Wednesday, May 11, 2016

All the faiths to choose from

Moving from Ohio to Nevada, I was officially regressed from Counselor license-holder to purgatory-dweller and had to pass a big flatulent exam. To prepare for it, I reviewed many of the established schools of counseling and psychotherapy. The result, other than exam success, was this thought:

I wonder if many people would be discouraged to enter therapy if they knew of the numbing proliferation of theories and practices – all princely little islands – that have accreted over the past hundred-plus years –

acceptance and commitment therapy / acceptance-based behavior therapy / addictions counseling / Adlerian therapy / affective cognitive-behavioral therapy / aversion therapy / behavior therapy / behavioral activation therapy / bioenergetics therapy / bonding psychotherapy / brief cognitive therapy / brief solution-focused therapy / brief psychodynamic psychotherapy / cognitive behavior modification / cognitive behavior therapy / cognitive processing therapy / cognitive restructuring / cognitive therapy / coherence therapy / comprehensive behavioral intervention for tics / dialectical behavior therapy / eclectic therapy / electroconvulsive therapy / emotion focused therapy / emotional freedom technique / existential therapy / eye movement desensitization and reprocessing / family-focused therapy / family systems therapy (structural therapy, strategic therapy, systemic therapy, transgenerational therapy, functional family therapy, multidimensional family therapy) / focusing / gestalt therapy / group cognitive behavior therapy / group therapy / holding therapy / holistic therapy / hypnotherapy / imagery therapy / interpersonal and social rhythm therapy / interpersonal therapy / Jungian psychotherapy / logotherapy / Masterson Approach (to personality disorders) / Maudsley family-based therapy / mentalization-based therapy / mindfulness-based stress reduction / multisystemic therapy / narrative therapy / neo-Freudian analysis / neurofeedback / biofeedback / neuro-linguistic programming / object relations therapy / parent-child interaction therapy / parent management training / past life regression / person-centered (Rogerian) therapy / primal integration therapy / primal therapy / problem-solving skills training / psychiatry / psychoanalysis / rational-emotive behavior therapy / reality therapy / rebirthing therapy / relaxation therapy / schema therapy / self-control therapy / self psychology / sex therapy / social constructionism / social skills training / somato-emotional release (body) psychotherapy / STEPPS group therapy / thought field therapy / transactional analysis / transcranial magnetic stimulation therapy for treatment-resistant depression / transference focused psychotherapy / transpersonal psychology / trauma-focused cognitive behavioral therapy / virtual reality therapy
– and, if they knew the meanings of this profusion. What does it say about our grasp of psychological truth, human functioning, objectivity, that there are so many educated guesses about them? And if you accept that an individual is capable (though with difficult and subtle work) of learning the sources of his emotions, turning points, his suffering, his character growth, what does this legion of pet theories suggest about any given therapist’s – your therapist’s – self-generated self-knowledge?

All of these philosophies, schools, systems, programs and techniques come from hairsplittingly to grossly divergent takes on human nature. An assumed positive but, I believe, damaging factor is that all of them, with the exception of Freud and psychoanalysis, suffer the personality disorder of global optimism*: They believe in the inherent potential good (or wonderful) outcome. This includes Existential Therapy with its death anxiety, ultimate aloneness and meaninglessness. This optimism, were it built into medical practice, would have doctors proclaiming that no condition is terminal, all dysfunction no matter how deep-seated or malignant can be either healed, safely ignored, predominately surmounted, or accepted with grace and good spirit. Shouldn’t we ask – Why is the physical body deterministic and fatalistic in the ways it is, but the mind-body is not?

Another problem with the therapy smorgasbord is that theories of emotional healing are self-medicative for the counselor. Just as a person adheres to a political or religious doctrine because it conforms to his self-image, soothes or enhances him; just as an unloved boy must warp reality and believe that feelings are “weakness”; so therapists gravitate to psychological theories that support their defenses, their hopes, their view of themselves. Individuals who live in their head, who have run away from their childhood catastrophe, are bound to accept a Cognitive theory that promotes the power of thought over feeling. Clinicians whose past was hell will swear by “here and now” approaches. Those uncomfortable with ambiguity and the cloudy turmoil of emotion will leap to the solid, arid land of Behaviorism and Reality Therapy. People whose story is, in their heart, intolerable, will love Narrative Therapy, which invites them to rewrite it.

All said, most clients, probably, do not know that our field is splintered into micro-religions. While a minority of my clients have heard of, or even ask for, “cognitive therapy,” most are facing new information when I describe the simple differences between present and past focus, thinking versus injury focus. Ignorant, though, as they may be, clients must still suffer the effects this therapy inflation and this faith have had on practitioners. Imagine if there were no religions and that each one of us was left to search our world and soul for meaning. How many would find a God in our image? How much herd consensus would there be? How little abdication of self-development and deeper truth-finding would there be? Psychotherapy needs workers who have dissolved the churches by searching the primary field – inner experience – with clean reason. It needs the emasculation of all these pretentious do-good-isms. It needs less faith, actually, to be the most useful.

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* If global pessimism, which identifies the unofficial (DSM-IV) Depressive Personality, meets the definition of personality disorder: “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture; “inflexible and pervasive across a broad range of personal and social situations” (American Psychiatric Association, 2012), then so should global optimism.

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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.