TRANSCRIPT
We live in the era of evidence-based therapy, and I think this is the time of the death of psychotherapy. This is an end postmodern result of what happens when therapy has lost its way so much that the only way we’re able to determine if therapy is good or not, a school of therapy is good or not, is whether or not it has an evidence base. As if this evidence base really tells us anything about psychotherapy. Heaven forbid it even tells us anything about the psychotherapists who practice it.
Now, therapy, all these different therapies have different names and acronyms: DBT and CBT and EMDR and this one and that one. People often reach out to me, “What type of therapy should I choose for this type of problem that I have?” And it’s yet another connect the dots. That’s what the psychology world says. “Oh, you have this problem, you must connect it to this because this diagnosis, which has this acronym OCD, is connected to this acronym B.” And it becomes very mechanistic and simplistic, and I would say wrong.
And here is how I formulate my idea that it’s wrong and that really the psychology field and the psychotherapy field has lost its way. This whole evidence-based thing is all about science and trying to find the scientific validity of XYZ and collecting data and crunching the numbers and using the scientific method to determine statistically if one type of therapy helps reduce symptoms of this problem in this way. Well, I don’t view therapy as a science at all. I view therapy as an art, and not an art of a specific school, but an art where the therapist is an artist. Where the therapist is an open-minded, gifted, creative, flexible person who meets each person who comes into the therapist’s office as their own individual self, not a conglomeration of diagnoses which you can label as certain acronyms: OCD, major depressive disorder, schizoaffective. But instead, a human being with creativity, a life force, a life history with traumas, with pain, with gifts, with flaws, with relationships, with strengths, with weaknesses, with motivation, with lack of motivation.
The gift of a therapist is their ability to connect with this human being, human to human, to see eye to eye, to listen, to be present, to be honest with the therapist’s own self, inside the therapist’s own mind. To have these qualities is a gift. To have these qualities is a creativity. There’s some magic in it that’s inexplicable, and it’s not something you can teach. In fact, what I experienced in school when I studied to be a psychotherapist myself is that often the teachers were the worst therapists. The people who were teaching psychotherapy, because they bought into all this. My supervisors were the same thing: horrible people, more or less. People who liked the power of being teachers, liked the power of being supervisors, often liked the power of being therapists, but didn’t have that spark of gift.
Often nowadays, I see they are the ones who are putting forward this idea of, “This is what we need for more of an evidence base.” And for a therapy, a new school of therapy, a new type of therapy to be taken seriously, we must come up with an evidence base. As if you can’t fake it. Because that’s another thing. Look at all these psychiatric drugs out there. All of them have an evidence base behind them, and yet they’re dangerous. They’re poisonous to people. They actually shut people down much, much more. Oh, the evidence base might say, “Oh yes, you can help people function better when they take these psychiatric drugs.” But no surprise, sometimes people’s painful upwelling feelings of their traumas, the very painful upwelling feelings that they need to heal, well, they can for a while go against someone’s functioning. They can actually create more so-called psychiatric symptoms.
And when the evidence base is all about reducing symptoms, and schools of therapy are all about reducing symptoms for certain DSM diagnoses, well, no wonder the whole concept of an evidence base is screwed up. Because a lot of times, people’s so-called symptoms need to get worse as they heal. I think about myself and healing from trauma. Incredibly painful. Much more difficult to sleep when I was looking at the truth of how horrible my parents were, looking at the truth of how rotten my childhood was, looking at the awfulness of what I had been through. It’s like this was not easy. This didn’t allow me to function better. This didn’t allow me to have a more normal life that plugged into our crazy society. In many ways, it’s like for a long time I had to pull back and feel very, very alienated from our world. Alienated from our world, more psychiatric symptoms. This is the evidence base that shows what I was doing was wrong. And yet the evidence in my own personal life showed that the creativity and courage that I had to heal, and the same thing I see with others. So much of the healing that they do goes against the mental health field. The healing sometimes has to directly contradict what their therapists want them to do.
Why is it that so many people that I’ve seen do better in their lives when they can figure out how to taper off their evidence-based psychiatric drugs? So the evidence base, I was thinking about this also when we talk about the value in an evidence base in a type of therapy. Well, by that same logic, why don’t we say, “You know, that art is no good because it doesn’t have an evidence base?” I think nowadays what we need for any art to get into an art museum is evidence-based art. And the same thing: no more music on the radio, no more music on television, no more music on the internet. It’s all canceled unless it has an evidence base behind it. Oh, now Mozart? Well, you know, he didn’t exactly follow chord progressions in a proper way. Let’s cut him out. No more evidence base behind it. Or Tchaikovsky? Ah, you know, some of his dissonance, it kind of doesn’t work. It doesn’t follow the evidence base. Evidence-based music, evidence-based art. H, what else? Evidence-based drawing. Drawing has to follow exactly certain rules; otherwise, it does not follow the evidence base.
And I think it’s the same for therapy. So if you ask me what would be best, get rid of all the evidence-based. Probably get rid of a lot of different schools of therapy. Instead, let the therapists follow their own creativity. Yes, follow good boundaries. I think there are certainly some very important good healthy rules of psychotherapy, like have good boundaries with your client. You are not their friend. You are here to do a service for them. No romance with clients, it’s another one. I think another one, yes, have good boundaries. Start on time, end on time, be fair with people, be open-minded. But I really think people who become psychotherapists are best served if they’re not following a rule book, a formalized rule book for a school of how to do it. Instead, they’re following their hearts. They’re listening to the needs of their clients. They’re being open-minded enough to try new things. They’re being strong enough within themselves to have the allowance to be creative, to say things that maybe don’t follow the rules of the school that they thought. And in so doing, can most optimally help their clients.
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