December 27, 2005

"In the 1960's and 1970's, ... psychotherapy felt like a social movement, and you just wanted to be a part of it."

But now, says psychologist Jeffrey Zeig, it's just not the same. The "cool logic of science" threatens to unseat the "spirit of humanistic activism."
[Hunter "Patch" Adams] called for a "last stand of loving care" to prevail over the misery in the world, its wars and "our fascistic government." Overcome by his own message, Dr. Adams eventually fell to the floor of the stage in tears.

Many in the audience of thousands were deeply moved; many others were bewildered. Some left the arena.

At the conference, many said they found it heartening that psychotherapy was finding some scientific support....

Many therapists at the conference said that if the field did not incorporate more scientifically testable principles, its future was bleak.

The "humanistic" psychotherapists remind me of the proponents of Intelligent Design. They don't have science, but they have the deep conviction that what they believe is more profound. The question is: What do you do with it? If you try to sell to patients/students as science, you've got a problem.


Ron said...

Does it seem wierd that with some things the feeling is "If I don't sell this as science, it's And who would believe that?" It makes you wonder if they have any faith in their words, if science is viewed as the only acceptable means of argument.

bill said...

Patch Adams? I hate clowns.

And while I'd prefer doctors not be unfeeling bastards, the Gesundheit Institutes priorities are way down the list of things I'm looking for when it comes to medical care:

Our Mission
To bring fun, friendship, and the joy of service back into health care.

Our Vision
The Gesundheit! Institute is dedicated to upholding a radical socio-political vision replacing greed and competition with generosity, compassion and interdependence.

David said...

In the final analysis, each of us has only faith and hope! Many of our collective problems are a direct result of a defective moral compass that has no 'true north' to guide us.

Although I have met some poor souls lacking the saving grace of a conscience, most of us know the difference between right and wrong.

As a guy I was raised to 'suck it up' and do my job, accept responsibility for my choices/actions, and find my happiness in life.

Along the way, I met some wise people who taught me that happiness was to be found in the journey of life.

I believe that many of us have the ability to psycho-analyze ourselves, make the best decision we can, and move on with our lives. Whether we do that or not is fodder for the psycho-therapist.

Hallucinogenic drugs did not help the legacy of the 60's social movement. Timothy Leary and the others of his ilk, harmed more people than it helped.

Jacques Cuze said...

Is that NYTimes article even for real? My understanding is that Mr. Toad's Wild Ride was shuttered in 1998. Did they bring it back?

But um, psychotherapy is junk. And therapy as presented in court, it is junk science that has created a slothful court and an enormous industry sucking at our teat.

I would like to see a Constitutional Law Professor do her damndest to kick them the hell out of court.

Pogo said...

The very human need to belong is not surprisingly replicated in the treatment of psychology. People need to be part of something larger than themselves, and in psychology, that creates movements and followers.

Unlike religions, such movements always fade, most often succumbing to the new new thing.

Those techniques with a strong scientific basis are easily turned into techniques that no longer require a priestly class to administer, and they quickly lose their luster among the discipline's elites.

There is in psychology a search for the single answer to man's misery. But there isn't one. The cognitive-behavioral approaches have a degree of success, to be sure, but it is incomplete in most.

It has always surprised me that psychologists have missed this fundamental truth: man will always suffer. Suffering can only be eased, not eliminated. Why man must suffer and how to lessen this burden are the subjects of both philosophy and religion. As such, it can never really be made into a science.

Very often, people need a metaphysician, rather than a physician.

Pogo said...

And for quxxo, now channeling Tom Cruise, psychotherapy is not junk. It can be transformative. It can be merely useful. Ot it can be harmful in those who never seem to advance. It's not likely ever to be a science per se, as it is mostly sociology, a very unscientific field. But not junk.

But not everything that matters can be counted.

Verification Word: omzdmfou
An old Czech Republic term for "leftover beets, one day too old".

Goatwhacker said...

According to the Disneyland site, Mr. Toad's Wild Ride is still running.

Psychotherapy is not junk, when done well it's probably as effective as medication. The problems with psychotherapy are it takes a long time, it's expensive and it's dependent on a skilled therapist and a receptive patient, both of which are often absent. Many therapists should be flipping burgers, but a good one is worth her/his weight in gold.

On Patch Adams: How can he be effective when he's overcome by his own presentation? Maybe some patients will be helped by the sight of their physician sobbing on the floor, but I'd guess many more would be put off by it.

37921 said...

quxxo, you finally wrote something I can agree with. Psychotherapy is junk science, on par with homeopathy, reflexology and feng shui.

Of course, there's no denying that many people have been helped by psychotherapy. The placebo effect (and the Hawthorn effect) are quite strong.

By the way I believe the version of Mr. Toad's Wild Ride in Anaheim (where the story opens) is still in operation.

Jacques Cuze said...

Ah, I see, it was closed at faux Disneyworld, but is still open at Disneyland.

PatCA said...

Well said, Pogo.

We all need mentors from time to time as we navigate the rough waters of life. By now, the basic principles of psychotherapy are so commonly understood (or, yes, misunderstood) that the process takes place in many settings other than a therapist's office every day. In the end, we are left with larger philosophical questions that we must learn to live with, like suffering, like death. Shakespeare knew as much about that as Freud, IMO.

My own favorite old time "therapy" was Wilhelm Reich and his Orgone Box!

Palladian said...

Who else would this topic bring to mind but Woody Allen. It reminds me of "Manhattan" when the Diane Keaton charater is talking about her "analyst":

Mary: Donny my analyst always tells me...

Isaac: You call your analyst Donny?

Mary: Yeah. I call him Donny!

Isaac: I call mine Dr Chomsky, you know, or he hits me with a ruler.

And the description of "Patch" Adams' episode reminds me of later in "Manhattan":

Isaac: So what does your analyst say?

Mary: Donny's in a coma. He had a very bad acid experience.

Isaac: Oh, that's gr... That's great. I mean, you know...

Goesh said...

Crystal gazing, shamans with drums and rattles, past life regressions and hypnotic regression back to the womb - lovely, lovely, but for some good political commentary, I go to Shrinkwrapped, Neo-neocon, OneCosmos and Dr. Sanity, all trained therapists. They have a solid take on things, IMHO, and may well be good therapists, since they don't have a need to pontificate much about it and convince others of what they are accomplishing with patients.

Ann Althouse said...

Palladian: We just watched "Manhattan" a couple days ago. (And, within the last week: "Annie Hall," "Sleeper," and "Crimes and Misdemeanors.") "Annie Hall" also compares Woody's analyst to Dianne's.

Dr.JM said...

There's a huge difference between teh type of psychology/psychotherapy discussed here, and the broader body of psychology. quxxo's post reveals the, dare I say, ignorance of some, regarding the discipline as a whole and therapy in particular.

Some veins of pyschology are highly scientific, well supported by sound research, with highly beneficial findings for individuals and society as a whole. Sensation and perception for example, environmental psych (some, not all), and clinical pharmacology are some examples. To say psychology is nonsense, junk, and ineffective is to deny decades of valid, replicated, scientific, sound research, let alone ancedotal evidence of self improvement.

Pyshcology, like most social sciences, is limited by its very nature and for certain is vulnerable to various shortcomings, most of which I believe reflect the practioner, not the practice.

All's I'm asking for, is that you try to separate the moonbats in pysch from the rest of the decent, legit, professionals - all disciplines have their unethical, ineffective snake oil salesmen, I think the highly scientific world of genetics just identified a new one in Korea.

Dr.JM said...
This comment has been removed by a blog administrator.
Palladian said...

I think a major thing contributing to the decline of psychotherapy is the availability of increasingly better psychotropic drugs. I bet you could chart this decline, beginning in the later 1980s with the advent of Prozac and the SSRIs, the first truly effective anti-depressants with mild side effects (the earlier drugs like MAO inhibitors and tricyclics were dreadful in this regard). Suddenly people with severe problems got better after languishing so long in mediocre talking therapy and said "wait, what am I paying you for? Just write the prescription and I'll be on my way." It's fashionable to trash psychotropic drugs, and I think they are grossly overprescribed and do have side effects that people should be concerned about, as is the case with any drug. But they've also helped a lot of people with severe problems become functional and balanced once again. Go science!

I do admit to having a fondness for the writings of one of the most "sixties" of all psychotherapists, R.D. Laing. He was very, very good at describing the frightening power of mental illness and the smothering inertia of bad human relationships and quite absent of the touchy-feely -ness of many of his contemporaries. Especially recommended is his book of poems called Knots.

Palladian said...

Ann: Wow, a Woody Allen Christmas! Your post about Annie Hall got me to rewatch some of my favorites as well. The split screen analyst bit in "Annie Hall" is very funny. Come to think of it, a lot of Woody Allen movies have a psychotherapy subplot. I haven't rewatched "Crimes and Misdemeanors" but I recall a shot of Martin Landau smoking in his therapist's office.

"Pretty soon, when I lie down on the couch, I won't have to wear the lobster bib"

nunzio said...

As long as insurance companies reimburse psychotherapists for up to 10 visits a year, it is a science. If not, then they are tennis lessons for the soul.

StrangerInTheseParts said...

What a treat to see psychotherapy defended articulately here! I am a practicing therapist myself and am DEEPLY skeptical of much of what goes on in a lot of offices I know of. But when it's done well, and it's what you need, there's nothing like it.

Particular kudos to Pogo and Dr. JM. And especially Goesh's comment that "...good therapists...don't have a need to pontificate much about it and convince others of what they are accomplishing with patients."

The pracitce is hurt most by those that see it as a movement, a hard science, or a, worst of all, a social re-engineering tool.

Jacques Cuze said...

Construction worker, Dry Cleaner, Bus Driver: Actual Physical Labor

Software Engineer: Actual Hard Work, earns 1.5 - 2 X Bus Driver

Divorce Lawyer: Does little, cuts and paste from boilerplate in Microsoft Word. Runs Excel Spreadsheet written by Software Engineer, Bills 5 x Software Engineer

Psychotic Therapist: Does nothing. Sits behind patient, asks questions, says, "go on" a lot, doodles. No one ever asks to see doodles. Bills 1 x Divorce Lawyer.

It's a nice scam.

brylin said...

Quxxo: Even worse for software engineers is that their jobs are being outsourced to Bangalore.

Word verification: qdzoyk.
The noise Quxxo makes when he reads this comment.

Kev said...

I can't remember the name of the person who said it--maybe I'll Google him later--but a prominent British psychologist upset more than a few of his colleagues with his pronouncement that, if everyone had at least one good friend to talk to on a regular basis, nobody would ever need a psychologist.

(Obviously, this doesn't apply to psychiatry, since chemical imbalances are very real problems for those who experience them.)

I also remember the episode of the Bob Newhart Show (the original one) where Bob was concerned that his job was rather pointless, since all he did all day was sit around, listen to people and say "mmm hmm" with an understanding look on his face.

Verification word: "bmwpmdo." A new model of German sports car?

SWBarns said...

Palladian, I agree that the split scene in Annie Hall is funny, funny enough that I thought it should be quoted:

[Alvy and Annie are seeing their therapists at the same time on a split screen]
Alvy Singer's Therapist: How often do you sleep together?
Annie Hall's Therapist: Do you have sex often?
Alvy Singer: [lamenting] Hardly ever. Maybe three times a week.
Annie Hall: [annoyed] Constantly. I'd say three times a week.

Verification word: wpqisig-- a random selection of vowels and consonants.

knoxgirl said...

"And for quxxo, now channeling Tom Cruise"


That's below the belt.

Slac said...

Psychotherapy is marred by not having enough science, so that it forgets reality.

Psychology is marred by having too much science, so that it forgets reality.

*moment of zen*