The Lost Potential of Psychotherapy Part 2

‘Give me a child until he is 7 and I will show you the man’.

Aristotle, The Philosophy of Aristotle

by Peter Boger, M.A.

In my last article I talked about the assumptions underlying psychotherapy and the most basic one being the unquestioned belief that the ‘map’ we are taught in our childhood is true and reliable so if we are having trouble finding our way in life the problem must lie with us, not the map we were given.   Thus psychotherapy is concerned with identifying the ‘problem’ or ‘dysfunction’ or ‘mental illness’ that needs to be ‘treated’ or ‘corrected’ and the presumption is that everything else is just fine, thank you. 

For most people this arrangement is accepted as perfectly appropriate and all the customary structures around it, the ‘authorities’ and ‘experts’ who research, teach, certify and regulate the practice of psychotherapy ensure that people have confidence that what is provided is going to be helpful and not harmful. 

Mental health treatment today is fundamentally defined as either ‘talk therapy’ or the use of medications that target what are considered brain disorders such as depression, anxiety among a long list of diagnoses, or both.   While these treatment approaches are both considered ‘mental health treatment’, they are profoundly different, and the health care providers come from completely different educational and training backgrounds.   Medical doctors who specialize in the brain and nervous system are called neurologists and a small subset of these go on to get further training in the specialization called psychiatry.   Psychotherapists are primarily educated in universities and while many major in psychology, their undergraduate studies can span a wide variety of different backgrounds.   In my experience over many decades of practice many male therapists started out pursuing a career in the clergy or ministry and ended up as psychotherapists.   All therapists have at least a Master’s degree in psychology, social work, or related fields.   Each state licenses therapists and sets rules governing mental health treatment.

Nowhere in the above described system for the training, certification, and regulation of mental health providers is the basic assumptions underlying our cultural and societal beliefs ever questioned or challenged.   In fact some have argued that mental health treatment is ultimately one of many ways societies maintain conformity and protect the ‘status quo’,  whether done in obvious ways such as political dissidents being ‘committed’ to psychiatric hospitals in dictatorships to more subtle ways it can be employed in more ‘democratic’ countries.   In any case no one wants the social stigma that comes from having one’s sanity called into question. 

To summarize,  we currently have an uneasy relationship with mental health and mental health treatment in this country.  While we have come light years from the days when we treated people suffering from emotional, cognitive or behavioral problems as possessed by demons, burned them as witches or isolated them in ‘madhouses’, we still keep mental health as a ‘stepchild’ in the larger healthcare system in this country.  

To further complicate an already complicated picture, we live in a current capitalist culture that has embraced the area of mental health as a lucrative marketplace where everything from the ubiquitous self help book to new drugs for everything from depression to addiction can be extremely lucrative and there is a virtual parade of mental health celebrities like Dr. Phil, that seem to come and go with great regularity. 

I write this here to give some context to this topic of the lost potential of psychotherapy, not to attack the field of mental health care.   When you start to get curious about yourself and others as conscious beings it’s important to appreciate both the complexity of the subject and the likelihood that your exploring will take you to places you hadn’t anticipated. 

Most people will live out their lives and die of old age without ever questioning anything –  they are too busy just trying to survive in a world dominated by war, natural disasters, poverty among a host of other challenges.   We in our country (and other so-called ‘First World’ nations) have the luxury to take basic survival for granted and put enormous resources of time and effort into thinking about things.  This has led to challenges to conventional wisdom in a number of areas, not just psychology.

I hope this series of essays contributes to this ongoing challenge in the  spirit of seeking understanding as a process that is never ending.   In my next article I will look further at the experience of psychotherapy and it’s still mostly unrealized potential.