Therapy is Not the Answer

This is sort of a PSA for clients and therapists alike.  Therapy is not the answer to our problems of relationships, depression, grief/loss, addiction, taking food from others, communication, our sense of broken-ness/low self worth/shame, loneliness, etc.  Therapy isn’t just a way of being either.  It’s probably a way of being that solves these problems, and can prevent many in the future as a result.  The only exception, if seen in a particular light, might be around issues of safety that require immediate intervention.

Therapy should be a space where we work through the feelings we’re carrying with us that prevent us from coming to these answers on our own.  It’s an activity that should prompt us to be without our defenses and distractions as much as is possible, with a guide that has done enough of their own work that we can be taught how to live gracefully with these feelings, let go of them/transform them, and provide us principles and ideas that will help us not make some of these mistakes in the future.

We certainly should be giving direction about how to handle some circumstances, communicate more effectively, learning parenting and relationship skills, symptom management, relapse prevention and etc.  There should be an organized body of material to assist with these things.  They will all be rendered useless though, in absence of a principled way of operating, and or in the presence of enough emotional intensity that the tools cannot be used or we cannot see “answers” clearly or the simple consequences of not having these feelings gracefully end up exacerbating problems.

So, a suggestion.  Learn some survival skills that lend themselves to our ability to get some new ways of operating.  Have enough support from family, friends, and professionals that will enable surviving the process.  Deal with the feelings that come up, then set about “solving” things.

What to Do?

From P.16 of the PDF “Statutes and Regulations” from the California Board of Behavioral Sciences (the regulatory agency that oversees MFTs, Social Workers, and etc):

“§4980. NECESSITY OF LICENSE (a) Many California families and many individual Californians are experiencing difficulty and distress, and are in need of wise, competent, caring, compassionate, and effective counseling in order to enable them to improve and maintain healthy family relationships.”

Clients as above, come to us for wise counsel.  Among other things of course.  This idea has far-reaching implications, not just for our clients, but for us.  Wisdom is hard to come by!  Oversimplifying, “wisdom” in this case is often a euphemism for answers.

Claiming (or believing) one has wisdom or answers is of course a Bad Idea, yet it seems we have a responsibility to work toward them.  There’s some great ideas and techniques supporting the principle of not giving “answers” (suggestions, direction, etc) outright to clients (or loved ones, certainly) from the therapist’s chair.  My basic mode of operation is to try to lead someone to those answers, typically only giving direct suggestions when my efforts to lead a client to their own answers have been exhausted.

We do treat several diagnoses and/or issues that have “community standards”, fundamental practices or “conventions” most therapists agree on how to treat.  Schizophrenia, bipolar disorder, and other more severe illnesses for instance almost always direct the client to: not “self-medicate”, takes the best supportive medication regime as directed, and is getting :talk therapy” and/or peer/familial support with their illness.  There are few that argue with the utility of these interventions.  There are other examples for addiction, depression, anxiety, and more.

Two things are of interest to me though.  The first is that during the therapeutic process, I often see clients get a suggestion, and dismiss the suggestion out of hand.  What I think is happening is that rarely do I suggest an idea that in a vacuum will ever be sufficient.  What I mean is, most any suggestions I have will never be singular.  It seems that the depth of our sadness or anxiety or pain or whatever often keeps us from “getting” what is offered, unable to accept the responsibility of taking several suggestions.  Summarizing: rarely is one idea sufficient to change anything in the therapeutic process.

The second thing that prompts me to mull this over is the “active” therapists versus the “passive” therapists.  In my view there is room (and each therapist I think, ought use) both styles, often with the same client.  There are times that we should be directive, and not just in terms of extreme examples like when a client is being abused.  Discouraging self-medicating, engaging a support group, ruling out medical concerns with a physician, ways to stop a behavior etc are all examples where there is little controversy over giving someone “direction” about an issue.

People come to us for answers.  We are paid to have a toolset, methods, principles of operating that in many cases should help diminish depression, stress, relationship conflicts, behavioral concerns and the like.  On the subject of not holding these ideas close to one’s chest: there is a great (and occasionally controversial) martial arts instructor who critiques traditional means of training, idealizing the “teacher” and etc.  He also critiques traditional martial arts training as being “cultish”- keeping secrets, claiming answers from some (out of touch and unknowable) “higher source”.  His “instructors” are all referred to as “coaches” or by their first names, and their focus is very simple: performance improvement.  That last idea is part of what I’m getting at here- the “answers” we give as therapists should improve “performance”, which I would argue is diminished if we are too passive.  It is very significant of course, that what is being improved, is clearly defined.  If we think something might be helpful though- there are certainly compelling reasons we should disclose it.

When it comes to performance, we should be helping people get more in touch with their emotional condition, have those feelings gracefully, diminish (but not eliminate) the intensity of negative emotions.  Our interventions should help decrease or stop unwanted behaviors.  The direction we give should help increase intimacy.  Of course this is not an exhaustive list, it may take a long time for these things to happen, and some cannot happen without the others.

My experience has been that many (arguably most) of my clients have come into my office, suffering enough, and out of enough answers, that they are willing to do most things we come up with together.  Had they been in possession of this material on their own to begin with, there would be no (or little) need for my education and experience with the issues they struggle with.

My effort is to put me out of a job and it does people a disservice I think, to have an insight that I wait for them to come to on their own… which they’ve already arguably been trying to do.  Sometimes I ask my clients if they have spent a great deal of time in their lives, saying something like this to themselves: “I just wish someone would tell me what to do about this.”  There are many things, that most(not necessarily all) people can do, directly, to diminish feelings of low self worth, sadness, struggles in relationships and most of the problems they come to a therapist.  If I didn’t go to school to learn to help people know and do these things, then what exactly did I go for?

Connected.

This will relate to you and psychology/therapy/counseling, I promise… just hang in there with me…

Some friends of mine have been really struggling with the BP oil… spill? (Wiki here)… it’s so big, I scarcely know what to call it.  Have seen and heard some things I’ll not reiterate- not because it wouldn’t serve, but simply because we’ve been so inundated with the details of most of this news I’d be afraid that anything I’d have to say to describe such would be heartbreakingly insufficient.  The effects of this are catastrophic, to say the least.

Earlier too today, I was talking with a client about consciousness.  What is “I”, how we know such things and etc, a lot of things rooted in Eastern thought, the ideas of Daniel Dennett (Dennett’s Wiki), Stephen Pinker (Pinker’s Wiki), and the like.  My client began to talk about having the awareness that we’re all “one” (maybe that should be capitalized), and what that means in terms of how we experience our world.

This made me bring up another great thinker, a gentleman named Chuck Chamberlain who wrote a book called “A New Pair of Glasses“.  In it, he asserted what I think is a fundamental truth (paraphrasing), that our real problem as humans is seeing ourselves as separate from “God” (the “universe”, physics, whatever one prefers).  Ignoring this is far from inconsequential.  Our view, true or not, that we are somehow separate from others is part of what enables us to lie, cheat, steal, things much worse.  Even make oil spills.

As I’m alluding to above, whether we are all “one” or not, it’s arguably true that we indeed operate (behave) this way.  We certainly see the consequences, but as with many things, we don’t really see the etiology of them.  The Horizon spill is only the most immediate example.

Had we been behaving since the industrial age as if we are all connected, including the flora and fauna we are surrounded by (or more tragically accurate, that we are surrounding…), our world would look much different.  As promised, bringing this full-circle to the soul of this little corner of the web, the application of the idea that we are all connected has deep-reaching utility in psychology/therapy/counseling.  My world, and I hope the world of my clients have likely been improved greatly by finding ways to operate on this premise.

As noted earlier, it’s pretty easy to see the negative consequences of operating as if all humans, animals, plants, etc are different, whether this is true or not.  There’s pretty amazing benefits to operating as if we are indeed one in the same.  Behaving this way allows me to be as gentle a person as I intend.  It’s a great method for being more considerate/thoughtful.  This may be true, because it’s an idea that lends itself to increasing empathy.  It’s a great way to diminish selfishness/self-ful-ness.  So many people are speaking in the “human potential movement” (*ahem* I struggle with these kinds of euphemisms and etc, but for the sake of simplicity…), behaving as if we are all one is fantastic mindfulness training.  We could certainly use a softer, warmer world (among some of the other ideas above), and this is a great way to help turn some of those problems around.

Again, I find that there’s too many positive things to gain from such an idea to write here.  What prompts this though, is my own deep sense of sadness for the creatures upon whose lives we’ve so encroached because of not just our desire for a certain way of life, but because we avoid the emotional consequences of such a life in part, maybe because of the misperception that we are separate from these creatures, making it much easier for us to operate the same way every day, regardless of the consequences theyhave to endure.  Much as it’s important for us to clean up the spill, have clean means of energy and etc- all of these things are rooted in a philosophy of separateness, that if we sit with a minute, we might realize how much less of our own hurts, sadness, fears, shame and etc might have been avoided had we or the person who stepped on our toes behaved as if this encroachment was really upon themselves.

Transformation.

So, we can’t heal what we can’t feel.  If we’re really trying to transform “depression” (not a feeling, but a diagnosis), “anxiety” (another non-feeling), grief and loss, abuse, abandonment and neglect etc- we have to “let go of some old ideas” about how we perceive and experience these circumstances, and the attendant e-motions (emotions, energy in motion).

Some of these ideas we have to let go of are:

1.  That we can turn our feelings on/off.
Stimulus/response (to steal loosely from Gary Larsen and others).  All we perceive has a stimulus and response attached to it.  It both amazes and saddens me that despite such a fundamental law of physics we behave as if we can somehow do something (or not) that will allow us to not have a response to a stimulus about what someone says or does.  Some basic “untruths”: “I need to not take _____ personally, give _____ power over me/allow them to ‘get to me’, it’s water under the bridge, it’s all in the past…” etc ad nauseum.

2.  That we can decide how intense a feeling we are having/going to have.
Back to physics- we can’t decide or influence how much of a stimulus we take in.  Save with the use of drugs or alcohol, even despite attention- we experience what we experience.

3.  That we can decide what type of feelings we’re going to have in response to some experience.
Sometimes we feel sad about something, only to have a similar experience later and feel hurt instead.  If this were true- why couldn’t we simply “decide” to feel joyful, grateful, happy, etc about a thing?

There’s more, but these are a fairly good starting list.  If we’re going to transform our feelings (or help others to do so), we have to change our philosophy, our relationship to our emotional condition.  Some of the most frequent problems I run into both personally and professionally around this are around the kinds of beliefs above.

Beyond this, we do things that prevent us from being fully in touch with our emotions.  As Sheldon Kopp has famously (or not so famously) said, paraphrasing: “When we stop trying to overcome anxiety, avoid depression etc, we can experience how sad and scared and hurt we sometimes truly feel.”  I would argue that one of our most basic problems as humans is that we do things that put distance between us and us, us and others, us and the “universe” or “God” as we MISunderstand he/she/them and/or it.  The list of the things that we do that result in these effects, is the list of things we have to stop doing to have access to how we feel, and transform it.

On a professional level, I have been struggling deeply with how far away we’ve gotten from doing “depth work”, processing, “uncovering, discovering, discarding”, “naming it, claiming it, and dumping it” (or whatever euphemism one prefers) for dealing with the likes of grief, loss, addiction, depression, anxiety, relationship problems and etc.  “Outcome measures”, insurance companies etc do not support this process.  There are sociopolitical (or as I prefer, “sociopolytrickal” as in “many tricks”) forces that diminish both focus and support on these types of services.  The hows and whys of this are beyond the scope of what I’m getting at here.

My tactic for dealing with issues are (hopefully) pretty simple and direct.

1.  Take the list of things we do that put distance between us and us/others/the “universe” and/or “God” if one prefers, and stop doing those things.  If it’s hard to stop doing them, try doing these things.

2.  Take steps to survive not doing those things.  This may take therapy, a support group, a church, support group, or whatever.

3.  What will most definitely take therapy: process what comes up.

Even if one does need medical intervention with psychopharmaceuticals, has a medical condition that might prompt difficult feelings/behaviors etc, getting therapy can only support this process, and arguably in some cases, is insufficient without it.  These three simple ideas above support all the ideas about “processing” (like the “uncover, discover, discard” etc above).  Hopefully we will get past the era of simply thinking that we all only need to act better, or otherwise “get over it”.

Lastly, need to make mention that this is of course not this simple, and would encourage more work around these things to be “happy”, free of depression, anxiety, addiction, etc.  A “resource group” of supportive people is necessary.  An organized set of principles to deal with new issues is significant.  Would also say that it’s important to have principles that allow us to grow as people- doing the work to transform and/or let go of these issues are the bare essentials for us to get to these things… and are totally possible.

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