Psychotherapy without the bushy tail

Picture yourself as the ocean. There are many apt likenesses. A known object, an identity from a distance: "person," "ocean," but up close, heterogeneous, and inside, infinite. Our eyes are the whitecaps and waves frolicking or calm, warmed by the sun or cold, while our depth remains dark and still. In that depth are sharks and treasures, countless death and countless life, driven "sea change" movement yet with undertows, riptides that contradict.

History is almost meaningless: The present and the past are one. Even beneath the sea floor (our birth), the molten forces (our first nine months) erupt through. Those lava extrusions influence those whitecaps.

I often prefer, in therapy, a tree analogy. Picture a forty- or a hundred-year-old oak tree. Use your x-ray vision and see the roots: They are "the past." Yet they continue to feed every leaf and branch on the tree.

In today's quick-fix TED Talk culture, we believe we are the waves and the branches and leaves. We feel something very special about our perceptions, our head. Like our confidence in questionable beliefs such as free will and the necessity of a beginning to the universe, our mind feels, ipso facto, wise, commanding, controlling, creating. We create happiness by thinking right. We grab the reins of our childhood problems by understanding them. We find in our anxiety that we are thinking, thinking, thinking, racing thoughts with no finish line.

But psyche and soma are always being fed by the roots, by the lava. We are the elaborate accretion upon them. Picture floating upright in your ocean. You gaze on the fantastic panorama, the sea birds circling in the sky. But with sharks and invisible unknowns below your feet, can you be free of depression or anxiety?

Psychotherapy, originally psychoanalysis, began over a hundred years ago in pseudo-scientific adolescent arrogance, the pontifical dogma of Freud. In the intervening decades, one might have thought maturity would be reached. But like many troubled adults, therapy continues to embrace self-soothing certainties. It acts, in its "Cognitive" methodologies, as though we live in our head, not in our body and our history. It believes that the many du jour techniques one learns in workshops and webinars can change the homeostatic, oceanic self. It assumes that my empathy, your action, my confrontation, your insight will alter your inner terrain to make you a different (or better) person.

The psychotherapy that has the best chance of helping a person must embrace the holistic self: mind, body and time through three dimensions: core injury, core vitality, and emotionalized attitude (I borrow this term from Virginia Axline's classic Play Therapy). Injury: We are impaired because we've been hurt at our root, our most formative, defenseless era. Therapy that doesn't see, stay with and work through childhood injury is like a surgeon who applies a Band-Aid instead of a scalpel. Vitality: We own -- most of us do -- the birthright of life-love and curiosity. It may have been in hibernation from our first moments, but the indestructible kernel is there. Attitude: The complex chemistry of strength to weakness, hate to love that accrues through our life and informs our philosophy and our possibility. In therapy, strong convictions, reasoning and positive thinking won't be sufficient: Those frothy whitecaps will not move the sharks. Catharsis and abreaction may leave us doubled over, unable to get up. The core of health will lie dormant until we've reached the splinters in our child heart. A therapist, finding or hoping for that core, will help you guide yourself to those splinters. Then, your desire and sense of life will decide if we pull them out or only respect and keep them company.

Effective psychotherapy must teach you to scuba dive, and hope you'll trust the deep.