reply deserves comment: