Tag Archives: talk therapy

Who Do You Think You Are?

The modern paradigm of medical and mental health has a built-in bias for diagnosis, due in large part to its historical interest in isolating and treating pathology of various kinds in the body and mind. A consequence of this bias is that while we can zero in on what’s wrong or not working properly, our understanding of what constitutes psychic (mind) and somatic (body) wholeness is less developed.

Individual sufferers go to professionals for help, many of them privately hoping that their psychosomatic health and quality of life will be elevated as a result. Instead they find themselves subjected to ‘treatment plans’ designed to suppress symptoms of dis-ease rather than actualize genuine wellbeing.

When I was in graduate school for a master’s in counseling I was surprised – and increasingly more aggravated – by the requirement put on students to choose our guiding theory from among current orthodox protocols of diagnostic psychotherapy. As professional therapists we would need to work closely with insurance companies, with doctors who could prescribe drugs, and (of course) with the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) which is continually inventing more categories to pigeonhole the symptoms of suffering among the general population.

Even then it was obvious to me that a concept of ‘disorder’ must presume some deeper grasp on what ‘order’ (aka health, wholeness, or wellbeing) is, but this was barely discernible in the literature and never explained in the classroom. I began to suspect that some larger conspiracy might be directing our training as students and future professionals in the field. As counselors (and not drug prescribers) we could offer short-term talk therapy for clients, but the real money lay in tying client symptoms to more serious disorders with a basis in neurobiology that could justify pharmaceutical interventions.

Now, I’m not denying that some cases can benefit from a combination of talk and drug therapy – although the trend these days is to get patients through counseling and on open-ended prescription medication plans if their symptoms persist, which in 70% of cases they do. Strong research suggests that this rather abysmal success rate of therapy (of either type or in combination) can be attributed not to the particular protocol used, but to the fact that individual sufferers don’t readily take responsibility in the salvation they seek.

And this, in my opinion, swings back around to a diagnostic paradigm that effectively ignores the person and reduces suffering to symptoms seemingly outside the individual’s choice or control.

If we are to take responsibility in our suffering as well as creative authority in our pursuit of wellbeing, we need psychotherapeutic models that envision us as actively engaged in the construction of both suffering and wellbeing. In a sense, that’s what I am working toward in this blog. So it’s in that spirit that I offer another installment on the question of identity and our human journey.

My diagram contains a lot of terminology relative to the construction of identity, but we’ll step through it in a way that simplifies things considerably. Let’s begin at the middle, where the executive center of identity known as our ego is represented. Ego is how we identify ourselves, as the starring actor in a story we’re continually telling ourselves and others – our personal myth. Every myth has a supporting cast of other actors whose importance in the narrative is a function of their proximal influence on matters concerning our need to feel safe, loved, capable, and worthy.

Each of these four feeling-needs (referring not to the fact of our being safe, loved, capable, or worthy, but our need to feel we are such) presents itself at a critical period of our development, in this precise sequence, rising upon earlier ones and setting the stage for those coming later. (As is often the case with my diagrams, information should be read organically from the bottom and flowing or growing upward.)

The four feeling-needs further organize into two broader concerns connecting to ego’s need to belong (or fit in) and be recognized (or stand out) – the two polar drives in our construction of identity. Belonging answers our need to feel safe and loved; recognition satisfies our need to feel capable and worthy.

You can appreciate their polarity in the way they pull against each other: the effort to gain approval (a type of social recognition) often involves a willingness to give up some anonymity (a type of social belonging). Conversely, if our first priority is to hold a position of acceptance (another type of belonging), we will try not to draw undo attention to ourselves (another type of recognition).

In dynamical systems, something called an ‘attractor’ is a recurrent code that draws a system into persistent patterns of organization. In our consideration of the pattern known as personal identity (or the construct of who you are), two polar attractors drive development: at one end is the secure base (an attractor for safety, love, acceptance and belonging), while at the other end is the proving circle (an attractor for personal power, worth, approval and recognition).

Archetypally these correspond to our mother (or mother figure) and father (or father figure), respectively. A number of Freud’s most enduring insights can be liberated from his theory of sexuality and better understood archetypally in these terms instead.

The unique admixture of temperamental predispositions, environmental conditions, and personal life events tends to ‘lean’ our personality more toward one attractor than the other. Even within the range of so-called normal psychology this is the case. A normal well-adjusted personality can value belonging over recognition, or vice versa. The important point is that both attractors and their associated values are critical to our identity and mental health.

What this suggests is that our individual personality can be understood (not diagnosed!) as either security-seeking or esteem-seeking. Identifying more with one doesn’t mean that we have no interest in the other; healthy identity is somewhere in the balance of both. If you happen to value safety and love over power and worth, it may simply reveal that close relationships are more important to you than personal achievements, not that accomplishing things and making progress don’t matter.

You were probably waiting for me to mention this: It can happen that the balance snaps and we get stuck at one pole or the other. Security becomes everything and we end up giving all our energy to pleasing and placating the people we feel we can’t live without. (This is common among children of addicts and victims of abuse.) Or else if we’re caught at the other end, we stay busy trying to flatter and impress others so they’ll esteem us as somebody important and worthy of praise. (This is frequent among celebrities and performers of various kinds.)

The goal of development is to hold the balance and use our stable center of personal identity to leap (or drop) into a larger (or deeper) experience of wholeness and wellbeing. More about that next time …


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Fully Present

Fully PresentIn the Wisdom Circle I’m part of, conversation flows along tangents into topics that interest us or challenge our pursuit of a relevant secular spirituality. Whatever arena we wander into, it’s not just a new perspective we’re after, but some kind of meaningful and responsible course of action. Given such-and-such, what can we do in the interest of greater honesty, integrity, and effectiveness? Our objective in every case is to clarify how a fully engaged spirituality might affect or transform the way we live in this world.

I am reminded of the diagnostic matrix used in conventional psychotherapy for identifying and treating a client’s peculiar form of suffering. Typically a strong and overwhelming feeling of unhappiness is what first motivates an individual to seek professional help, and it’s here that interpretation begins. And as such feeling will commonly exert either a suppressive or compulsive effect on behavior, sapping one’s drive or spurring conduct that only adds to the problem, any counselor who’s paying attention will also look carefully at what the client is doing.

After the linkage between feeling and behavior has been established, the task of therapy becomes one of bringing to light the associated thoughts and beliefs which have the client locked in a mindset that is perhaps irrational, unrealistic, juvenile, or delusional. As thinking provides an overlay of commentary on suffering – adding justification, self-judgment, conspiracy theories, or just more confusion to the pain – it is necessary to get this storyteller out of the closet and into the light of interrogation. It is hoped that by changing up the mental script a client will begin to feel better about things, start acting differently, and thereafter produce more positive results.

In the diagram above, a red line from feeling to doing represents that irresistible impulse to act in ways that perpetuate or amplify an individual’s suffering. The curved green line is meant to illustrate that elevation into thinking which will expose the faulty logic and distorted beliefs keeping it all in play. Higher elevation into thinking involves the individual in more rational reflection and discrimination, where the driving narrative of one’s personal myth can be analyzed, updated, and strategically modified.

In our Western psychology of mental health, these three correlates – feeling, doing, and thinking – form the ‘holy trinity’ of therapy. The better therapies work with all three in a more or less balanced way. Nevertheless, each one has also been favored over the others in the major schools of medicinal (feeling), behavioral (doing), and cognitive (thinking) therapy. Competition among these schools has prompted research into which modality is superior, or what combination of factors represents our magic door to mental health.

Interestingly enough, the research has shown all of them to be about equally effective, and maybe the results improve a little when they are combined in some way. But ‘effective’ here doesn’t mean significantly effective. In fact, they perform just slightly better than placebo and often come with side-effects no one wants. Research consistently bears out the greater influence of another factor, quite apart from the specific treatment protocol: The quality of relationship between therapist and client (called the therapeutic alliance) proves to be the real magic door. Any why is that?

In my diagram, the deeper essence of this fourth factor is identified as the individual’s sense of grounding in a reality that is supportive and provident. Obviously, a therapist (or anyone else) who is welcoming, trustworthy, empathetic, insightful, and encouraging will demonstrate such a reality to the client. The ‘alliance’ part of this involves an individual in gradually calming down, finding ground, getting centered, and opening up to the other person. The more open a client becomes, the more confirmation he or she receives that reality is provident and supportive, which in turn encourages an even deeper release and a larger horizon of faith. This is the dimension of being (be).

This factor of grounding offers a fourth correlate in a more complete picture of mental health and happiness. Changing how we think with talk therapy, how we feel with drug therapy, and/or what we do with behavior therapy is not enough. I have drawn lines from each of these three to the grounding mystery within, because it’s only as they are internally grounded that our thoughts, feelings, and behaviors can be genuinely creative. Otherwise, insecurity will tend to hijack our faculties and generate a delusion of our separateness (isolated, exposed, defensive, critical, judgmental, etc.) – where true happiness is impossible.

You’ll notice that the line between think and be is actually an arrow, from the latter to the former. Because thinking is the mental activity by which we construct meaning and build out a worldview, it is vitally important that its product (i.e., our perspective on and orientation in reality) is properly grounded in the way things really are.

No doubt this reveals my cognitive bias, but enough of my own experience and observation of others has convinced me that until our thinking is reality-oriented and the meaning we construct is sufficiently clear-sighted to acknowledge that the grounding mystery cannot be captured in words or theories, we will tend to become prisoners of our own convictions and fall that much farther out of touch. By the time that happens, how we feel and what we do have been commandeered by a distorted, outdated, and dogmatic orthodoxy.

A human being is a human manifestation of being, an expression of the grounding mystery in human form. The wonderful thing is that each of us can contemplate and release ourselves to that deeper mystery at any moment. Ideally we live our lives as passionate and reasonable people, growing ever more proficient in the skills that help us be successful individuals, partners, parents, community members, and citizens.

The big question has to do with the degree in which we have realized our full potential, evolved our consciousness, and found our way back to the place it all begins, right here and now.

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Posted by on January 22, 2016 in The Creative Life


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