In part one of this series, I discussed some of the challenges facing psychotherapy. In part two, I introduced multi-lens therapy and outlined its central goal, which is to do a better job than the DSM and current psychotherapies of taking into account what is causing a client’s distress. In part three, I explained how therapists can gain a beginning understanding of what might be causing their client’s distress by listening in new ways to the causal hints that clients drop in session, and by employing “talking points” to help educate clients about the reality of multiple causes and what that means for them with regard to “what might help.” In this post, I’ll introduce the 25 lenses of multi-lens therapy.
Your current way of doing therapy may not include much teaching, explaining, or using talking points like the ones above. But if you’re engaged in explorations and investigations with your clients, as I believe you should be, that requires that you help your clients understand what you have in mind. You want to be able to say, “That’s one possible way to look at what’s going on. But there are also other ways. Can we check those out?”
If your client agrees, then you will need your talking points so that you can introduce those “other ways of looking at what’s going on” in simple and clear ways. With those talking points at the ready, you’re much more likely to learn what’s really going on, which then allows you to aim your helping in the appropriate direction. By paying real attention to what may be causing your client’s distress, you greatly increase your therapeutic options.
Of course, that you have done some excellent work discerning causes doesn’t mean that you or your client will then know what to do. But that information must prove valuable, at the very least insofar as it prevents you and your client from misunderstanding what is going on. And it is bound to suggest possible avenues to try. Whether those avenues will prove fruitful must remain to be seen. But you are traveling down them for good reasons, because you have inquired and listened.
Psychotherapy as an idea and as a practice has not completely escaped critical scrutiny. But, on balance, the critical psychology movement and other critics of contemporary mental health practices have more often taken aim at deconstructing the mental disorder paradigm, as reified in the DSM, than deconstructing the psychotherapy paradigm. Psychotherapy has managed to fly a bit below the radar of critique.
But it has needed critiquing, in large measure because it has taken too cavalier an attitude toward causation. What a doctor does is generally well justified by virtue of the fact that he is treating the causes of things as well as their symptoms. He cares if it is a virus and he cares which virus it is. What a psychotherapist does is on much shakier ground, since psychotherapy has taken a cavalier attitude toward causation and not made “investigating causes” a central activity of the practice. Therapists, provided by psychiatry with a checklist way of labeling clients, have been rather left off the hook when it comes to tackling the matter of causation.
A multi-lens therapist is on much more solid footing, since he or she can say, “I check carefully for causes by investigating the causal hints I hear and the causal clues I get. I then connect my helping strategies to what I learn. If I can’t discern what is causing my client’s distress, I can still be of help, because talk helps and support helps. But I don’t act like causes don’t matter and I do my human best to figure out what’s really going on. This is no easy task, as causation in human affairs is typically complex and obscure. But I try.”
The following, then, are the 25 lenses of multi-lens therapy, lenses through which to view what might be going on “in” and “with” your client. This list is not meant to be comprehensive but it does an excellent job of not being reductionist and it allows for a lot of rich thinking and investigating.
1. The Lens of Original Personality
2. The Lens of Formed Personality
3. The Lens of Available Personality
4. The Lens of Circumstance
5. The Lens of Time Passing
6. The Lens of Mind Space
7. The Lens of Instinct
8. The Lens of Individual Psychology
9. The Lens of Social Psychology
10. The Lens of Development
11. The Lens of Biology
12. The Lens of Family
13. The Lens of Cognition
14. The Lens of Behavior
15. The Lens of Social Connection
16. The Lens of Experience
17. The Lens of Endowment
18. The Lens of Stress
19. The Lens of Trauma
20. The Lens of Emotion
21. The Lens of Culture and Society
22. The Lens of Environmental Factors
23. The Lens of Psychiatric Medication and Chemicals
24. The Lens of Creativity
25. The Lens of Life Purpose and Meaning
Multi-lens therapy asserts that if you are leaving out temperament, social and cultural realities, life purpose and meaning issues, and the other lenses through which a multi-lens therapist looks at her clients, you are leaving out too much. You are operating from too limited a place and making it harder on yourself to be effective by virtue of not meeting your client where she is “really at.” If you do meet her there, she will trust you more, warm to you more, engage responsively, and do more work out of session. Multi-lens therapy paints a truer-to-life picture of human reality and also makes the work of psychotherapy much easier. There’s a lot to value there.
How a Multi-Lens Therapist Views Life
How is life really experienced? The actual experience of living is very different from the reductionist view that we are either healthy or have a mental disorder. Our experience of life isn’t captured by words like normal and abnormal, healthy and disordered, and the other sterile constructs of contemporary psychology. Do you view your life as either “normal” or “abnormal”? Do those words capture anything about how it feels to be alive?
Each of us is a real human being dealing with real circumstances and experiencing the passage of time. First, there is a real human being. A real human being is a willful creature with drives, needs, opinions, beliefs, and all the rest. No adjective or list of adjectives captures his particularity. A given member of our species may be dull or brilliant, empathic or merciless, feverish or apathetic, and all the rest. And each member of our species will be knitted together and wound together as his or her own multiplicity, smiling one moment and dreaming of revenge the next, oblivious to the world one moment and marching in protest the next, selfless one moment and selfish the next. Labels do not capture this reality, adjectives do not capture this reality, and what goes on “inside a person” happens behind closed doors, making each individual implacably mysterious.
Second, there are real circumstances. A prisoner’s cell and a monk’s cell may look very similar but the prisoner is in one set of circumstances and the monk is in another set of circumstances. If your parents are cruel to you, that matters. Those are real circumstances. Try shrugging them off or wishing them away. A war breaks out and you must fight or not fight. Will your choice not affect you? You spend a dozen years learning a subject and at the end of that time you discover that it bores you. There you are, a professor of nothing that interests you. Try ignoring that.
Then there is the matter of time: the passing, pressing nature of time to be filled. Time is the wild card. Time is most often described nowadays as “not enough,” as in there is too much to do and not enough time in which to do it. But in reality, time is “too much” rather than “not enough.” The astounding pressure put on us to pass the time is a full player in our experience of life. How many billions of people are racing into cyberspace hours and hours each day because time must be filled? Imagine a life without the experience of time passing. We would live that life very differently from the ways that we currently live.
These three together make up each snapshot moment in the sequence of snapshots that amount to a lived life. Life may feel more like a film than like snapshots, but that is a trick of the mind. A film implies a director. There is no director directing human life, including the self. You and I are not auteur directors. Rather, we live in discontinuous time and the continuity that we experience has to do with the consistency of our formed personality, which causes us to repeat ourselves, for better or worse.
That felt consistency also occurs because when we head off in a certain direction, we tend to keep heading there, as the laws of physics and human nature predict. Life plays itself out with plenty of anticipated results: the divorce can already be seen in the first date, the abandoned career can already be seen in the first day of work, the clash between you and your society can already be seen the instant you say “No, I refuse.” The power of our formed personality to cause us to repeat ourselves, our tendency to keep going in the direction we have propelled ourselves, and the logic of life producing anticipated results, give life its filmic look. That look obscures the real nature of each moment, which is up for grabs.
How is each moment up for grabs? Maybe every time you get off the subway after work, you go home. But you might not go home. There is always the potentiality for flying off and leaving your life behind. We know this because people do exactly that: they do not go home to dinner but instead run off to South America. But even if no one ever did it, we know by virtue of our own experience how wild and tumultuous each moment is, how we just might have had that affair, how we just might have thrown over our profession, how we just might have decided to sharpen all of our knives, how we just might have changed our mind about life being worth living. That we do go home each time we get off the subway amounts to a decision, one that we usually only vaguely comprehend but that sometimes we very clearly know that we are making.
The experience of being human can only be understood in terms of these dynamic, pregnant snapshot moments, one happening right after another. And circumstances must always be factored in. A person is one “snapshot of himself” in one set of circumstances, say as he rushes down the street to get home for dinner, and another snapshot of himself in another set of circumstances, say when he is the subject of a psychological experiment. Countless psychological experiments have shown that most people are different in an experimental setting from how they usually are. In experimental settings, they are more obsequious than usual, more savage than usual, more deferential than usual, more sadistic than usual. They are not different people but they are different expressions of themselves.
We are each full of such potentialities: to be more savage than we usually are, to be more dismissive than we usually are, to be more frightened than we usually are, to be less principled than we usually are, to be more demoralized than we usually are, to be a million things different from how we “normally” are. We contain a multitude, both as potentiality and in reality. One and the same person can have a deep understanding of the power of cravings and give a wonderful talk on the subject of addiction, then leave the stage and eat a thousand peanuts. One and the same person can be charming in public and a monster at home. All of this makes our experience of life even more fraught. These potentialities and realities give lie to the idea that we can ever really be settled.
Multi-lens therapy envisions each individual as an unsettled creature for whom each moment is up for grabs. That each moment is up for grabs provides the multi-lens therapist with a golden opportunity to help clients proceed differently and grab a next, new, so-to-speak better reality. In charting this course, the multi-lens therapist takes a particular view of personality as made up of original personality, formed personality, and available personality. Investigating that “take” on personality is the subject of the next several posts in this series.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.