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The Value of Psychotherapy
I’ve noticed that some people on Ricochet harbor a suspicion of psychotherapy (which I will call therapy hereafter). The issues seem to fall into three categories:
- Therapy is bunk;
- Therapy is part of the leftist movement;
- Therapy is only for people who are “sick.”
1. I cannot really address item 1, and it seems to be rarely expressed anyway. If someone thinks therapy is all bunk, no study I link too, nor argument I make, is going to change his or her mind. Still, this has come up recently with therapists called charlatans who prey on the sick and confused. Also, I have seen more than once the implication that we keep people ill so they will keep coming to see us and pay us money. I will say this: Every therapist I know would love to live in a world that did not need therapist.
2. Many therapists are democrats. It stands to reason, as more therapists are women than men, and women are more likely to be democrats. Further, the whole “I care for people” message tends to attract touchy-feel types, who, let’s face it, like the liberal-lefty language of caring and feelings.
And therapists, as a whole, are a whole lot more accepting of peoples “alternative” lifestyles. We make a point of meeting people where they are to help them without judging them, whether that be because they sleep with the same sex or they killed 16 people. (There are therapist who work in prisons).
Of course, what therapists are doing is looking at human beings as unique individuals, each with their own rights and responsibilities. And despite what you think, most therapists are not trying to get criminals off with excuses, get people out of jail on technicalities, or blessing “bad” behavior. As therapists, our goals are to help people live the fullest, most productive, satisfying lives they can lead. What that is varies from person to person.
Now, if you want to say that is a leftist message, you can. But that is like saying all expressions of patriotism come from the right. While the left seems to have made flag-waving a GOP province, I don’t think we should just concede therapy to the left.
Besides, there are lots of conservative therapists. Like me. Y’all know me. I am to the right of Attila the Hun on foreign policy. There are more like me.
3. The idea that therapy is only for the sick is the most important criticism. But therapy is not just for people who are “crazy” or “insane.” Anyone can benefit from talking to a counselor or therapist. All of us have our “pockets of crazy,” as a colleague of mine says. None of us are as rational as we would like to think. There is always something we could work on to live more actualized lives. Now, most people do okay without it, but we all could do better with it. It is like a massage: Most of us don’t need them, but man, do they help.
Mental illness in general gets a bad rap. It has a high stigma. People look at someone who’s depressed and say, “Just snap out of it.” As it were easy. There are arguments over the use of medications. Certainly, Hollywood doesn’t help, either with its portrayal of illness or therapists.
Still, anyone can benefit from a therapist. In fact, higher-functioning people get more out of it. There are more skills they can learn and more techniques they can work with. You have to have the right fit, of course. Not every therapist is for everyone. If you try one and he or she doesn’t fit, seek out another. That not all therapists are created equal is no different from any other profession.
I’d be happy to answer any specific questions people have.
Published in General
I think that having the same sex as a therapist can be vital, or not important at all. It really depends on you and what you feel comfortable with. I prefer a male therapist.
Not sure if the list needs to be secret. In your story, the therapist acted unethically, imposing her views on the client. Because she is hung up on guns, she has to make a big deal about it, and hound the client. I’d not pay for that session.
This is no different than a therapist who believes in monogamy, attacking a client for having an open marriage. You might discuss risks, but if the clients says, “That’s not why I am here”, it is her dime and her time.
Therapists cannot impose their values on clients. I would guess that therapist destroyed the theraputic alliance in one session.
Oh, she said the q-word!
I’m sure Bryan’s a nice, well-meaning individual, so this should not be interpreted as a personal attack on him.
But if you were to design a profession that met this description:
You’d be hard-pressed to create a better fit than that of psychotherapy.
Based on word limits, let me take this on in two parts:
The therapeutic alliance is the core of therapy. As your quote shows, clinical studies bear this out.
But, that is not hand holding, and your quote does not call it such. Words like “interpersonal process” do not imply the passivity of hand holding. Nor do they have the pejorative formulation that hand holding implies (i.e. the person is in a child-like state).
Therapy is about a relationship with boundaries, that gives the client a space to be heard, feel understood, and reflect on his or her internal processes. It is a safe place to practice skills, explore options, and face some reality. I think Clarie’s post above highlights this well.
Sometimes, therapy is about a kick in the rear-end. You don’t always leave a session feeling good. It is not to feel good it is to grow, and growth is painful.
Drug trials of psych medications are just the same as the ones for other medications. As I noted, all medications have side effects. You have singled out these medications because of a personal experience. I might post other links to the side effects and how drugs have misused for any number of other conditions.
As far as FDA warnings are concerned, that is murky when it comes to practice. Lots of medications are used off label. And other drugs get prescribed despite warnings. It is not as clear cut as the media would have you believe.
Since you want to generalize from your one experience though, let me tell you mine. I have seen 1000’s of people helped with the antipsychotic medications you are against. Their lives are greatly improved.
Again, I am sorry your mother had such a horrible effect, and that it was so hard on you. Clearly, you still have a lot of anger about it.
Who said “hand holding” is pejorative? And you can’t hold adults’ hands?
Sometimes people need hand-holding, that’s not inherently a bad thing. But if you do need it, you need to be very aware of the downsides of what is a very dangerous profession, prone to fads and quackery.
I have sought out marriage counseling, but made sure the practitioner was also a pastor, as I wanted to make sure our interests were aligned. I think that’s a pretty good check…
And yet there are plenty of studies that show psychotherapy works. Your quote in your last post acknowledges that. You just choose to then write it off as “hand holding”.
Here is an article talking about how we are starting to use brain imaging to better understand changes. Much of this is still in the early stages. Our understanding of the brain is very basic, as it is so complicated.
I agree the that diagnosis mechanic is poor. Most therapists don’t really like using them at all. That is more of an insurance thing. ACA does not help.
Car mechanics, on the other hand, don’t have fights and do research over whether there products are even effective at all…
Doctors in general are very good at taking credit for healing that would have occurred regardless…
By definition, a therapist is an activist. They are the experts on what you should think.
There are plenty of studies that show that placebos work, too. That doesn’t mean that they do. By the low standards used for medical “evidence”, you can pretty much prove anything, as randomness will produce effects that doctors will point to as “evidence”.
The hand-holding aspect is the most valuable part of the profession. Having an objective referee can be quite helpful. I wouldn’t be so quick to write it off.
And there are people for whom psychiatric meds are valuable. But, as with ritalin, they’re just a fraction of the people to whom they’re prescribed.
Yes, back to the “unscientific” part… Call me when you folk have a clue as to what’s actually going on. :)
Actually, we are not experts on what people should think or do. The real expert in the room on the client is the client.
Most clients have all sorts of “shoulds” already. We don’t need to add any.
Tuck,
As I said, the people, like yourself, in Group 1, are not going to have their minds changed.
Based on your hostility, it is clear that your hurt is pretty deep.
I am glad that when you have needed it, you have still found someone with that worked for you. There are many good Christian therapists out there.
Thanks for pathologizing criticism behind anodyne CoC-compliant phrasing.
Yes, people like myself, who’ve done the research and are familiar enough with the practice of psychiatry not to fall for its worst excesses.
I’m definitely not your target market. :)
Careful there, practicing across state lines can get your license yanked [pdf]!
LOL. I needed a referee to resolve a fight with my wife. He was quite effective in that.
Of course, maybe things would have just gotten better with time.
That’s what they do. If you don’t believe in psychiatry, you must be crazy!
It’s very good for business. :)
To be blunt, I have seen no sign in this discussion that you could possibly be persuaded that psychotherapy is something other than making people feel good about themselves or quackery. It would be as likely as you or I suddenly deciding to be Obama drones. I say this as someone who had one experience with a therapist, and that experience was strongly negative – the jerk lied to my face and exploited my trust.
I don’t think Bryan is saying you have a disorder or something. He’s just saying that you are VERY unlikely to change your position, and that he can understand why that’s the case. He’s no longer arguing to persuade you, but to address the arguments you have made for the sake of the audience / other Ricochetti.
I am sorry you had that experience. Therapists should never lie, and not exploit trust, or anything else about the client. Like any other profession, there are bad apples, and like any other situation with a power differential in the relationship there are risks of abuse. That is one reason I advocate that all therapists continue to have their own supervision of practice.
If psychotherapy was merely “making people feel good about themselves” it would be doing good, wouldn’t it? But that’s not what I said, I said it amounts to handholding.
And that’s not a bad thing, as I said before.
But the profession has many, many problems… And no, you’re right, I’m not going to be persuaded to the contrary here. I know too much about it…
Effectively he’s dismissing my objections as irrational, the result of injury, not thought.
If I were a psychotherapist, I might suggest he’s suffering from experiential avoidance:
However, I’m not a psychotherapist.