This is an interesting topic regarding psychotherapy that I actually don't think I've written about much lately on FPL, although it is a subject I certainly have talked about and thought about quite a bit.

In an editorial piece in the New York Times called "The Wrong Type of Talk Therapy," a psychologist, named KEELY KOLMES, worries that "consumer review sites like Yelp have the potential to harm both the provider and the patient" when it comes to reviewing psychotherapy.

How, or why, you might ask?

Well, according to Kolmes, because "psychotherapy services are special. If you wait an hour for an appetizer, chances are that other diners will have a similarly bad experience. But unless a therapist regularly falls asleep during sessions, patients’ experiences in psychotherapy are more subjective. A certain treatment might help one person but not another. Something that works for one patient at a particular point in therapy might not work for him later, when his needs change. What makes one patient upset enough to write a bad review might not bother — in fact, might even help — another."

Kolmes raises two good questions, questions that I grappled with a lot in the 1990's when my own private practice as a therapist really expanded into a full-time endeavor:

1. Can a patient objectively evaluate their own experience in therapy?

2. Why do some patients progress significantly in therapy while others do not?

Regarding the first question, I would have to say, ultimately, yes, a person in therapy can reliably evaluate their experience, but... it's complicated.

More people quit therapy than go the distance with it. Meaning a significant number of people jump ship on their healing process before they've gotten down to the core of their issues and really freed themselves up emotionally, psychologically and physically. Resistance is a powerful force, and overcoming it enough on a consistent basis to cross the barrier into self-actualization is a Herculean task at times. Of course, the pay-off is always worth it, but you don't totally know that for sure while you're in the midst of the painful excavating that is true healing.

When people quit therapy before they're "done," true, they often will rationalize: "It was too expensive." "I feel better spending the money on a trainer at the gym." "I just need to change jobs or move to a warmer climate." And yes, sometimes: "My therapist didn't really understand my problems."

But here's the thing - sometimes therapists suck! And not just the ones who fall asleep during sessions. Far too many therapist's egos are so involved in either "saving" their patients and/or feeling superior to those who seek their guidance, that said therapists cannot be the clear, empathic mirrors and guides their patients need (Both of those negative intentions, by the way, are for the purpose of artificially boosting the therapist's own flagging self-esteem)

And patients know the difference between their own rationalizations and the reality of having a problematic therapist... even when said patients are running from their own healing process.

Throughout my years of private practice, I would have to say that 80 to 90 percent of my patients had previously been in psychotherapy, or some other kind of healing process, with another practitioner, some for several years. They were coming to me because either the previous practitioner in question had unworked-on issues that interfered with the therapy. (Yes, patients know when you haven't done your self-work.) Or the patient had gone as far as that therapist was able to take them on their quest for self-actualization. (Yes, sometimes patients have a higher capacity for self-actualization than their therapist.)

Onto the second question: Why do some patients progress significantly in therapy while others do not?

This was a conundrum I pondered a lot back in the 90's. If similarly dedicated patients, with similar histories, working with the same therapist (me) were engaged in treatment for a similar length of time, shouldn't their progress be similar? You'd think so, but it's not so. Some really moved forward at a fast clip, some moved forward at a snail's pace and some didn't move at all.

Just as I was finally arriving to a conclusion that there must be a spiritual/energetic component to a person's personality that was determining the pace of their evolution, I came upon a book, "Upcoming Changes," by Joya Pope, that beautifully illuminated the answer, what she called, through channeled information, to be "Soul Ages." It was a revelation for me. The proverbial light bulb went on.

The descriptions in Pope's paradigm were so clear, and so clearly an answer to my questions about what can make one person so different from another in spite of apparent similarities in circumstances. I highly recommend reading these passages in case you also are wondering why people in your life seem to behave so inexplicably.

Anyway, folks, if your therapist falls asleep on you, and he or she is not employing a paradoxical technique, you might want to get a referral.

1 comment:

Jason Loffredo said...

Well, the fallacy of the review doesn't just apply to Therapy! In my business it's par for the course. A show gets a bad review, but sells like hotcakes. A show gets a good review and closes in a month. I've been to shows that got amazing reviews and didn't like it and I've also been to shows and thought I was seeing the greatest show to hit New York only to realize the public AND the reviewers all hate it! I guess that's art.

...which leads me to believe that Therapy is more an art then a science.


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