Bessel van der Kolk is a Harvard psychiatrist specializing in trauma, dissociative identity disorder (DID) and post-traumatic stress disorder (PTSD). I love the tale he tells on himself of the client who came to him to announce she was quitting therapy and promised not to sue to get back the money she paid for services not effectively rendered. Van der Kolk had been treating her regularly without much real progress for years. In a few sessions with Francine Shapiro, the originator of Eye Movement Desensitization and Reprocessing (EMDR), she found her trauma issue fully resolved. Her surprising recovery eventually inspired van der Kolk to take EMDR training himself.
Van der Kolk also admits to having a son bedridden for two years as a teen with psychological trauma whom he was unable to help. It took years for him to find a program that actually ended up healing his son (City at Peace). This isn’t an indictment of van der Kolk, per se, but more questioning a field that he himself regularly indicts.
Part of the problem, argues UCLA neuro-psychiatrist Dan Siegel, is that until he constructed one several years ago, large numbers of psychotherapists he surveyed never had a clear definition of what mental health was. Few have ever taken a course designed to teach the characteristics, principles and practices of good mental health, essentially operating as a field that was primarily defined by what it wasn’t. (Siegel currently considers me to be mentally healthy when I can easily express authentic emotion, while continuing to steer a “satisfying, cognitive course through the future emotional jungles” of my life. In other words, I can suffer the slings and arrows of outrageous fortune and still manage to find a way – sometimes even joyously – to keep on keeping on, unerringly motivated by autonomy, mastery and purpose.
Research as Me-Search
Peter Levine, dissatisfied with conventional therapy, founded Somatic Experiencing as a therapeutic treatment modality in response. It is his observation that many people become therapists in an attempt to address their own suffering – that “research becomes Me-search.” And such “Me-search,” Jungian therapist James Hillman and co-author Michael Ventura argue in We’ve Had 100 Years of Psychotherapy and the World’s Getting Worse, very often produces a population of powerless, self-centered juvenile adults who have little capacity to effect real change in their own lives or in the lives of people around them. Are these the results a field of professional practice should celebrate and be highly paid for?
Psychologist and martial arts Special Forces trainer, Richard Strozzi-Heckler makes another telling point about conventional psychotherapy. In his book, Holding the Center, he writes:
… one of the failures of contemporary psychology is that it doesn’t provide practices that lead to fulfillment, new competencies, and the satisfaction of taking on that which is difficult. Most talking therapies…often drive us inward, away from a larger world of social sensibility, the politics of care, and stewardship of the natural world. (Psychology’s) reductionistic bias has a tendency to rigidify and fortify a self that ultimately becomes isolated from others and the environment.
Meeting Heartbreak with Hard Work
Josh Waitzkin was an eight-time national chess champion as a kid and has won more than 21 National and World titles as a martial artist. In line with Strozzi-Heckler’s observations, Waitzkin argues that since growth comes at the expense of current comfort or safety – at points of resistance – peak performance requires responding to heartbreak with hard work, cultivating courage and becoming unhindered by internal conflict. This last – fostering internal conflict – in my experience, is something psychologists are world champions in facilitating. I’d prefer they teach me to perform with grace and the easy freedom of a child, in the face of world championship pressures. And if they can’t, then call me and tell me not to bother coming in like this doctor does with his clients.
To the Listener Go the Spoils
Finally, here’s a study that serves as the clincher for me. From an Interpersonal Neurobiological perspective, it certainly looks like more benefits accrue to the therapist than the client. Carolyn Schwartz and Rabbi Meir Sendor recruited non-professionals with multiple sclerosis and trained half of them in active listening in order to provide support to the other half, afflicted with multiple sclerosis as well.
Two years later, the peer telephone supporters – the listeners – were queried about the changes they noticed over the course of their participation in the study. In this follow-up evaluation, these listeners reported more improvement than the talkers. They reported improved listening skills, a stronger awareness of the existence of a higher power, increased self-acceptance, and enhanced self-confidence. Additionally, they also reported experiencing a sense of inner peace that allowed them to listen to others without judgment or inter- interference.
So a genuine question seems to be, who receives what real benefits from psychotherapy? And who should be paying whom?