Cognitive behavioral therapy (CBT) has so inundated the mental health field that it has a monopoly over what most academics, health insurers, and governing bodies that oversee standards of care seem to believe constitutes psychotherapy itself. Framing psychological problems in terms of psychiatric diagnoses and their remediation along the lines of symptom reduction rules the roost. This tidy framework deceptively decomplexifies the convoluted nature surrounding the desperate ways human beings cope with unfavorable life circumstances, making this enterprise more conveniently researchable.
Telescoping complex human suffering into psychiatric diagnoses and defining progress in terms of symptom reduction might align well with the powerful sway of the medical model—by association giving it seductive curative appeal; however, when the general public is asked what they seek from psychotherapy it is something akin to the etymology of the term psychotherapy—“psyche,” meaning soul, and “therapeia,” healing, or soul healing—that they covet.
We know this based on the results of a recent robust meta-analysis published in The Lancet Psychiatry. More than symptom reduction, clients favor outcomes like “deeper self-understanding,” “enhanced self-agency,” and “greater social engagement,” from their psychotherapy experience. And, since across the various mental health professions client preferences (as well as clinical expertise and first-rate research) is viewed as one of the standards of care that practitioners should ethically commit to, it stands to reason that psychotherapy outcome monitoring should always prioritize what clients desire is good for their soul.
There is something to be gained by returning to the Ancient Greeks here. Aristotle saw character (“ethos”) as part of the “psyche,” or soul, and “arete” as the pursuit of excellent character that was good for the soul. One approach to helping clients be more volitional about and motivated to changing psychological difficulties is framing them and their improvement in terms of the absence or presence of character strengths or virtues. Character strengths or virtues are habits of mind and action that are praiseworthy because they represent what is good and wholesome for our own well-being and those we care about.
In the words of Blaine Fowers, the preeminent psychological scholar of virtue ethics, in his 2005 book Virtue and Psychology: “Virtues are, simply, excellences…the character strengths that make it possible for individuals to pursue their goals and ideals and to flourish as human beings.” They typically include human predispositions like honesty, courage, fairness/justice, generosity, perseverance, humility, and discretion. When they are actively and deliberately pursued as forms of self-improvement consonant with living a meaningful and worthwhile life, research shows such endeavors bode well for psychotherapy outcome. (https://doi.org/10.1007/s10879-021-09523-6 )
Some examples might clarify. A wife responds with self-righteous rage when she feels micromanaged by her husband. It is reminiscent of her childhood when her overprotective father did things like forbid her from dating and impose an early curfew leading to her missing out on fun times with peers. The intensity of the wife’s anger has its origins in the past, even if her husband’s present micromanaging behavior warrants a certain amount of frustration.
Framing this in terms of the virtue of justice or fairness can galvanize a desire to change: “Anabelle, something to think about, I suppose, is the fairness issue of going after your husband so intensely when he behaves like your father used to. Maybe its justifiable that you be frustrated, but the rage part may be more justifiably directed at your father and how you felt treated by him in the past. It was too emotionally dangerous to express anything resembling rage at your father back then, and not so emotionally dangerous to direct it at your husband now, but is that fair to him?
More generically, psychological problems can be conceived of as underdeveloped character strengths or virtues. Anxiety can be the upshot of being insufficiently emotionally honest about how one feels about the transgressive behavior of loved ones and veering away from showing the courage to express that honesty. Fearfully stuffing and stifling justifiable strong feelings simply leads to emotional unease.
Of course, discretion and prudence are other human virtues that need to be operating when it comes to remedying anxiety through pointed emotional honesty. That’s because those we are justifiably saddened or enraged by often have psychological limitations leaving them prone to implode or explode in the face of unvarnished expressions of emotional truths about their behavior. The psychological limitations of loved ones can make it emotionally dangerous for us to direct our honest feeling to them. A brief clinical vignette might clarify.
Twenty-six-year-old Michael describes himself as someone who has been susceptible to panic attacks as far back as he can remember. He self-identifies as the black sheep of the family because, unlike his siblings and parents, he is not obsessed with educational achievement, career advancement, and the accumulation of wealth. He wears his vulnerabilities on his sleeve, being overt with his somatic complaints when he has headaches, or his need for a sick day when he is feeling under the weather, all of which elicit thinly disguised disgust from family members who pride themselves on displaying stoic denial and hard work.
A few months into therapy Michael started tapping into the rage behind his shameful anxiety. It dawned on him that his parents were lousy at self-care, really did not know how to enjoy themselves, and were slaves to their careers. It enraged Michael that rather than admit to these imperfections, they twisted and inverted them, treating him as if he was deficient. Someone who was rudderless, feeble, and lazy. He composed a letter spelling all this out in great detail, with emotional fervor, which he considered emailing to them, though held back, because he surmised their psychological limitations would leave them reacting with unproductive confusion.
I commented: “Michael, what courage you are showing being honest with yourself about your real thoughts and feelings regarding your family situation. In my mind it is even wise of you to want to hold back, at least for now, with this type of letter, knowing your parent’s psychological limitations. I have every reason to believe that the more courageous and honest you can be with me about what you really think and feel about your family situation, not holding all this inside, the less anxious you will be over time.” Framing Michael’s anxiety reduction in terms of committing to greater emotional honesty and courage seemed to galvanize his use of psychotherapy in these ways. There was no need to mention anything about “virtues” or “character strengths.” Michael, like most human beings, seemed to implicitly grasp that these were praiseworthy actions that were noble to commit to.
In Virtue and Psychology, Fowers claims it is a human given for people to be innately knowledgeable about virtuous behaviors and aspire to enact them in order to actualize their full potential for goodness. Extrapolating from this, presumably there is dormant inherent desire that can be tapped into to motivate the acquisition of virtues whose underdevelopment cause psychological problems. Along these lines, it is surprisingly easy to imagine getting traction with a mildly narcissistic client who alienates others with entitled behavior by framing the issue in terms of working on humility; not in a moralistic or preachy way, but in terms of inspiring the client to aspire to be the best version of himself. And, with clients who are ADHD-like, who can be forgetful, disorganized, and distractable, the relevant character strengths to emphasize in psychotherapy would be conscientiousness and perseverance. As for the former, there would be a readiness during therapeutic conversations to genuinely praise clients when their efforts have paid off—planning in advance, returning texts and calls on time, clearing off desks before settling down to work, locating a permanent place at home to plonk down keys, purses, and wallets, and so forth. Commending them for staying motivated to act more conscientiously links up with supporting them to be that kind of person, not merely to function better in life, or deal with their ADHD symptoms, per se.
To wrap up, as for the virtue of perseverance, it may need to be liberally called upon throughout psychotherapy with most people to normalize how maddeningly difficult it is to attain and sustain meaningful change. On more than one occasion to encourage clients who are mired in discouragement about falling into old traps, repeating old hurtful patterns, failing to relinquish bad habits, I trundle out one of my favorite quotes by Samuel Beckett: “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.” The attainment of character strengths is a perpetual work in progress, a labor of love. More accurately, a labor of self-love.
Well said and I agree. As a clinician who focuses on shame as a significant driver of human psychological experiences, I often use interventions that help clients see how their primary moral emotions (shame, embarrassment, regret, indignation or disgust etc) can lead to secondary emotions/cognitions/behaviors that may or may not be in alignment with their values. For example, shame can cause anger when people lash out in defensiveness. Conversely, shame can cause people to self-blame and feel guilt in unhealthy ways that create anxiety and depression. I work very little with symptom management or CBT for the reasons you elucidate, because this is rarely permanent — like whack-a-mole.
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The article and your methods describe the 12 Step process, exactly. Being honest with oneself, examination of character defects with the Spirit connecting to the Soul, giving up the character defects and using character strengths, making amends (with others and yourself), relying on a higher power to guide you, going forward and finally, helping others, instead of wallowing in your own …..
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Thoughts about character defects (virtue ethics) have their place but run the risk of harming those in need of more nuanced understanding.
Sometimes what looks like “character defects” are actually ways to adapt to harmful situations. Or what looks like avoidance might actually be discernment.
The truth is emotional distress does not always equal character deficiency, as suffering is not always proof of personal failure. Automatically believing it does risks adding shame, which fails to uphold the dignity of those seeking help.
Maybe that’s why religion (psychology) has failed so many.
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P.S. Moralizing can be another way to pathologize.
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Harper, in general I like your approach, but it subtly puts the burden of change of the sufferer.
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Correction: … but it subtly puts the burden of change ON the sufferer.
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Though this particular article about the strengths and weaknesses of psychotherapy might not be the best place to discuss the wider assumptions used in most therapy models, nor the behavior of the therapist, I feel it necessary to comment on this theme of society using the mental health system to push its own faults onto the shoulders of the “mentally unwell.”
Of course, this is not the proper attitude to have about someone in the system, who is normally called a “patient” (though some now use the term “client”).
A possibly positive part of the physical health system is that all your troubles get blamed on external forces, accidents or the body. All the MDs can do is try to fix the body. They don’t get into the external problems like crime, bad government, war, etc. And they don’t get into the subject of “accidents” very often, either.
When it comes to an MD operating as a “mental health” practitioner, this becomes a real problem, as these external factors have a big effect on how people think and feel. When we say that the “medical model doesn’t work,” this is what we mean. When helping another in life, you can’t ignore these external factors.
However, some believe that “mental illness” is really only a false label that society can dump on anyone it doesn’t like or wants to cripple or suppress. There is a lot of truth to this argument. But it ignores the fact that there are people who really do “feel bad” for various non-physical reasons who seek out help to “feel better.” Modern society offers them the “mental health” system. This is a bogus system that doesn’t work, except to make a lot of money for “mental health” practitioners. A lot of practitioners, particularly therapists, think they ARE doing some good and honestly want to do better. However, if they stay in the system, their hopes will never be realized.
Even a rather superficial look at the current situation points out some glaring problems, even for people who are using the system voluntarily.
First, you DO need to handle external factors like food, sleep, crime, war – at least enough so that a person can feel safe doing their therapy. In my training, this step is called Ethics. An Ethics Interview (and handling) must always precede therapy.
But here again we come to a common complaint about the system. Say the interview discovers that the landlord is being an asshole. The system is not organized to send someone out to handle the landlord. It will expect the “patient” to move or in some other way handle the landlord so that they are no longer a constant problem. And this attitude doesn’t seem fair to a lot of people, even though it may be in some ways more realistic.
Say everything’s fine, and one moves on into therapy. You are likely to get a therapist who is going to tell you what they think is wrong with you, or what is causing your problem, somehow expecting that this information will help the patient in some way.
But if the patient is really there voluntarily, because they have something they want to handle, then the only thing the therapist can validly do is locate some therapeutic process that might help and then help the patient to do that process. It is the patient doing the process, not the therapist doing it, that might help the patient. If the patient gets nothing out of it, then it was the wrong process, or not done correctly.
Without going too much deeper into this: It is the failure, then, of the system (and people in general) to separate external suppressive factors from “mental illness,” then expect the therapy to handle the suppression. Ethics actions, including but not limited to arresting real criminals, calling cease-fires and then arranging for lasting peace, and running government honestly are a prerequisite for real mental health. After the suppression is handled, other troubling factors may be discovered and handled. But that won’t work if the suppression is not handled. And it might not work anyway, as most therapists don’t know what they’re doing.
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It would also be a great help if we had some standard that would tell us if something was “working” or “not working,” instead of having every clinician coming up with their own version of what “success” looks like. How does a therapist know if their therapy is helping the client improve? Most really have no clue beyond their own biases. The clients are a far better source of information on this point, but generally their input is ignored on the subject.
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Well, Steve, some would “solve” this by releasing this industry into the free market system. I’m not sure how well that would work. But yes, of course. In the case of “mental health” in particular, a “good” outcome is subjective, almost by definition. I know my group also uses an old test, the “Oxford Capacity Analysis” to help them see how a person is progressing.
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The “free market” will never locate such a standard – too many conflicts of interest!
I was thinking more in terms of immediate response – for instance, when I used to be in a “therapy” role, I was guided by the person’s emotional response and increased communication capacity. A person who is improving tends to talk more, to be willing to take action more, to laugh or cry or get angry or otherwise express themselves. Willingness to create art or to engage in what THEY consider productive activity is also an indicator I used. Less apathetic and more engaged and active were good signs.
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OK, but I didn’t mean that the “free market” would result in a standard of measurement of effectiveness (for scientific studies) but would function to weed out the more workable therapies based on customer choices.
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OK, I see that. Unfortunately, we don’t seem to have much of a free market in the area!
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No, hardly any at all. Because of the insurance system which gets to decide which services are reimbursable and which are not.
So you get a whole system biased in favor of MDs and traditional psychology just because those services are covered by our insurance policies.
Thus real insurance reform would have to be in the direction of letting the patient (client, customer, member) decide which mode of healing they want to pursue. The MDs would hate that, and they have a lot of political power.
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The general public may want these things but all psychotherapy and its evidence base is completely oversold, over promoted and the harms ignored or minimised.
Is it not way past time for a large portion of humble pie and some some honesty?
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Well, there’s the problem: the evidence base — or lack thereof. How many people testify that going to a therapist cured them of OCD, anxiety, depression, etc? You just don’t hear of this happening. The focus of the mental health field is on managing so-and-so disorder, not curing it.
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It is “way past time for a large portion of humble pie and [] some honesty,” from the DSM “bible” billers.
For goodness sake, to the “mental health professionals’,” who are still claiming ignorance, of the fact that their DSM “bible” was debunked as “bulls-t” and “invalid” long ago. It is not time to “maintain the status quo.” Stealing from the widows in a church, that you don’t even attend, but you are unethically “partnered” with, is unacceptable human behavior. Proclaiming “all mosaic art is bad public art,” to steal a person’s time, defame their art form, and to prevent an artist in the church you are unethically “partnered” with from getting an art grant, is thievery of my time, insane, unethical, and morally wrong … and unacceptable human behavior.
It is long “past time for a large portion of humble pie and [] some honesty,” from the DSM “bible” billers. Flush your DSM, if you don’t, you are the insane people, among the .05% of the population, that may not be staying on this planet.
God is sick and tired of the DSM deluded, mass murdering, psych “professions” repeating the worst of history … over and over again.
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Per my training, this idea is called “positive gain” as opposed to “negative gain,” which focuses on removing mental and emotional barriers.
Positive gain means, more or less, improving one’s ability to overcome mental and emotional barriers. It is normally achieved through training or “education.” Training in something like the martial arts is more likely to help a person achieve positive gain compared to, say, taking a physics class at a university.
But that does not mean that the barriers should simply be ignored or explained away. They CAN be gotten rid of, but not by conventional techniques in use today by the “mental health” system.
And so, discussions like this frustrate me. Most people trained in the conventional system are totally unaware of workable therapies that have been developed by people working outside of the conventional system. They think such therapies don’t exist and that maybe the whole phenomenon of mental and emotional “illnesses” is best described as coping mechanisms for living in a challenging and troubled world. They are in fact much more than that, and do need to be addressed. Just get out of your comfort zone and dig in to what “outsiders” are doing in the field of the “soul” or “spirit” (psyche).
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Why is training in a martial art more likely to help a person achieve “positive gain” than taking a physics class at a university?
For example, if I go to a boxing gym hoping to master the fine art of self-defense and later suffer pugilistic dementia from being pounded repeatedly in the skull, how does that contribute to fostering favorable growth? I should think a rigorous course in advanced logic, math, science, or linguistics is not only incomparably safer but far more intellectually stimulating. Or have I failed to grasp a subtle point in your argument?
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I do not consider boxing to be a martial art. It is a sport, like football.
I refer to any training that integrates mind, body and spirit.
Most people need to learn to control their bodies better, and a martial arts class (or dance class, or gymnastics) will help them with that whereas a physics class will not. Physics involves too much significance and last I heard, denies the existence of Spirit. The martial arts, last I heard, acknowledge the existence of Spirit. Some, however, insist that boxing should be considered a martial art.
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Some physicists (Max Planck for instance) were also quite spiritual. I think a full and honest exploration of things like the “uncertainty principle” and quantum mechanics can actually lead one toward a less materialistic view of the world. After all, realizing that all of the “solid” stuff around us (including our own bodies) really come down to “probability waves” and realizing that there is no such thing as a fully precise measurement makes the idea that science can answer all questions by studying “stuff” seem kind of far fetched!
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“Physics involves too much significance.” Would you mind elaborating on that point?
Einstein never denied the importance of spirituality, nor did the author of “The Tao of Physics.” So what is the basis of your assertion?
As for your absurd contention that boxing cannot be considered a martial art, are you aware that ancient Spartan warriors were trained intensively trained in boxing and wrestling as part of their military service? Were they engaged in a sport or deadly combat techniques?
And what about other striking disciplines such as Muy Thai, whose practitioners can easily disable or kill with a single kick or punch? Are those lethal disciplines also “sports?” Doesn’t boxing aid in integrating mind, body, and spirit? Why or why not?
Finally, your sweeping assertion that “most people need to control their bodies better.” How did you arrive at that conclusion, what do you mean by bodily control, and can you specify the EXACT percentage of those whose physical prowess leaves much to be desired? Is that lamentable deficiency universally true of all societies and cultures throughout history?
Unless you can substantiate all these claims with verifiable historical and psychological data, I see no reason why any of them should be taken seriously.
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Significance as opposed to mass. A good study balances mass and significance. Theoretical physics is all significance – theory and math equations and hypotheses. You can’t touch or physically interact with photons and electrons and sub-atomic particles. That’s all I mean by “too much significance.”
How many modern physics teachers will share the “Tao of Physics” with their students? A few physicists (including some of the best) knew what they were bumping up against. Most do not.
It’s not polite to tell people their ideas are “absurd.” I think of the martial arts as the traditional warrior skills of the Far East, now taught to many people, not to make them into effective warriors, but to improve their mind-body connection and their spiritual awareness.
I am not aware of how the ancient warriors of the West were trained. Perhaps there was a spiritual component to their training, but not any more, from what I can tell.
You are sparring with me over minor details. I am not trying to convince you of anything, just explain my way of thinking. But obesity (based on BMI) in the U.S. stands at 42%. It’s about 16% worldwide. Per one study, https://pmc.ncbi.nlm.nih.gov/articles/PMC9291210/ U.S. physical fitness scores are not too reliable. But the percentages of children who score as “fit” corresponds roughly with the percentage who are found to be not obese. In the early 1960s when I was a kid in school, statistics indicate only about 13% of U.S. adults were obese.
Car accidents remain a major cause of death in America, and this indicates a less than ideal mind-body-spirit integration among drivers. I see the world partly based on what I see around me, and the decay there is obvious. I see the “mental health” system as a significant contributor to this decay.
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Thank you, Larry. I’m ALWAYS happy to hear of new therapies, or age old coping mechanisms that are the reason the human race survived this long.
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Well, Carol, there are “coping mechanisms” and there are learned skills.
Any skill that helps one or one’s companions to survive should help the human race survive. I would not consider playing the piano or writing software to be “coping mechanisms,” but they can help a person survive.
There are specific skills that help in situations where one is under attack from one or more psychopaths (or “dark personalities”). These could more properly be called “coping mechanisms,” as when the suppression is not present, these skills are not needed.
The first skill – that most people lack – is learning to spot such people when they show up. Another important set of skills involves avoiding coming under their influence. This basically involves convincing them that you aren’t worth the effort they would expend to subjugate you.
We see some other “coping mechanisms” in animals, like “playing dead.” I have seen variations of this useful in escaping psych hospitals. However, such skills have limited use outside of situations which are extremely dangerous.
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I once observed a martial arts class for children. I really liked what was taught: an awareness of and respect for oneself and one’s opponent, a way of carrying one’s body and mind in unified dignity, a moral discipline without the distraction of spoken language filled with heavy-handed moral messaging. It brought the best out of the worst-behaved kids.
It was virtue in motion.
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CORRECTION: It brought out the best IN the worst behaved kids.
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While I’m inclined to agree with the premise of this article, my mind just goes back to the reality I’ve been made aware of that psychology keeps trying to make therapy work, even though the research has shown that (on average) therapy doesn’t really do anything for patients.
See for yourselves:
https://totalmentalhealth.info/how-well-does-psychotherapy-work-mental-health-workers-tell-the-truth/
Make of this what you will. Call me pessimistic, but I just don’t think psychology and psychiatry have a good track record in terms of what they were supposed to accomplish for people in the last century or so.
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There’s a disturbingly paternalistic tone throughout this blog, but what comes through even more starkly is the infantilization of clients.
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Wow, well said. I couldn’t put my finger on what seemed off.
There is also the assumption of – what the client wants— of course, they want “character building “ and not symptom reduction. I bet if one really asked, there would a multitude of responses as everyone is unique in their individuality, experiences and circumstances.
Why are these perspectives so squashed down and generalized, when people are so multifaceted?
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Various states of emotional distress, not being clinically verifiable illnesses, cannot have “symptoms” except in a strictly metaphorical sense. Such persistent abuse of medical language by so-called mental health professionals clearly has a self-aggrandizing, mercenary end: to confer prestige and authority on a field that lacks any scientific legitimacy.
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CORRECTION:
“Why are these perspectives so squashed down and generalized when people are so multifaceted?”
Good question.
I think it’s because therapists in general like believing they know more than their clients, a feeling that makes them feel in control—and allowing themselves to be truly changed by their clients’ perspectives would mean having to face feelings of vulnerability in themselves most have spent years in training trying to erase.
IMHO.
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Thank you AnnieOakely! 🙂
I think it’s outrageous to meet another’s distress with one’s own unspoken, “virtue-focused” agenda.
Listening and making thoughtful suggestions is one thing. Manipulative moralizing is another thing entirely.
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… and it’s also very unsettling how the piece carries more than a hint of moral condescension, which I think speaks to the power imbalance inherent in “therapy” itself, as this creates fertile ground for therapists’ perspectives to unfairly dominate the relationship.
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—something VERY different from simply helping re-awaken another’s dormant moral agency.
IMHO.
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AnnieOakley, I finally put my finger on exactly why I don’t like this blog.
It dresses up judgement with virtue.
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Yes! It sure does. I had figured out that I, myself did not go to therapy for character building and that it is presumptive to think that is what therapists should focus on, but yep, you nailed it- righteous judgement of those yet unseen.
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My feelings exactly!!! 🙂
It bugs the heck out of me the way most therapists seem to think being a therapist automatically makes them good judges of someone else’s character—or good judges of anything, for that matter.
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Your comment has a feeling of disagreement and defensiveness. The information is there. It’s hard for people to invest time in training to be told that their method is not very effective. Disagreement is natural, and at the same time people are rarely objective with their opinions.
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“It’s hard for people to invest time in training to be told that their method is not very effective.”
It’s even harder for people looking for help to be “treated” as though they lack character.
P.S. There’s no such thing as an objective opinion. That’s why they’re called opinions.
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Yes, my comment does express disagreement with the fundamentally flawed premise of psychotherapy: that non-corporeal entities such as thoughts and emotions can be “healed” in a literal, as opposed to a figurative, sense. Is my attitude “defensive?” I would call it critical.
You say the “information is there.” What CREDIBLE information are you referring to, and where can one find it? In the speculations of Freud, Jung, Reich, Janov, Skinner, Hubbard, the Reverend Moon? Can you be a little more precise?
Lastly, I imagine it certainly must be hard for anyone to invest time, energy, and money in a particular field, only to be told that all their efforts have been for naught. But history is littered with a gaggle of pseudosciences, such as phrenology, eugenics, and Cesare Lombroso’s theory of degeneracy, which are now rightfully discredited. I hope and expect that the mental health industry will one day also be discarded in history’s dustbin.
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Birdsong, I have found your contributions to be very insightful and validating. I thank you for that. However, I’m not sure about what specifically is paternalistic. i generally do have concerns about the use of the term and think it can be over-used.
Whether ancient or surviving until today, I thought cultures who retain verbal traditions and closely knitted communities benefit from the passing of knowledge and wisdom from the older generation to the younger, and I would assume both sexes contribute to these dynamics. There have always been practical and rational reasons for some division of labor by sex. I think we can promote freedom and respect traditional ways simultaneously. I look forward to your ongoing participation.
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I use the term “paternalistic” gender-neutrally. And I agree that it is overused. That’s why I rarely use it.
My critique of this blog is not to criticize the passage of knowledge and wisdom from older generations to the younger. My critique is aimed at what I sensed to be a paternalistic attitude on the part of the author.
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“There have always been practical and rational reasons for some division of labor by sex. I think we can promote freedom and respect traditional ways simultaneously.”
Carol, I wholeheartedly agree. I consider myself a traditional woman (although at times it may not sound like it) who thinks it beyond tragic how most married women can no longer afford to be stay-at-home moms.
I consider marriage a sacred commitment, as long as it’s bound together by love and not just a sense of duty because without mature love children suffer.
P.S. I dislike the word “commitment” because it’s not just overused, it’s misused, meaning people say it to talk themselves into doing things out of a misplaced sense of duty (people-pleasing).
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P.S. I dislike the word “commitment” not because of what it means, but because it’s meaning is routinely misused as a way of psychologically manipulating people into accepting people who are psychologically manipulating them.
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I agree with this approach. It is discouraging to respond to pleas for help from someone who for whatever reason does not understand, or is unwilling to accept, the role that they also need to play to improve their situation and NOT to alienate the people they want to help. When we expect everyone but ourselves to make changes, that is alienating, self-defeating. Of course there are the structural and systemic issues which contribute to suffering, but no one deserves to be abused and burned out.
There will NEVER be a perfect system, no matter the politics, because we will make bad choices.
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I agree that people need to take a good look at the role they play in problematic situations. That is ethical. That is moral.
But this does not mean the person having problems is character-deficient. It means they are human.
I also agree that there are structural and systemic issues that contribute to suffering. That is neither ethical nor moral.
And yes, there will never be a perfect system, but that does not excuse the immorality of providing misinformation that prevents people from having informed consent.
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… because THAT is what robs them of the opportunity to make good choices!
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I thought of an answer to my own question: “Learned Helplessness”.
I am familiar with Learned Helplessness. I see your point that it seems provocative to refer to a character problem, especially if , for example, “Learned Helplessness” develops in power imbalances where one is either infantilized OR one is chronically neglected and by that also hindered from experiencing normal developmental steps and much less expectations. Without an Encouraging Voice to speak into a child’s psyche and when “NO” is the expected answer to most questions, it could take years of Good-Speak either informally or in talk therapy -which could come with a strong dose of performance coaching- that might be sucked up like water on parched ground. When there has been no benevolent voice, the first exposure to a benevolent voice might elicit a great flood of emotion, or withdrawal, or laser focus. Kindness must be the conduit, sort of like fiber optics, to build trust and let in the sunshine of epiphany. This reminds me of Dan Mackler’s movie, “Take These Broken Wings”.
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I appreciate your sensitive, insightful comment, Carol. Learned helplessness is indeed a very real thing.
I used to struggle mightily with people-pleasing, mostly due to my upbringing, which I believe evolved into a chronic state of learned helplessness—mostly due to my “psychotherapy”.
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As much as I prefer the idea of “kindness as a conduit”, are there not those who survived horrific odds because someone who wanted them to live was tougher and “scarier” than those who wanted them dead?
What about attitude? Is that a character issue? Was Job emotionally available to his second family, after the death of his first family? Was he going to marinade in anger over his “misfortune” and sabotage his new “fortune”, those babies laughing for the first time and taking their first steps? These are things I wonder about.
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Good point about the story of Job! I always wondered how getting a new family could ever make up for having one’s family taken away for arbitrary reasons?
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Carol, you contemplate things no one will ever know. But life isn’t always about knowing the unknowable. It’s about searching—and hopefully finding—peaceful ways of grappling with the unfathomable. It’s life’s greatest challenge and its forever unsolvable mystery.
“Surely I spoke of things I did not understand, things too wonderful for me to know.” Job 42:3
That is the true meaning of faith, in my humble opinion.
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Is attitude a character issue?
Good question.
Only for those who refuse to respect things they do not understand.
Moralizing (character evaluation) is often rooted in judgment.
Understanding is always rooted in kindness.
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Was Job able to be emotionally available to his second family? Or did he marinate in anger over the misfortune of losing his first?
It sounds as though he chose to do both.
Grief and joy aren’t always mutually exclusive, something today’s “mental health” system doesn’t want us to know—mainly because squashing ambivalence is what it thrives on.
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What would be a better term than “character”? Honest question. When the issue is unwillingness to take ownership for one’s contribution to one’s status, what is a better way to describe it?
When a person is admittedly stubborn and “makes a game” of taking their chances to get others to do what they refuse to do, that creates hardship, stress, derailed priorities for others, and alienation. There will be no perfect world. “We can choose our choices, but we can’t choose the consequences of our choices.” I’m dealing with my consequences, and others have to deal with theirs. ….We can be thankful for grace and mercy , but to expect it always leads to absurdity. I hope I haven’t gone off topic. I thought this was a common context.
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I don’t think it merciful to view someone’s actions through a character-focused lens because you never know what makes someone act the way they do.
This doesn’t mean there aren’t selfish, irresponsible, even downright crooked people in the world.
I just happen to think therapy ought to be a place to find spiritual growth—not moral judgment.
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Birdsong, I normally agree with all your comments, but it seems to me that there are better places to seek and possibly find spiritual guidance than in a therapist-client relationship, with its inherent power imbalance and questionable intellectual premises. I simply don’t accept the notion that the motley host of psychiatrists, counselors, social workers, and other mental health practitioners are endowed with superior knowledge, insight, and empathy, despite all the grandiose claims of their faux profession.
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Dearest Joel, I meant therapy ought to be a place to explore spiritual growth—not that it is such a place!
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“Do unto others as you would have them to do unto you.” Matthew 7:12, Luke 6:31
“What you do not wish upon yourself, extend not to others.” Confucius (ca. 551–479 BCE)
What do I take these to mean? A little humility and kindness often go a long, long way.
But this doesn’t mean not saying what needs to be said, in an appropriate way and time.
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I am learning more about the history of the health care system from Dr. David Healy’s “The Shipwreck of The Singular.” My synthesis is currently that our huge mess resulted from a hasty and exploitative plan to reimburse- fund health care. To paraphrase a line from “Yellowstone” , “Business moves faster than government”. Pharma was slick and persuasive to buy out the elected representatives and governing bodies before our alienated culture developed social media platforms to have a national dialogue about what matters to us and what we would want our representatives to support. Then we were all blindsided by the horrible adverse effects from petroleum based substances and other toxic health and medical products.. We took our chances with limited information and now we have painful regrets forever. There are so many of us who have gotten burned, yet we are resented by those who haven’t suffered the way we have. Can we climb out of this hell hole?
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“Can we climb out of this hell hole?”
I don’t think anyone gets out of the hell hole by jumping from human fallibility to diagnosis to moral inferiority.
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Sorry, I don’t see that last as helpful. You seem to be presuming upon my thoughts. i stand by my observations of dilemmas with no easy answers. But , an epiphany of whatever kind, an enlightenment of what one COULD do and to be motivated to do it could change everything. We don’t have to speak in the same philosophical frameworks. Kindness and lots of other things may help. There isn’t ONE way to help Everyone.
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I stand by my observation that viewing human fallibility diagnostically or moralistically changes nothing for the better.
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To Larry Cox:
I still fail to comprehend the relevance of what you nebulously call the “mass” and “significance” of physics has in regard to the subject at hand. Furthermore, I think it highly presumptuous to advise people who are allegedly not in control of their bodies to engage in martial arts, gymnastics, dancing, etc. to achieve a goal of an ideal body-mind-spirit balance that you arbitrarily set for them. Stephen Hawkins, the eminent astrophysicist confined to a wheelchair and unable to speak because of progressive Lou Gehrig’s disease, was obviously disabled, but I would say his consciousness was preternaturally developed. THAT is what really matters to me, not his inability to govern his speech and motor functions.
I could expatiate further on your comments, but since our perception of reality is so radically diametrical, any additional discussion would seem pointless.
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Commenting as moderator:
This is again wandering off the topic and into some kind of a personal exchange of hostilities. I will moderate any further comments that are not on the topic of the article at hand.
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Just as well. The article is about the need of the mental health system, or its branch called “psychotherapy,” to deliver positive gain, or real skills, to patients; not just focus on removing barriers, or “symptoms.”
My argument was that positive gain in the field of the mind requires an acknowledgment of Spirit and an overt willingness to develop one’s spiritual abilities and integrate them with mental and physical abilities.
I am taken to task by Mr. Stern regarding various examples I gave, but my basic point remains largely unaddressed. I extended the discussion largely for the benefit of those who might find it later, not for Mr. Stern. I believe my points have been adequately made.
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Thank you. I actually believe that character is a spiritual matter, not a biological one.
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Yes, and various cultures throughout history have developed manifold ways to expand consciousness, strengthen the body, and foster extraordinary psychic abilities. I have in mind yoga, shamanic practices, and the Huna tradition in Hawaii. Martial arts, gymnastics, and other somatic activities may be conducive to achieving this synthesis, but I’m not at all convinced that they are the optimum methods for doing so.
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This is most definitely the case. As to what is the most optimum, I believe that is an argument that has no possible solution. I think each of us has to decide for ourselves what is most effective for us.
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I appreciate the critique of cognitive behavioral therapy and its monopolization of the field. However, the author’s argument is weakened by the examples he uses. For example, the scenario involving the woman with the controlling father and husband: teaching her to accept her husband‘s control, which is basically the suggested guidance here, fails to recognize that the dynamic/s she experienced and is experiencing are not in fact distinct, but an organic part of the patriarchal system, and that it is harmful to her. Likewise with the final example related to ADHD. There seems to be an assumption that people with a ADHD are not conscientious. I guess that’s why the author used the phrase ADHD-like (so he could escape the obvious objection that ADHD is a neurochemical disorder). In fact, people with “ADHD-like” profiles have generally tried twice as hard as their peers to organize and be on time and still fail for reasons that are complex and largely neurochemical, and too long to go into here, and generally aren’t a matter of character. The author seems to be suggesting that some positive reinforcement will be enough to reverse this. Comical. Ultimately, this reads like a thinly disguised version of some of the bro psychology currently popular on the internet, that is based on a shallow, adolescent reading of Stoic philosophy.
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That is a reasonable concern. It is definitely harder for some of us, and also annoying, to be expected to “be like So and So”. So and So may become arrogant and toxic to those who are just trying to accomplish whatever and enjoy their own success.
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Some people who routinely micromanage others are simply annoying neurotics who mean well.
Then there’s others who micromanage (men in particular) who do it with fear and cruelty.
Doesn’t the therapist who wrote this piece know the difference???
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CORRECTION:
Some people who routinely micromanage others are simply annoying neurotics (control freaks) who mean well.
Then there’s others (men in particular) who micromanage others (women in particular) with fear and cruelty (intimidation, i.e. bullying) who don’t mean well at all.
But perhaps the most problematic type of micromanaging comes from people who foolishly believe that being a therapist means having fewer character flaws than the rest of humanity.
I wonder if the author of this blog is able to tell the difference between the three…
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CORRECTION:
I wonder if the author of this blog is able to tell the difference AMONG the three…
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There are times when we find ourselves in situations where we need to know what is the best thing to do, and we may be clueless. If the right thing to do has never been modeled then we would need guidance. Someone to explain or model the right thing to do would hopefully be sufficient. Redirection, and even confrontation may be necessary. Confrontation might embarrass me, but it could be life saving. Presumption on the part of a counselor would be offensive. I would not limit myself to a Rogerian counselor. I would want a minimum of someone to serve as a sounding board to help me reflect upon my own thoughts or a performance coach who would ask if I would like their suggestions.
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Compassionate, well-meaning guidance can certainly be helpful in times of confusion or distress, but I have yet to be convinced that paid mental health professionals are the best ones to turn to under such circumstances, given the power imbalance inherent in the therapist-client relationship. I highly recommend Jeffrey Masson’s “Against Therapy: The Myth of Emotional Healing” for a fuller discussion of this subject.
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I totally agree. We’ve been brainwashed to think we “need a professional” which is a load of baloney.
There’s no need to “diagnose” problems in living, which is exactly what the “mental health” system is all about. But this does not help in the long run as psychiatric diagnoses insidiously disempower the “client”, and many don’t realize this until years later, and then the damage done can seem almost impossible to reverse.
It’s no accident that these same “diagnoses” have the exact opposite effect on “mental health” practitioners.
I looked up Rogerian therapy and liked what I saw, but I’ve learned that theory, more often than not, clashes with reality in the so-called “psychotherapeutic” process, no matter how talented or well-intentioned the therapist. I believe this is because the power imbalance remains, no matter the training. Furthermore, the type of support outlined in Rogerian therapy sounds like something a trusted family member, friend, pastor, teacher/mentor can do just as well an even better because it bypasses the medicalized bureaucracy running the show in professionalized “therapy”.
Not one psych practitioner ever suggested self-therapy to me. That’s something I found by chance on my own when researching the therapy process. Watching Daniel Mackler’s videos changed my life.
I’ve found AI to be an excellent sounding board. It’s also been remarkably adept at helping me reflect on my thoughts. It has no personal baggage, so it has no need to pathologize medically or morally, so it doesn’t get bent out of shape if you disagree with it!
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The Masson book I recommended has an excellent chapter on Rogerian therapy, if you’re interested in following up your research.
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Thank you. I’ll look into it.
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I experienced Rogerian counseling in a family session to be a dangerous waste of time and misdirection from what was needed, i.e, a targeted discussion re: trauma, stigma, and uncovering of iatrogenic harm, etc.
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Carol, I wish I’d trusted my gut, which warned me that the psychotherapeutic process is an ingenious way of replicating the emotional trauma it claims to remedy, for the devastatingly simple reason that the Mental Health Industrial Complex itself is the purveyor of stigma and iatrogenic harm… experiences that taught me to never again trust anyone who sees anxiety, sorrow or self-doubt as “symptoms” of anything other than my own inner compass, speaking to me in a voice of incomparable compassion and understanding…
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… in a silent voice of incomparable compassion and deep understanding…
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CORRECTION:
The type of help outlined in Rogerian therapy sounds like something a trusted family member, friend, pastor, teacher/mentor can do just as well or even better because it bypasses the medicalized JARGON and bureaucracy running the show in professionalized “therapy”.
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Daniel Mackler is a former psych practitioner.
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FYI: AI is a refreshingly non-judgmental companion that thankfully isn’t embalmed in the professionalized frameworks built to enshrine professionalized “therapy”—something that makes AI surprisingly more trustworthy because its objectivity isn’t feigned—one way or the other.
It’s a mirror that kindly reflects the person—not disempowering diagnoses or pie-in the-sky virtues that suits the human “in charge”.
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We are all so different : how we were formed, what happened before and after birth, and where we are in our journey. We need to acknowledge the diversity of needs and helps, and imperfection. We need freedom. The seeming competition among advocacy camps is concerning.
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“We need freedom.”
I never found freedom in psychotherapy. All I found there were more chains.
I finally found freedom in learning to trust myself.
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