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The Therapy Delusion |
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The Therapy Delusion |
by Bryan Knight
The delusion is that any particular psychotherapy is based on fact, not metaphor.
All psychotherapies can be reduced to these four equations:
Where:
In other words:
Whichever of the 400 or so psychotherapies you choose you can be sure there is a Ritual involved.
Three examples:
The Ritual of classical Psychoanalysis consisted of:
The Ritual of Emotional Freedom Techniques [EFT] consists of:
The Ritual of Hypnotherapy consists of:
All three therapies (and all others) are preceded by an Explanation.
This Explanation may be offered directly to the client or patient or it may be implied. Books, movies, plays, TV and the Web frequently provide cultural expectations of what to expect in a therapist’s office.
These expectations coupled with the relationship of therapist and client (arising from the 4 equations) are what bring about change. [This special relationship is also known as “Psychotherapeutic Eros”]
The Explanation rests on a Theory.
In the case of psychoanalysis it was theorized that free association (letting the patient talk freely about whatever came into her head) would eventually help to resolve inner conflicts among her id, ego and superego.
In the case of EFT the theory is that there is an imbalance in the energy that runs in the client’s body through a bundle of meridians.
In the case of hypnotherapy the theory holds that the client is basically ruled by her subconscious and that hypnotic techniques provide her with direct access to her subconscious mind.
No meridians, ids, egos, superegos or subconscious** minds can be seen under a microscope. In other words, they don’t actually exist. But believing that they do – or at least behaving as if they exist – encourages Belief.
And with Belief we have the beginnings of successful psychotherapy. Because the fascinating fact is that Belief in any particular Ritual can bring a successful result.
In other words, the ritual itself is therapeutic because the client or patient, and often the therapist, believes it will be.
Let’s look at another therapy: Rogerian. In contrast to classical psychoanalysis, the client faces the therapist. Whatever the client says is fed back to her in similar words thus demonstrating the therapist’s understanding of the client.
‘Unconditional positive regard’ is a key element of the Rogerian Ritual.
The theory underlying the Ritual of Rogerian discussion is that inner strengths in the client will be fostered as long as the therapist continues to reflect the client’s words to her while at the same time displaying total acceptance of her as a person.
Another example of the 4 equations is EMDR. [See EMDR®: Hypnosis By Another Name]
Is CBT [Cognitive Behavioural Therapy] different? Clearly, when CBT works, change in thoughts and behaviours is real, not metaphorical. But what enables one client to benefit from CBT and another not? It’s the 4 equations herein presented.
**Donald Robertson answers the question: Is there actually such a thing as 'the subconscious'?
"I don't think so. The use of this term, in fact, really highlights
one of the major problems in the field of hypnotherapy. This concept
was not used in the original hypnotism of Braid, Bernheim, et al.,
and was only imported later by Pierre Janet -- and 'the unconscious' by
Freud and his followers. It's a slightly metaphysical and
pseudoscientific concept that isn't normally used in mainstream
psychology, having fallen out of fashion about half a century ago.
Hypnotherapists often incorporate elements of seriously outdated
psychological or psychotherapeutic theories into their work. They do
this simply because they tend to attend courses which steer them away
from modern research and toward slightly cultish or fadish 'pop
psychology' approaches such as NLP, or toward very old books written
before the 'cognitive revolution' in psychology penetrated
psychotherapy.
Obviously, there are things which we are not conscious of at any
given time, and things which we cannot easily be conscious of, such
as certain internal processes of our body and nervous system. It
seems clear, though, that people don't just mean 'brain'
by 'subconscious mind' but something much more speculative.
Conveniently, the subconscious mind ends up being defined as
a 'realm' which can contain almost anything and which can be directly
observed by neither therapist nor client. Unsurprisingly, therefore,
it has become a magnet for pseudoscientific theories.
They say that
flawed theories often collapse under their own internal
contradictions. Freud thought the unconscious was the seat of the
Oedipus complex, Adler thought it was the inferiority complex, Jung
the archetypes, Klein the internalised breast, Rank thought it stored
birth trauma, etc., etc. Therapists of all persuasions used it as a
repository for whatever they wanted to project into it -- because
nobody could check.
There are, in fact, many different conceptual problems with
the 'subconscious mind.' (The subject of my master's dissertation!)
So perhaps the simplest point to make is that it's fallen out of use
as a concept in most modern psychology, and has been replaced by
reference to specific non-conscious neurological processes, etc.
To pick just one of the issues at stake, however, for anyone vaguely
interested in philosophy of science... Aristotle warned nearly 2,500
years ago against the tendency to take "potential' entities and treat
them as 'actual' ones - a common fallacy in primitive science.
When
Freud and many hypnotherapists talk about 'the unconscious mind'
or 'the subconscious', they are often simply referring to the
potential that a person has to experience certain emotions or
memories, etc.
If I am 'regressed', for example, and recall an event
in childhood, the hypnotist often says that it was stored in my
subconscious mind. The appeal of that is that it's close to a figure
of speech we use in ordinary language. However, even in common
sense 'folk psychology' people also recognise that by 'stored' they
often mean that traces or ingredients of an experience exist which
are reconstituted at a later date.
The memory or emotion could be
stored, in other words, in the same form (like a picture in the
attic) or in potential, in another form (like music stored on a hard
drive). It's generally recognised now that when people try to
recover memories they usually embellish them. The more vague or
distant the memory, the more embellishment that occurs. That's
because we're not simply 'uncovering' a picture in the attic, but re-
assembling it from a few ingredients each time we re-experience it,
and filling in the gaps with guesswork.
If we think of potential memories or emotions as being 'hidden'
inside the subconscious awaiting being uncovered then we're usually
led into many other similarly false conclusions about the nature of
human experience and psychotherapy.
For instance, if we think
of 'repressed emotions' as lurking hidden from view in the
unconscious mind then it encourages the notion that 'venting' them
should be therapeutic, a notion which makes little sense if we think
that potential emotions don't actually exist except in the form of a
predisposition to respond under certain circumstances. In fact,
there's a general consensus among researchers that 'venting' is of
little long-term therapeutic value, and trying to 'vent' anger often
makes it stronger, rather than purging it from the mind."
Donald Robertson
College Principal & Executive Director
Senior Clinician Hypnotherapist (NCH)
Registered Psychotherapist (UKCP)
Member of the European Register of Psychotherapists (ERP)
Fellow of the Royal Society for the Promotion of Health (RSPH)
The UK College of Hypnosis & Hypnotherapy Ltd.
A great historical example of therapy delusion was published in The Skeptical Inquirer November/December 2012": The now near-dead therapy of Phrenology was exposed as "hugely influential despite being totally invalid."
"Is psychotherapy going to POT?"
We know that belief is a huge factor in therapy and a good convincing pre-talk is central to belief and ultimately change, even though the "Explanation" may be flawed. I do like the sub conscious - conscious model of the mind, and I also like the longer gentle inductions (Rituals) rather than the rapid or instant type, and I know that my clients enjoy them as part of my process. (I have occasionally used rapid or instant when appropriate however)
The thing that struck me most was the direct parallels with religion. Your equation could work equally well for most religious practice. On reflection of my own experiences with religion, the Explanation and Ritual were never well enough presented to engender, in me, a Belief.
So in religion and in therapy one has to be very convincing to achieve results.
Regards
Daryl Wilkinson
http://www.stressfree.com.au
"Your Belief is Your Reality"