Adam Blatner, M.D.

(Re-published, July 30, 2002)

(I mentioned these ideas briefly in my books, noted below in the references, but I thought I ought to explain them a bit more.) Four categories of learning may be discerned:
  • information
  • competence
  • understanding, ... and
  • wisdom.
  • Each involves a different kind of learning process. This has relevance for the training of the psychotherapist, for the planning of treatment, and for thinking about education and personal development in general.


    One acquires information through reading, attending lectures, listening to audio-cassettes, watching videotapes, and the like. Learning in this fashion emphasizes primarily the "left brain" modes of memorization. Traditional schooling has utilized this approach as its dominant approach, in contrast to more apprentice-style contexts.

    Because of its pervasiveness in the curriculum, the memorization of information has come to be unrealistically associated with competence. The actual correlation between "book learning" and ability is not so impressive. Yet our culture relies on this criterion largely because of its relative ease and economy of assessment. That is, paper and pencil tests can be applied on a mass basis, and the faculty/student ratio can be rather low. Both teaching and testing an individual's competence requires much more time and attention. (This point takes on added relevance now that standardized testing is becoming a more prominent component in the curriculum, as a political response to the demand for accountability–with the ironic association of the arithmetic sense of accounting overlapping with the illusion of education.)

    Another element lending illusory authority to the acquisition of memory is the information explosion. It seems as if the knowledge of all the most current professional literature should lend an aura of real mastery to anyone who could conceivably keep up, but in fact the nature of most of this information has little direct practical applicability. The best that could be said it that most of the professional literature offers resources for constructing a basis for further specialized research. The problem of eliciting relevant information from the morass of published material is daunting, and in truth perhaps one of the most important components of information processing is that of ascertaining which bits of data are useful. Often traditional education doesn't teach students how to ask the meaningful questions.

    Indeed, one of the challenges of modern education is to deconstruct the illusion of pseudo-education, to debunk the false values of scientism (i.e., applying the norms of science as a philosophy of life), and to appreciate the pitfalls of what Neil Postman has called "technopoly." We must question programs which infuse information and grant certificates based on the memorization of information much of which is quickly forgotten after some key qualifying examination.


    While information is acquired primarily through what the developmental cognitive psychologist Piaget called "assimilation," competence, the knack of doing something, is acquired through "accommodation." Individuals constantly revise their picture of the world, and assimilation involves the adding of data and filling in the gaps of information. But when people learn to climb a tree, swim, ride a bicycle, make love, deal with a child's tantrum, etc., they have to change that picture of the world on the level of their feelings, their body's physical orientation, complex coordinating and integrating processes. Indeed, while assimilation seems to be largely reversable in that it's easy to forget so much, accommodation seems to be largely irreversable: Once people learn to swim, make love, etc., it's not only impossible to forget these skills completely, but it seems to become difficult if not impossible to remember what it was like before one ever knew these skills.

    Accommodative learning occurs through actual experience. Lectures or books can only offer a general cognitive orientation, but the acquisition of the knack of most skills comes through actual physical practice. Role playing, experimentation, simulation, these and other training methods offer relatively fail-safe precursors to the actual experience, and the skill building progresses from a beginner's to an intermediate to an advanced level.

    One of the sayings in medical training is "see one, do one, teach one." This is grossly misleading, a residual of the high pressure settings of interns in county hospitals, overburdened with patients and demands. Sometimes an intern might in fact only see a procedure done once before finding himself challenged to do it without supervision! Yet in fact most skill components require many repetitions in order to gain the knack. People need to be given opportunities for sufficient practice, and if not given, the student must request--perhaps even demand--more time and situations in which the important skill can be exercised. There must be access to modeling--seeing the required activity performed by someone more skillful, and then when the student tries it, this practice must be observed and modified by constructive and encouraging feedback.

    At a certain point in the development of a skill people come to recognize consciously that they have achieved a degree of mastery, and that awareness adds a measure of confidence to the overall level of competence. Another component of competence is that of "flow," a degree of mastery in which the practitioner can allow some spontaneity to become a part of the work, to balance the structured elements.

    One implication of this is that students of psychotherapy should prioritize their learning opportunities so they attend experiential programs more than didactic ones. Most lectures are either already in print or soon to be published, but the learning of therapeutic techniques is best accomplished through workshops in which one becomes both subject and practice facilitator. I encourage my students to learn about methods derived from various types of "body" work, such as Bioenergetic Analysis; Gestalt therapy or psychodrama; use various art, dance, movement, poetry, drama, and music therapy techniques; participate in experiential therapy or personal growth workshops; take courses in hypnosis, meditation, or other new approaches; and continue to utilize these learning experiences as a way of deepening and broadening their own personality.

    The artist recognizes that in addition to the acquisition of mere technique, the challenge involves also the integration of the unique blend of the artist's many personal variables. In this sense, competence moves beyond simple craftsmanship and opens to the deeper sources of creativity and healing.


    This category may be appreciated in two senses. In a more general way, a person develops understanding through integrating both information-oriented knowing and competence-knowing, as well as learning also about the general contexts and other related systems of knowledge. More specifically, in the realm of psychotherapy and interpersonal relations, understanding refers primarily to an awareness of the dynamics and world-view of the other person, a kind of empathy. Learning this skill involves an exercise of the imagination, an opening to what it might be like to be in another person's situation. This mode of learning also involves an integration of one's own intuition and emotions as well as some creative elements of rational cognition. I tell my students, "You need to learn to think like an actor or playwright as much as like a textbook."

    Understanding is the primary skill dimension involved in becoming "psychologically minded." By considering the range and depth of personal experiences, one learns about psychodynamics from the viewpoint of the other person's own "self system." People don't think of themselves in terms of the cliches of psychology, as "controlling" or "manipulative" or "defensive" or "dependent" or "avoidant." They have more concrete ways of articulating their experience, and therapists must learn to appreciate these modes of perception.

    Having lived through a given experience lends some degree of understanding, although perhaps only on a superficial level. Many people have gone through a divorce, the death of a loved one, a life-threatening illness, or some other challenge and yet gained very little insight. They may have adapted by escaping from any awareness of the rich variety of their own feelings through the use of any number of techniques, ranging from the various defense mechanisms to the flight into alcohol, aggressiveness, or sexuality.

    I've found the best method of acquiring understanding is through role playing, taking the part of the person whom one wishes to understand. Either some scene can be enacted or perhaps the person (in role) is interviewed by others. The teacher helps the student practicing this skill to avoid overgeneralizations, psychological jargon, vagueness, or other tendencies to create emotional distance.

    Once the student has learned the basic skills, the situations are moved gradually from relatively familiar roles to increasingly foreign experiences. George Bernard Shaw, the humorist and playwright, noted that one shouldn't "do unto others as you would have them do unto you!--They might not have the same tastes!" Yet this doesn't mean we should abandon the effort to empathize, only that we should temper it by (1) trying to include as much as possible the awareness of different temperamental or cultural preferences, and (2) whenever possible checking out one's developing hypotheses with the person with whom one is attempting to empathize--and utilizing any corrections to refine or redirect one's line of thought.

    One of the most powerful benefits of this mode of learning is not only a tremendous broadening of one's role repertoire, but more, practice in at least partially relinquishing one's own egocentric and ethnocentric perspectives.


    Certainly this is the most elusive category, but I believe for all practical purposes it can be defined in a reasonably operational fashion. Wisdom consists of the ability to draw on one's ideals and to integrate these personal aspects of character with the other aforementioned modes of knowing.

    It is possible to be competent and even understanding without being wise. In fact, most people relapse repeatedly into a state of automatic reactivity, habitual responses which reflect more childish modes of thinking and feeling. When one can notice these tendencies, stop them, and replace the reaction with a behavior which integrates the greatest degree of awareness, then he or she has expressed a degree of wisdom.

    Wisdom is a higher-order skill that can be learned and practiced. It can be taught to some small degree, in terms of talking about it, putting it in books, etc. Having living models of the behavior who inspire identification is an even more powerful source of learning. As with understanding, though, this mode of learning requires, in addition to  practice, a process of ongoing inner maturation. (It was for this reason that the tradition began of psychotherapists in training taking on the process of self discovery in their own therapy with a more experienced clinican. Alternatively, pastoral counselors might undergo their own process of "spiritual direction.") The integration of the other three approaches with one's own deepening in turn gives those other skill areas a depth of sensitivity.

    One component of wisdom is the conscious cultivation of ideals, in terms of talking about and affirming noble aspirations, adapting them realistically to one's own temperament, abilities and life roles, and then learning to integrate them with the other aspects of the personality. This should not be thought of as easy. As part of genuine maturation and health, an individual learns to tap into the inner resources of such qualities as faith, openness, responsibility, letting go, patience, courage, humility, simplicity, generosity of spirit, sensitivity to beauty, humor, compassion, etc. These function as the motivators and guides for understanding one's own tendencies towards impatience, judgmentalness, or whatever other "blind spots" are discovered in the course of learning to understand oneself.

    Because our culture has avoided any semblance of sentimentality and our profession has moved away from mere exhortation as a mode of therapy, the articulation of ideals has lost its place as a part of instruction. Certainly exhortation alone will not suffice, but weaving a discussion of ideals into a multimodal educational program is appropriate and effective.

    It's impossible to assess wisdom on tests. Nor can it be taught in a didactic fashion. The process occurs most typically when students (or intern or resident) are on call, unsupervised. Perhaps they're tired, and they're tempted to feel self-pity, overloaded, overburdened--in other words, a subtle state of pre-clinical "burn-out." They're tempted to snap at the patient, overlook the subtle elements of compassion, or in other ways become judgmental. To the extent that they can pause and avoid these temptations, will themselves to encounter their patients and co-workers with a more humane attitude, they express their growing wisdom.


    Students of psychotherapy and experienced therapists who are continuing to develop their own skilfulness may structure their own learning by considering these four categories. Teachers of psychotherapy also may utilize this schema. It's also a way of thinking about a more holistic approach to psychotherapy, as I discuss elsewhere that therapy may be considered a type of individualized education. Recognizing the variety of dimensions of learning also can help us to broaden and deepen our view of education at the primary, secondary, and college levels, as well as for training in other fields such as business and a variety of other professions. The goal is a more integrated form of adaptability, a goal which is needed in the face of a rapidly evolving culture.


    Blatner, A. (1996). The training of the psychodramatist (pg. 175), in Acting-In: Practical Applications of Psychodramatic Methods, 3rd Edition, 1996. New York.

    Blatner, A. (2000). Skill learning (Chapter 12, pg. 126), in  Foundations of Psychodrama: History, Theory, and Practice (4th ed.) New York: Springer.

    For responses, email me at
           Return to top