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Psychotherapy: The Games Societies Play on themselves?Aug. 13 2013
Herbert L Calhoun
- Published on Amazon.com
This cartoon guide to psychotherapy is true to its subtitle: A Graphic Guide. For that is exactly what it is. It spreads out across a vast landscape of time (from Empedocles to the Existentialists and beyond) -- and a vast jungle of techniques (at least 60) the confusion that remains contemporary psychotherapy.
Among many other ways of critiquing the reasons why so much confusion reigns in the field, one is sure to come away with two glaring impressions: (1) that for some unexplainable reason, this is not a scientific enterprise being conducted by adults; and (2) that culture and society are two of the most glaring variables missing from the diagnostic setting.
As for the first concern, were psychotherapy under even minimal adult supervision, it would seem obvious at this point in its erratic evolutionary development that just as the DSM defines and catalogs psychological symptoms, so too should patient's diagnostic tests be analyzed and catalogued on the basis of which "suite of therapies" (almost never a single therapy as is the case today) represent a best match. That is to say, which group of therapies would be the more efficacious in relieving a particular patient's symptoms? And while it is true that both the catalogue and the diagnosing of symptoms continue to be more art than science, the attempt to match "groups of therapies" with dialogistic findings for a given patient, would be a first step towards bringing some sense of coherency to applying psychotherapeutic techniques more efficaciously to patient's problems.
As it stands today, patients have available to them only "single technique therapists," when clearly even the most elemental psychological problem demands multiple and overlapping techniques if there is to be any chance at finding a solution. In the current environment, the therapists is a hammer in search of a nail: the patient, any patient. All patients are forced to look exactly like the nail a therapist is trained to drive. The result is that psychotherapy has become a Procrustean Bed in which the patient's legs are chopped off above the knees in order to make his symptoms fit the therapists' skills. This glaringly ill-defined process is already an embarrassingly untenable place in which a profession of adults should find itself.
But the second critique is even more devastating: How can a whole profession ignore perhaps the most obvious, the most important, and one of the most potent variables in determining the psychological health of its patients: the nature of the culture the patient lives in? This is an especially egregious oversight since all psychologists, psychiatrists, sociologists and social-psychologists worth their salt know that culture is the most important variable (or meta-variable) for determining-the health and well-being of a patient?
The answer to both critiques appears to be that psychoanalysis is a game that societies play on themselves and the psychotherapist is just a societal tool that aides and abets this game? Otherwise, if cultural variables were taken into account in the therapeutic setting (as a variable on both sides of the diagnostic ledger), inevitably it might be concluded that the health of the society is as important to the health of a patient as any other variable? And thus it could well be concluded that the society itself might be heavily implicated in the mental diseases of its citizens? [What a novel idea?] This would mean at the very least, that the society itself may indeed need to be in the witness' dock, or better yet, lying of the psychoanalyst's couch along side the patient.
In this book, of the literally hundreds of psychoanalytic techniques and psychotherapies discussed, only existential therapy as practiced by R. D. Laing, Rollo May and Jean Paul Sartre appear to take culture and society into account in the therapeutic setting. These adult therapists use it to discuss and confront patients about how they experience life within the culture they live in, and try to get them to focus on taking responsibility for their own being, on becoming self-governing, exercising conscious intention, making ethical choices, discovering ways to change the society, accepting fear and anxiety as a normal part of life, how to engage in loving relationships, and how to move beyond oneself into full fellowship with others. Three stars