Monday, December 30, 2013

Dry humor, or wet seriousness, for the end of the old year


In February of 1958, classical music composer Milton Babbitt published his notorious article, “Who Cares If You Listen?”*  The article expressed indifference, or worse, to the listening audience who had hidebound tastes,** could not grasp the complexity of “serious” and “advanced” music, meaning serialism, and didn't like it.

There are psychotherapists with a similar sense of rectitude, which might be expressed: “We know what you need, what is good for you, and what your best is – whether you want it or not, and what your worst is – whether you want to ‘go there’ or not, and we will promote the ultimate good and cleave to the truth irrespective of your liking it or your improving.”

I know about these imperialists because I am sometimes one of them.  And I hope that very many of my fellow therapists are, too, because I’d hate to think we are pusillanimous dance partners whose definition of “help” is to masturbate our clients’ defenses.

Who masturbates their clients’ defenses?

* Therapists who practice the latest vogue, “strength-based counseling.”  This politically and bureaucratically correct inebriant, according to a University of Miami course outline, “represents a new paradigm in the field: from viewing clients primarily through a deficit lens, to a view that focuses on client strengths.”  “The aim of a strength-based counselor would be to identify and amplify client strengths, not on diagnosing problems.”***  See Appendix for an example of the strength-based approach.

* Therapists who assume that strengths are strengths, when they may be weaknesses.  Hope is a strength, unless someone continues to prostrate herself before a toxic parent, hoping for love that parent is incapable of.  “Hyperfocus” and hard work are strengths, unless you are hyper-avoiding the feeling world within and around you; unless you are struggling to be acceptable not worthless.  Kindness is a strength, unless it is the false self or your perfumey armor over shame.  Reasonableness is a strength, unless it is what grew over the corpse of your emotions, the fire of a feeling self.

* Therapists who believe in “solution-focused brief therapy,” another lobe job**** philosophy that believes pointing a rudderless ship to shore is good help.

When I describe my paradigm at the beginning of a therapy – after the psychosocial assessment or a good listen to the client’s distress, which sometimes replaces the required interview – it is saying that your problems fall within human nature as I understand it.  You have been hurt and have grown a wounded self.  The past is not the past, but the roots beneath your feet.  Time doesn’t heal – it masks and suffocates, abandons, intensifies, twists, corrodes.  Rarely if ever do clients demur from this benevolent approach.  What they do, sometimes, is request a psychiatric referral then substitute medications for therapy.  But in twenty years the only contrarian position I’ve heard has come from another therapist, or actually from a student of counseling who was averse to the idea that one cannot smart-think one’s way out of mental pain.

And that long experience – that “my” people accept where I’m coming from – makes me wonder: Are there legions of strength-based, and solution-focused, and think-heavy (cognitive) therapists out there?  Clinicians who convince real people that capitalizing on their strengths will banish their ills?  Who convince real people that a new behavior or plan will change their different nature?  Who complexly out-reason their inferior-thinking clients?  Could it be just a reification of an echo – the way celebrities are famous for being famous – that the culture of psychotherapists buys these ideas, popular because we think they’re popular and therefore blessed?  Underground, are we really authorities, brain surgeons in velvet gloves, Babbitts in Rachmaninoff’s clothing?

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Appendix: Strength-Based Counseling

A man enters his strength-based Primary Care Physician’s office and says, “Doctor, I think I have cancer.  All the signs are present according to WebMD and my family history going back four generations.”  The doctor reassuringly says, “Don’t worry.  Let’s not focus on the negatives.  I hear you play a killer game of backgammon!”

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*** umbh.med.miami.edu/.  What terrible grammar!
**** Pardon this undefined term.  It comes from a science fiction story I read as a teenager.  A man in suspended animation wakes up in the far future.  Instead of finding an advanced civilization, he sees a decrepit cityscape, fallen to ruin from centuries of neglect, and nary a soul about.  He comes to learn (if I recall, in a disastrous way) that most of the population has succumbed to the pleasure of fantasy lobotomies "lobe jobs" by which they live out glorious lives of adventure, intrigue, etc. while lying comatose on a table.

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.