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by Cynthia Van Nus, A.C.S.W.
Today you cannot help but notice the tremendous increase in the public's
interest in finding the solutions to problems of human nature and daily
living. All you have to do is to turn on the TV to listen in on literally
hours of talk show hosts (esses) interviewing countless people coming
out of the closet about their deepest, most personal pains.
These interviews all seem to sound alike with nearly practiced crescendos
of anger, tears, and outcry orchestrated between the host, the guests,
and audience to create the maximum agonizing effects. Problems of incest,
cruel and inhuman child and spouse abuses, sexual dysfunctions and bedroom
matters of all kinds, parent-in-law conflicts, infidelity--all are revealed,
bar none, to the entire nation's viewing audiences.
You see many other sociocultural evidences of the public's interest in
the most personal side of today's living. Sales of self-help books on
all topics of problems in coping have skyrocketed to multi-billion dollar
levels. Books addressing topics of "adult children of alcoholics,
codependency, incest survivors" lead these sales, making these phrases
commonplace in our everyday conversations. Autobiographies of famous "survivors"
of some trauma of childhood also crowd the bestseller lists.
Countless sources offer weekend retreats and conferences. They claim
their participants will prosper from "reclaiming their lost child"
and will find their "true inner self." The idea is to use this
newly found, vibrant energy to rid oneself of his or her "dysfunctions"
and "addictions." This process is usually termed "recovery"
(based on the original, Alcoholics Anonymous 12-step model).
Self-help support groups comprised of other recovering people abound
to help members stay on the recovery pathway. TV advertisements offer
self-help cassette tapes geared to improving self-esteem, motivation,
and school performance.
Again, all of these represent not only a multi-billion dollar business
of selling, but also a nation of people hungry for answers to guide them
into successful and healthy living. Do these trends signal that professional
psychotherapy services are outdated or unnecessary? Professionals in mental
health have looked on this "self-help" phenomenon with interest.
They've tried to sort out the "fad" portions from the underlying
teachings that it does have to offer them.
The greatest lesson to professionals has been that the public wants fast,
clear answers to their problems. Most hurting people don't want or can't
afford long, expensive, and ambiguous therapies. As clients have made
this clear to professionals, therapy has become shorter (usually six months)
and less expensive, with clear goals. People seeking psychotherapy today
are in both a consumer and client relationship with the psychotherapist.
On the other hand, as the "casualties" and weaknesses of the
self-help movement have surfaced, it is increasingly clear that professionally
conducted therapies remain the most effective.
Regardless of what specific theories of psychotherapy professional therapists
follow, they must meet certain standards. To be considered competent to
practice and legally call themselves a "psychiatrist," "psychologist,"
or "social worker," they must complete all the education, training,
and licensing required by state laws and the code of ethics specified
by each profession. This reduces the "buyer beware risks." The
public is protected because they can expect to receive help from someone
held accountable to treat them reasonably, competently, and ethically.
In non-professionally led self-help-groups, no one person consistently
promises to deliver this nor to be held accountable.
Professionals train to diagnose psychiatric disorders and personality
strengths and weaknesses. This enables them to decide on goals in treatment
that they tailor specifically for the individual client. They gear the
nature of the goal itself and pace the goal steps in the therapy for each
person's needs. The professional weighs this against the patients' history,
current situation, ego weaknesses, and other factors.
When therapists offer group therapy, they carefully screen participants
to select people who have achieved the same level of psychological development.
They know about any risks patients might have for suicide or psychosis.
They prepare for or guard against this happening to reduce the risks in
treating several people at the same time.
Professional psychotherapists know when to use techniques that add to
a person's strengths and when to use those that cause anxiety by directly
confronting the weaknesses. They know when to focus on present life issues
and when to focus on the past. It takes years of training and practice
to develop the skills to make these decisions. It is both art and science.
Failure to attend to these important matters and poor judgment have resulted
in the self-help approach providers learning the hard way that treating
human problems can be both risky and complex work.
Some people obviously prosper through self-help approaches. Others get
a sense of confirming what they already knew to be true for themselves.
That part of the self-help approach is useful.
But what about the "casualties" of these approaches? Some self-help
group or conference participants have felt overwhelmed and psychologically
incapacitated by re-experiencing intense memories and feelings. Others
have sunk into despair, excessive guilt, and self-blame. Still others
have become suicidal or psychotic. Some self-help partakers have surprised
and worried those around them by making sudden and radical changes in
their relationships or life styles. They may announce their plan to divorce
to end "codependency" or may confront a person for allegedly
"abusing" them.
Professional psychotherapists do not recommend recall of painful memories
for all clients. Further, psychotherapists don't view the goal of "getting
out anger" as wise in all situations. Some memories and some feelings
are best left forgotten or unspoken. Feelings have their place in our
lives, but they aren't a "cure all" and can be used in tactless
or reckless ways.
The "Adult Child" movement has helped many people know they
are not alone in their struggles to establish lasting intimate relationships.
Others have learned the art of play, a missing part of so many people's
childhoods. These contributions to living seem helpful on the surface.
That doesn't mean, however, that the movement is right for everyone. For
some people, it spells disaster.
Some "adult children" have insisted upon, even demanded, their
right to return to the behaviors and dependency of childhood to recover
what they once had but lost. Some seek to have others "re-parent"
or "nurture" their "inner child." The underlying belief
is they can go through life's growing up processes again--only successfully
this time.
To some, this process of becoming like a child again feels so comforting,
they want to remain in this state. This often surprises and angers their
adult family and friends. "Adult Children" can argue quite firmly
their notion that what was lost is theirs--it's owed to them, finally!
Unfortunately, professional psychotherapists cannot promise a return
to a blissful state of childhood. Psychotherapy must be based on the reality
of people's lives. Therapists help people face what they lost and grieve
that, not try to become or recapture it. Successful grieving allows people
to re-emerge into current life. They're willing and ready to seek new
relationships as an adult--the only way it can realistically be done.
People tend to take themselves less seriously and to express themselves
more playfully when they can embrace all of life, its pain and faults
as well as its joys. They do this by seeing life as an adult, not by magical
efforts to return down the yellow brick road to childhood.
Psychotherapy focuses on this major task of living that we all face.
There are no shortcuts or safe havens passing through childhood once again.
No matter what approach we use, personal change is a long, slow process.
The growth of the self-help phenomenon signals that our society wants
more out of living. That's the good part. How to seek this and with what
help from others remains the question each seeker faces. When you choose
help with problems of living, the more individual an answer you seek or
the more serious the problem(s) you address, the more you should consult
a professional psychotherapist.
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