Oh... the evils of psychotherapy.

November 18, 2003 4:09 AM

Oh... the evils of psychotherapy.And they are many - by turning to therapists, we don't get the strong emotional bonds that are the benefit of sharing your trouble with friends. (More Inside)
posted by gregb1007 (35 comments total)

And incidentally, the other supposed folly of therapists is that they seem to encourage people to avoid becoming emotionally close to others. Conversely, they advise them to keep their distance. That's because the psychotherapists want their clients to treat relationships like stocks. Investing your time into becoming closer to someone is only worth it if the the relationship promises to yield fruitful dividents. But as soon as benefit-earning potential decreases, the relationship should be dropped.
posted by gregb1007 at 4:22 AM on November 18, 2003

And don't forget your tithe to the Scientology Church.
They will be sure to tell you more about the evils of therapy, for a price. :-)

Fundies of the scifi type.
posted by nofundy at 4:47 AM on November 18, 2003

True, but this column is a poor argument for it

In the therapeutic world-view, a person should not be emotionally dependent upon anyone else, but should be self-sufficient. Relationships with others should be distanced and mutually self-realising.

That doesn't seem to fit any form of therapy I've heard of: he doesn't seem to have any particular evidence for arguing that therapy discourages close relationship.

The rest of it seems to be the usual attack on moral relativism in general, rather than therapy in particular.

...there has been a loss of belief in the authority of inherited standards, codes, morals and so forth: every man has to work everything out for himself from first principles - every man is expected to be his own Descartes. This lead to a terrible cacophony of unshared values, while simultaneously rendering us susceptible to the siren-song of ersatz values.

We have also lost faith in politics as a source of betterment in our lives. We regard politicians, ex officio as it were, as self-interested opportunists and nothing else. This throws us back on the ups and downs of our private lives.
posted by TheophileEscargot at 4:51 AM on November 18, 2003

It is hard to make a case for a single 'theraputic view' when there are so many different types of therapies. The author seems to be arguing against the clinical diagnosis called codependency without explicitly mentioning it.
posted by srboisvert at 5:08 AM on November 18, 2003

TheophileEscargot said:
In the therapeutic world-view, a person should not be emotionally dependent upon anyone else, but should be self-sufficient. Relationships with others should be distanced and mutually self-realising.

That doesn't seem to fit any form of therapy I've heard of: he doesn't seem to have any particular evidence for arguing that therapy discourages close relationship.

Have you seen any Woody Allen movies? His characters visit Freudian analysts who tell them that their significant other is not good enough for them and they should seek out someone else. And then a lot of Allen's characters tend to approach relationships cautiously, trying to keep their mate at a distance while their psychoanalyst helps them figure whether that person is the one.
posted by gregb1007 at 5:12 AM on November 18, 2003

While there are cases where psychotherapy is beneficial, the majority of counseling (in U.S. society) is a symptom of the need for third places. Been posted here before, I'm sure. Basically, the lack of third places (informal gathering places in the community where all are on equal footing) forces us to seek the social interaction we crave in the 1st(home) and 2nd(work) places. Because 1st and 2nd aren't for that purpose, things get out of kilter and we then go for counseling, which also doesn't fill the need. (And some have proposed a place of worship as a 4th place.)

All of the above IMHO, of which I've been accused of b/w world viewing. My $0.02 +/-.
posted by yoga at 5:20 AM on November 18, 2003 [1 favorite]

gregb1007: Well, Woody Allen himself is a pretty persuasive argument against psychotherapy.

If he's using that or his movies as a basis for his arguments though, it would have been nice to actually mention it.
posted by TheophileEscargot at 5:21 AM on November 18, 2003

The book isn't talking about specific therapies, but about a culture and an industry that has arisen around the idea that we are all in need of mental health services in order to learn "self-esteem", "anger management", "positive thinking", and other ways of proper behavior in society.

This industry teaches us that some of our most basic emotional reactions -- anger, grief, sadness -- are not indicators of our own personal truth, and the basis of forming real relationships with other people, but rather are problems that we must distance ourselves from and learn to control. America is now drugging children who don't conform to a specific model of behavior.

From another, more detailed review:
It is in this sense that therapy culture promotes conformity: laying down a framework of acceptable emotions and behaviour that people transgress at their peril.

That one sentence captures perfectly why I stopped living in the US 15 years ago, and still don't want to go back. People in the US don't realize how tightly their society polices individual behavior, and how much of that policing is carried out by well-meaning people in the "helping" professions.
posted by fuzz at 5:24 AM on November 18, 2003

yoga, the "third places" point is very relevant. People need to be able to casually run into strangers to share their thoughts and issues with. Because you probably won't get much sympathy for your family problems at work and your family will get sick of hearing you talk about your work problems all the time. But at a "third place" people might actually be interested to hear you talk about your life, cause to them it's a brand new story. I've listened to people on the train talk about their work or their friends and relatives and it didn't bore me.
posted by gregb1007 at 5:28 AM on November 18, 2003

There was also a good Guardian review a while back.

The bit that annoys me is Dalrymple using it as just another excuse to go off on another nostalgic rant about the good old days when folk were godfearing and knew their place.

Dalrymple's appeared on metafilter before, if anyone remembers
Every multiculturalist is a recruiting officer for al-Qaeda. I think there was also one where he explained how African culture will always condemn them to corrupt government, but can't find a link now.
posted by TheophileEscargot at 5:44 AM on November 18, 2003

I didn't get that at all in my training... We weren't taught to teach conformity or that emotions, even negative emotions, are bad. Quite the contrary.

All emotions are beneficial. It's how you express them (or don't) that leads to so many problems in our society. The fact is, you'll get along better in life and with others if you find ways to express yourself where (a) other people can understand you and (b) it doesn't result in unintended harmful consequences. Now, you may call this "conformity," but most see it as helping oneself in this world.

It is the simplification of much of psychology, and therapy, that leads to these straw-man arguments. Gee, when authors argue that this "therapy culture" (which, frankly, I don't see) just wants people to be introspective and self-absorbed and not have relationships, it's easy to agree with that. But all of the colleagues I know in the field, and hundreds of people I've talked to over the years, have never viewed therapy as simply a matter of self-absorption or introspection.

Instead, most view it as a means of helping that person effect change in their lives. Change because they don't like something they're doing, thinking, or feeling. Nobody forces them into therapy, and most don't sit there simply to complain about their lives. They're there to find ways to change, and the therapist is there to help them with that. Not give advice.

I can always tell the quality of a reviewer of this kind of book by whether they simplify therapy into "advice giving." Once they do that, they've lost me. Good therapy has nearly no advice giving whatsoever.
posted by docjohn at 5:52 AM on November 18, 2003

By the way, I think Dalrymple contradicts himself here. When he says people have to seek out support from psychotherapists, he blames it on the fact the "loss of belief in the authority of inherited standards, codes, morals and so forth." But he misses that counseling itself represents inherited standards and authority (albeit pseudo-scientific.) The whole thing started with the wealthy elites seeking out Freud in turn-of-the-century Vienna and then become dogmatized into an authoritative science of psychology at the University level. So we do have a very mainstream tradition where emotional disturbances are treated as illness to be dealt with therapy.
posted by gregb1007 at 5:59 AM on November 18, 2003

I have a BA in Psychology and had no problems until I learned about some of the disorders that were clinically diagnosable. I agree with fuzz that we try to conform too much, in the US at least, and every little thing should be worried about (overly general statement, I agree). People have different temperments and that's life. I think it's good that someone can be in control of their anger so they don't harm anyone, but to get rid of their anger all together is a bad thing.

However, therapy can be a good thing for those that really need it. I don't think it should be a place to go solely to talk about one's day at work. If that's what someone is doing, then they don't need therapy. But for those that are struggling with issues, and that struggle is interfering with everyday life, therapy, I believe, is necessary.

[And it should not be a bad thing. Even though the US society wants all to be pleasant and conform, therapy and mental illness is still something to hide. That is unfortunate because it keeps so many who really do need help from getting it because of the stigma of therapy and mental illness.]

If someone gets angry and harms other people, or even things (like punching walls), then I think that person could use some help. That doesn't mean the person won't get angry, or it's bad if the person gets angry, just that the person should learn how to deal with the anger in a "better" way (meaning no hitting). I think we could all agree that that's not a bad thing.

And a therapist that wants you to distance yourself from people is not a good therapist, in my opinion. There will be good doctors and bad, just like in any profession, and you need to go in with common sense and see if you like this person's approach. If not, leave. You don't have to stay with the person you started with if it doesn't seem right. But don't assume all therapists are the same because of it.
posted by evening at 6:23 AM on November 18, 2003

evening, do you really think someone who punches walls needs to see a therapist about it? Couldn't any reasonable person talk to him about other ways to manage his anger?
posted by gregb1007 at 6:27 AM on November 18, 2003

Yet the bigger picture he presents is persuasive. He points out that in the not-so-distant past, people looked (at least in this country) to their relatives and friends to help them with their difficulties. They also turned to the consolations of religion, and believed in the virtue of stoicism.

In the good old days, people had to find solutions to their problems in the very people who were often causing those problems, so nothing much ever got fixed. And they were good people who would just suck it up and leave us alone without that pesky "changing," so we wouldn't have to deal with them ceasing to be our doormats.
posted by ROU_Xenophobe at 6:30 AM on November 18, 2003

Whatever. Therapy is the best $2/min I spend each week, you wouldn't want to know me if I didn't have it, and in all likelihood I wouldn't be alive today if not for it.
posted by Grod at 6:49 AM on November 18, 2003

gregb1007

I'm not sure citing Woody Allen films as your main point of reference in this debate is particularly persuasive.
posted by johnny novak at 6:53 AM on November 18, 2003

Johny Novak, it isn't my main point of reference, but I see nothing wrong with using films to reflect upon cultural issues. But, if you wish, I could also refer to self-help books that tell people to drop friends who aren't fufilling their needs. (Dont feel like sharing information about my friends though) These are of the codependency genre as sboisvert helfully pointed out. If you wanna browse through a title, check out "Codependent No More"
posted by gregb1007 at 7:03 AM on November 18, 2003

For the record the man's own thoughts:

Woody Allen spent years in psychoanalysis, although, he says: "After eight years, I got up from the couch one day and offered my analyst a draw. We shook hands."

From here.
posted by johnny novak at 7:16 AM on November 18, 2003

n the therapeutic world-view, a person should not be emotionally dependent upon anyone else, but should be self-sufficient. Relationships with others should be distanced and mutually self-realising.

This may or may not be "the therapeutic worldview," but it is a smart worldview. Others will let you down, and if they do deliver, their help often comes with strings attached, or with the danger that your admission of weakness will be used against you in the future. In my experience, if it is at all possible for you to solve a problem yourself, it's almost always better to do so.

There are times when it is not possible. In such cases, I imagine it is nice to be able to turn to someone who has no particular motives and who has had plenty of experience helping others with their problems. The right time to tell your friends and relatives about a problem, if you tell them at all, is generally after you've solved it.
posted by kindall at 7:24 AM on November 18, 2003

The fact is, you'll get along better in life and with others if you find ways to express yourself where (a) other people can understand you and (b) it doesn't result in unintended harmful consequences. Now, you may call this "conformity," but most see it as helping oneself in this world.

Yes, those are good ways to get along with other people, be a better member of society, and get ahead in your job.

The price you pay is that you learn to consistently filter your feelings and transform them into something that other people find acceptable and understandable. That filter eventually becomes part of your personality, and you become well-adjusted at the expense of the full range of your feelings. That's why I call it "conformity".

I imagine it is nice to be able to turn to someone who has no particular motives

The point is that as long as a therapist has his own definitions of "mental illness" and "mental health", he does have particular motives. Not to mention the extensive literature on counter-transfer. I'm with Lacan that the only real work that gets done in therapy is when you arrive at the realization that you don't need your therapist and you never did.
posted by fuzz at 7:38 AM on November 18, 2003

I could also refer to self-help books that tell people to drop friends who aren't fufilling their needs.

I see nothing wrong with that. People in my life either add something or take something away. Yes, some do both, as I am sure I take from people as well. But the ones that do nothing but take are no longer my friends. My life is exponentially better without them around. Same goes for family members. I don't buy into the whole idea that family members get passes for bad behavior because they are family.

I spent a year in therapy and it was money well spent. I went in with a specific purpose, set a reasonable goal for myself, found the right therapist for me, set a specific end date and learned a lot of things about myself in that year that I wasn't expecting. I didn't always agree with my therapist when she gave me advice (which was rare) but I agree with most of what she told me about myself or got me to see about myself.

Woody Allen, please. Anyone who is in therapy every day, with multiple therapists, for the majority of his adult life, does not want to change anything about his life. Someone with the same problems after 20 years, and with that much therapy, is just sad.
posted by archimago at 7:59 AM on November 18, 2003

I've seen the good and the bad. I went to a therapist for 2 1/2 years after my divorce. There came a time when I was done. I wasn't finished with all personal development, of course, but she'd given me all the help she could--the rest was up to me. I could have accomplished on my own pretty much everything I accomplished with her, but she help speed along the process, I think. she didn't try to talk me out of quitting therapy, was very happy for me, actually. It was great.

I've seen the bad, too--an ex-g/f went to the same guy for 14 years, definitely as a replacement for the "third place." He pretty much ran her life, very Svengali-ish. EVERYthing had to be vetted through him--she even talked me into going through couples counseling with him. When he started contradicting my own therapist, I got out of there, out of the relationship, too. Scary stuff. He was perfectly happy with the arrangement, though.

I can also connect the end of my therapy to the beginning of finding my own "third place." It was around the same time that I began forming strong friendships, began actively dating after a 10-year marriage, began going out to bars and stuff. My therapist helped me find alternatives to therapy, really--bad business model, huh?
posted by MrMoonPie at 8:22 AM on November 18, 2003

Psychotherapy was instrumental in helping me overcome my drifter-killing compulsion. Sure, I still have the occasional urge, but it's almost 100% controllable now.
posted by Mayor Curley at 8:56 AM on November 18, 2003

gregb1007 - Again, I think it depends. Is it someone who consistently takes their anger out on people or things? Even if it is a wall? Esp. in public? Then I think yes, the person could use some help. Now, does it matter if it is in the form of a friend or a therapist? No, not really.

But not everyone has friends they can rely on like that. Either they don't feel like they should burden their friends with their problems, the friends don't want to be burdened by others' problems, or the person just doesn't just have friends to do that with, then I think it's good that there is an alternative.

And, again, the person doesn't need to feel that their anger is bad, but that there are "better" ways to deal with it (more productive, less destructive, whatever you want to fill in for better).

I don't necessarily see that as changing the person so much that they are no longer themselves.
posted by evening at 8:56 AM on November 18, 2003

My Third Place is my Second Life =P

Seriously though, I think things like this are going to really start to take off, as it requires a lot less energy and time to form a "third place" in cyberspace than in meatspace.

Places like Second Life are much more realistic than an IRC channel or AIM chat room, becuase there are so many more ways to interact and make new friends -- maybe not as many as in Real Life, but considering the time/effort saved, it's worth recognition.

At the same time, virtual worlds give you more freedom to be yourself as represented by your mind instead of worrying about how you look physically.
posted by joquarky at 9:06 AM on November 18, 2003

Most of us who have chemical imbalances are advised to seek therapy as well as medication. I have actually found that my friends do just as well if not better most of the time. Then I have my online forum/support group. Occasionally I run into something that needs to be worked out by a professional-in my case I have a counselor who I see on an as-needed basis.

I think the main value of a counselor is that they are paid to listen to you. And sometimes they will tell you things you need to hear-things your friends don't want to tell you.
posted by konolia at 9:45 AM on November 18, 2003

fuzz, you seem to be saying that by adjusting your feelings, behaviors, whatever so that others better understand you, you can't express your true range of feelings?

I think it all depends on the situation and people you're dealing with. It's not going to get you far in life, and indeed, the Unemployment Office may be your Third Place if you are constantly expressing your anger at others in your workplace by yelling uncontrollably at the top of your lungs. As Ellis might say, you're being entirely genuine and living in the moment, but those qualities are not fully appreciated by society today in all contexts.

I'm not sure that such qualities should be appreciated by society today in all contexts and situations, as we develop specific contexts to fit specific situations.

Which is not to say that you can't find a way to be real and genuine with the expression of your feelings and emotions in other, perhaps more appropriate, situations. Like at home. Or with your wife. Or kids. I can express as much anger or happiness I want, pretty much when I want. I just take it outside, call a friend, or vent in a journal. Has any of that changed who I am, at my core? Or how genuine I can be with the people that really matter in my life? I don't think so for an instance.
posted by docjohn at 9:54 AM on November 18, 2003

I have dear friends with whom I talk about my feelings. My husband and I talk about our feelings a lot.

However, I appreciate the opportunity to spend an hour a week talking with a trained professional about some of the difficulties I am still having in dealing with some of the challenges of my childhood. I never feel as though I'm boring her, for one thing (or rather, I never care whether or not I'm boring her, because I'm paying her!)

I think that having a therapist means that I am better at communicating with my friends, because I am not whining on and on to them about my problems.

I am also not drinking myself into a stupor, dating inappropriate men, and indulging in disordered eating--things my therapist has helped me to stop doing. I can promise you that my friends and family really prefer the sober, sane, happily married me to the self-loathing wreck I used to be.
posted by Sidhedevil at 10:00 AM on November 18, 2003

i feel so violated. i'm killing my therapist right after we finish cuddling.
posted by quonsar at 10:30 AM on November 18, 2003

Oh please. What a false dichotomy.

I was extremely socially phobic. If I hadn't had a run of therapy a few years ago, I wouldn't have any friends today to tell my troubles to.
posted by 4easypayments at 11:13 AM on November 18, 2003

Full disclosure - I'm a licensed psychologist and do therapy among other things in my professional career. I've seen many patients over the years, I’ve directed mental health programs for kids, supervised, taught, etc. I’ve helped some people and I don't believe I've harmed anyone.

***sorry for the loooooong post - I had no idea I had so much to say***

There was a cartoon in the New Yorker a while back that showed a huge opera stage, with Othello weeping over the dead Desdemona on stage. In the foreground were two very fancily dressed women in the audience whispering to each other, “Just think, with a little therapy none of this would’ve happened.”

The whole business of whether people “need” to be in therapy because of life events is controversial among therapists I know. Does someone “need” therapy because something bad has happened to them? It depends. They might be helped by it, especially if they had some early experiences that makes it difficult for them to process their own grief, fear, and anger, or if their friends and family are into the mode of “Oh, just move on…” and they aren’t ready. In most cases, if therapy doesn’t help someone, my experience is that most people get out quite readily.

My role with patients is *not* to get people to be self absorbed or dependent on therapy, but, more often than not, to listen, to help people make sense of what’s going on, to normalize their feelings, helping them figure out how they may be contributing to their difficulties, and to make suggestions if something occurs to me that might be helpful.

People who are having a hard time get advice from all over the place, and usually therapists don’t have any magical advice that others haven’t already given. My advice, when I have any, is usually to discourage damaging ways of coping (such as alcohol/drugs, harming self or others, etc.), helping people remember things that have helped them in the past, and encouraging people to create and use social support networks.

Can people use therapy as a substitute for living? It’s a complicated question that relates to the skills of the therapist and the needs of the patient. The experience of being listened to by a sympathetic and knowledgeable person can be pretty cool, and even helpful at times. The expense can discourage people from “hanging out in therapy,” but ideally therapists should encourage their patients who are ready to move on. But some people take a long time to get ready…Obviously there’s a financial disincentive for the therapist to encourage patients to leave therapy, but most of the folks I know are pretty well grounded in their professional ethics and understand the importance of separating between their own need to make money from their patient’s needs for autonomy.

The whole business about therapy and social control is not, in my experience, an issue except under those instances in which there is a legal issue – i.e., I have to report if someone threatens to harm someone else, if I suspect that someone’s abusing a dependent person, etc. People who work in forensic circumstances have social control responsibilities built into their positions.

Therapists encouraging conformity and compliance and enforced happiness? That may have been true in the past, but is not at all an issue now, at least not in the circles I’m familiar with. The days of eccentric people languishing in back wards because their families didn’t like them is *way* over, in California at least. Those wards got closed down, and now jails are housing most of those chronic mentally ill people.
posted by jasper411 at 11:50 AM on November 18, 2003 [1 favorite]

When I worked in half-way houses I saw a lot of people in the mental health system who would have been far better served by having weekly therapy than they were having a prescribing doc up their meds everytime they went through a rough patch. There's a HMO driven push to get people out of therapy and on to psych meds, which insurance companies see as being more cost-effective.

I am glad I went through many years of therapy. It saved my life, or at the least, kept me from fucking it up to badly. My friends and family could not have done it - I had problems that could only be dealt with under the supervision of a professional. I learned how to communicate my feelings in ways that weren't so self destructive.

I think that therapy can do a lot of good. The danger I see is that diagnosis and treatment are sometimes dictated by faddish "syndromes du jour" rather than by foregoing labels and assessing the unique needs of the individual seeking help.
posted by echolalia67 at 4:26 PM on November 18, 2003

" the danger I see is that diagnosis and treatment are sometimes dictated by faddish "syndromes du jour" rather than by foregoing labels and assessing the unique needs of the individual seeking help." - I'll echo that!
posted by troutfishing at 7:54 PM on November 18, 2003

I really don't want to add to the pile of "crazy" "out there" theories already posted, but here goes;

Psychotherapy is sometimes beneficial and sometimes not, depending on the situation, and sharing anecdotes of either your negative experience of your positive experience with it only furthers this crazy idea of mine.
posted by Dillonlikescookies at 8:22 PM on November 18, 2003