The Myths of Psychotherapy

(3 minute read)

Every industry has its Super Conference, the one where everyone who is anyone turns up, gives a speech or has a booth. Psychology’s Super Conference is called the Evolution of Psychotherapy. I was there in California in December 2017 and saw the great and the good (and some of the not so good) of the Helping Profession. And psychotherapists, like everyone else, are susceptible to hero-worship: the line outside the auditorium for autographs from the keynote speaker snaked out of sight even while he was still speaking: it seems that many therapists valued his signature more than his words.

Just because someone is well known and gets to speak at a conference like this doesn’t mean they’re right. The best and the brightest of their age have at times believed the world is flat, illness is best cured by draining the body of blood, the sun circles the earth and mental illness should be treated by sticking an ice pick above the eye to destroy brain tissue. (That’s called a frontal lobotomy, and the inventor, Egas Moniz, received a Nobel Prize in 1949 for his work, before being shot and paralyzed by a dissatisfied patient.) Proponents of these and other theories no doubt presented at the Super Conferences of their day. Here’s a bio of one of the presenters in 2017: I’ve read this a dozen times and still have no idea what it means:

“Ernest Lawrence Rossi, PhD in Clinical Psychology is internationally recognized as a gifted psychotherapist and teacher of innovative approaches to understanding the theory and practice of the quantum qualia of consciousness and cognition for facilitating gene expression and brain plasticity to optimize human performance, stress reduction and well-being in everyday life.”

The Conference also taught me how hard it is for bad ideas, once rooted in common ‘wisdom’ to be discarded. While some presenters spoke of decades of research on psychotherapy that show no school of therapy outperforms any other school when it comes to making clients feel better, others happily promoted their own school as The Answer. Martin Seligman, who is well known to students of psychology as the person responsible for the theory of Learned Helplessness in the 1970’s has developed a school of psychotherapy called Positive Psychology. He presented his theories to the 7,500 participants at the conference. Now, Positive Psychology has lots of things to recommend it, and lots of nice techniques (like writing down three good things that happened each day, or continually expressing gratitude toward others). But Seligman himself said “This therapy works as well as Cognitive Behavioral Therapy.” Not better. Just as well as.

And there’s the bad idea that permeates the world of psychology and beyond that, western culture: The belief that somewhere out there is a treatment, a school of therapy, a set of techniques, that is the magic bullet for what ails us.

The truth is that what makes therapy work is the same across all different kinds of therapy. These are called the Common Factors. And that’s why Seligman’s Positive Psychology works no better and no worse than Cognitive Behavioral Therapy, or Solution Focused Therapy, or Emotion Focused Therapy or any of the hundreds of other schools. And what are those Common Factors that are found in all therapies? There’s some debate, but all psychologists who study this would agree on the following four:

• Relationship with the therapist. In the presence of someone we trust, respect and like, and who accepts us for who we are, we are often able to change ourselves. This is the single most important factor in therapy.

• Hope. When we’ve lived with anxiety, depression, poor relationships, etc. for many years the flame of hope flickers. A therapist who is undeterred by our problems, who remains optimistic that we can be happier and who has seen it happen before, can make that flame burn steady and bright. And belief that we can do something is the first and most important step to actually doing it.

• An explanation for our troubles that makes sense to us. If we think we’re too negative, then Positive Psychology might seem sensible. If we believe we’re still caught up in our childhood trauma, on the other hand, we are more likely to want to explore our pasts to understand and deal with the effect on our lives today. The explanation can only be ‘true’ if it fits with our view of ourselves and our world.

• A treatment plan that makes sense to us. Regardless of whether our therapist is asking us to write down our thoughts, or talk about our past, or approach a situation that makes us fearful, those treatments need to make sense, and to fit with the explanation of our troubles.

What does this mean for you? If you’re considering therapy, don’t be swayed by news reports of the latest fad touting the newest Martin Seligman with his or her terrific, new, shiny school of therapy. It won’t work any better than any of the other therapies that have been around for decades. Instead, find a therapist who you like, trust and respect, who makes you hopeful, who has a sensible theory for why you’re suffering and a reasonable plan for making you feel better.

And definitely don’t see any therapist if you can’t understand their biography.