by David M. Pittle, Ph.D., M.Div.
There is only one justification for any psychotherapy: the well-being of the client or patient.
Proclaiming a preference for Transactional Analysis, Reiki, EFT, Gestalt therapy, Group Therapy or Hypnosis as the focus of all one's psychotherapy work is a malpractice. Each client/patient is a unique individual. While it is true that people do tend to have commonality, each one has peculiarities, needs, tendencies that are different from others.
Because of all this, a therapist, to be good, must always be learning new approaches, new tools, new ideas and becoming good at them. A competent therapist must have a toolbox with many tools appropriate for different folk with different problems.
You are unique. Sure you are similar to other people. You need food, shelter, sleep, sex like everyone else. You are just beginning to think seriously about a long-term romantic relationship. Your cousin is seriously depressed. You have a mother who has just retired and doesn’t know what to do with the rest of her life. Aunt Nadine is already retired, but has just discovered the well of sexual feelings as she transitions into a new retirement community. Treating all these people alike, even if they had the same symptoms, should be malpractice.
Here a few of the unconventional tools that are or should be available.
The body-mind connection.
The trouble with the phrase, mental health, is that so much of our emotional dysfunction begins in the body, or stores itself in the body. We all know someone, or ourselves, who stores hurt in her neck muscles. It is commonplace to recognize that stress leads to excess stomach acid and heartburn—and maybe ulcers. But it goes much further. We can put our pain into our chest, our legs, our abdomen; and certainly our backs.
The reverse is also true. Living with physical pain also brings disabling emotional pain.
I am certain that many, though not all, of our negative emotions are triggered by what we think and believe. That’s why REBT and Cognitive Behavior Therapies work well to resolve so many of our emotional symptoms. But failing to deal with the source of our errant beliefs means that we will be prone to repeating the problem.
Why do we wear clothing?
There are several reasons. We use clothing to protect ourselves from the weather. Even in Northern California, we sometimes have less than ideal weather despite the Chamber of Commerce claims of otherwise. We also wear clothing to protect our bodies from physical dangers. Just as we use work gloves to protect our hands, so we need shirt and pants or skirt to keep hot grease from burning us when cooking. Maybe even use an apron.
But the most common reason we wear clothing is to hide the truth of who we are, project a partially true or false image and to armor ourselves from fully sharing our emotions. If I put on a suit and tie everyday as I go out to be a salesperson, eventually I may begin to see my identify as one who wears a suit and tie. So not only is our clothing armor against sharing with others, it also may become armor against our own awareness of our emotions.
There is ample research evidence that children who live in families which are comfortable with and practice social nudity have better levels of self-awareness and self-esteem, but equally, they are less susceptible to the blandishments of advertising that uses physical beauty to sell cars, beer, skin products and so on. Since they watch how bodies change with age, they are more comfortable with the aging process. Some studies followed them into adulthood and found more stable marriages and more realistic relationships.
It is good psychotherapy, with certain people, to recommend that they use nudity for self-discovery; to do this either at home or in session with the help of the psychotherapist.
(Let me be absolutely clear. Our culture tends to associate nudity and sex. They are neither the same nor necessarily associated. However, there is never a good reason for a psychotherapist to be sexually involved with a client—just as there would not be for a physician. In fact there are good reasons why this should never happen. Speaking technically, there is a phenomenon of “transference” and “counter-transference” that prevents a clear, honest and straightforward relationship. The second reason is that there is not the minimum requirement for ethical sexual relationships: a roughly equal power dynamic that can lead to consensuality.)
Children, at a very early age, make a "decision" about how to live their lives. As strange as it may sound, a child of three to five or six, operates on the basis of very little real information about the world. However on that small amount of information, she has to decide how to survive despite not having the intellectual skills to make a good decision; how to influence parents and other adults to support her. Most people continue to operate with that decision throughout their lives. Yes they do get more sophisticated, but we continue to view new information through the lens of our childhood mind.
REBT/CBT suggests that our beliefs are the source of most of our emotions and disturbances. A person believes that they absolutely must be perfect or they are simply worthless. (There are about 10-14 basic beliefs that get us into trouble. The common thread is the presence of a "should", "must", "absolute", or similar feeling, if not those words.) By adulthood, one would think that we would overcome this mustiness, this absoluteness, but we often do not. I watch people who intellectually understand that it will not be horrible if they make a mistake; it may be damn inconvenient, even very bad, but they needn't be filled with horror; yet they continue to hold onto the fear of horror feeling despite the evidence.
If the young child, makes the decision that perfection is the only route to survival, then all future evidence will be filtered through that lens. Helping the adult to understand their childhood decision and to make a new one based on the evidence, is often a key to the changes that are needed.
To redecide, as an adult, how to approach the future can help create a whole new approach to life and help the client to appropriate more rational beliefs.
The new drug scene.
For many decades, we have been subject to some problematic approaches to psychoactive chemicals. The law divides drugs into five “Schedules”. For more description you can go to the DEA.gov website. Suffice it to say that while some of the drugs being controlled may have potential to cause addictive harm, many of them are not addictive and are there for reasons that have proven false. The idea that alcohol is not a scheduled drug while marijuana is remains ludicrous. The other effect is to prevent research into potential uses of scheduled drugs.
Recently, after years of effort, some medical research efforts have succeeded in testing the use of psilocybin and psilocin (The active contents in so called “magic mushrooms.) in treating depression and anxiety. Harvard Medical School, Johns Hopkins and Stanford School of Medicine have each received permission to purchase and use these drugs for testing. Each of them has had excellent results, far better than the results of the commercial anti-depressant drugs on the market and with far fewer to no side-effects.
But not only psilocybin mushrooms, but LSD and MDMA have had recent research pointing to their use in psychotherapy as well as for spiritual purposes. The research is always hampered by the application of the Nixon era drug laws. (Up until this time in 1970, drug laws were directed to taxing substances, not prohibiting them.)
Of course, millions of people have been illegally purchasing and using these substances with positive effect.
This is another area where future psychotherapists will have a useful tool in helping people. It is not now possible to prescribe, even for physicians. But I’m hopeful that in the future it will be.