Here’s one I’ve been sitting on for a while. What does a Shrinky do when they’re having a bad day? Probably not what I’d do.. that’s for sure!
Yesterday I found myself on Twitter having the most fascinating debate with a whole host of clever people but particularly shrinkies @jaypsyd and @janettereinke.
A major critique in my recent readings (mostly humanistic theories) was that psychoanalysis delivers insight without ever achieving “change”. Whereas CBT* delivers short term change without any insight leading to a recurrence of behaviours/general unhappiness/woe in the longer term.
My question(s): Where is the connection between insight and change? What is the catalyst that moves the client from one to the other? What modality of therapy offers this best and how does it manifest in the relationship/process of therapeutic interaction?
And yes – we dug through this in less than 140 characters a pop. Neat, eh?
I think our conclusions ran thusly…
Insight leads to (self) knowledge and (self) acceptance. This (self) acceptance reduces shame, and ultimately creates a desire for change or alternatively, creates an environment conducive to change.
We also discussed the role/definition of shame. @Jaypsyd sees shame “more as a cultural artifact placed atop the psyche” whereas I definitely see it as a developmental issue, potential extant parental issues impacted/exacerbated by cultural influences but then placed upon (projected onto, if you will) the developing child, with each generation compacting the damage previously inflicted by the former.
Then I highlighted another critique appearing within the same set of texts, that person-centred therapy is too passive.. that “witnessing” is not enough of a catalyst for change. Which led us to discuss the role of unconditional positive regard and how difficult/challenging it is to maintain.
I’ve been asked (far more often than I’m strictly comfortable with) whether I want to become a therapist. For the reason of UPR alone, my answer is the same as the last panel of this cartoon.
Seeing as we now have more than 140 characters available to us, please feel free to add any comments on this subject at the bottom of this post.
*Don’t get me started on the lack of longitudinal studies on the magical cure-all that is CBT but if you’re interested, we’ve now seen the first publicly available longitudinal study – and it shows that it doesn’t work. In Sweden, much like the UK and USA they have wholeheartedly embraced CBT at the expense of all other modalities. A recent in-depth study has shown :
“The widespread adoption of the method has had no effect whatsoever on the outcome of people disabled by depression and anxiety. Moreover, a significant number of people who were not disabled at the time they were treated with CBT became disabled, costing the government an additional one billion Swedish crowns.”
(That’s USD $150,516,850,328 or in the UK £95,139,793,241)