Psychotherapy What?by Robert A. Yourell, MA | September 26, 2007
Here’s an interesting Google statistic. I searched on “psychotherapy innovation” and “engineering innovation.” Here are the hits: 1,210,000 for psychotherapy innovation, which is under 1% of 136,000,000 for engineering innovation. But I estimate that there are 45% as many psychotherapists as engineers (based on stats from the Occupational Outlook Handbook and an educated guess or two on my part). This is hardly a scientific exercise, but how can you ignore it?
On the first page of the engineering hits, there were three universities focusing on the subject, and three pages providing examples or history of innovation, including a media presentation.
For psychotherapy, I looked at the first two pages, because a book about managed care appeared so much. I found a handful of other books. All of them were intrapsychic, and were not about social systems, systems theory, recently developed modalities, emerging theories, biology or the biopsychosocial model. Ah, but there was the British Association for Counselling Psychotherapy Awards for Innovation in Psychotherapy.
I didn’t include businesses in either of my reviews of the hits.
Just to press the point, Amazon has 229 books for psychotherapy and innovation, while the number for engineering and innovation is 2,678. But at least 9% is better than the under 1% of Google hits.
I can think of reasons why the word innovation does not have so much presence in psychotherapy. It’s harder to prove that an innovation in psychotherapy actually works. In engineering, the light goes on or it doesn’t. In psychotherapy, the light bulb is a metaphor. Innovators in the field can be abused, even if they are research-minded. The developer of EMDR was treated viciously, and the modality even conspired against (literally) by a small group of researchers. The skeptics were content to pooh pooh it using outdated and inappropriate research studies. And then there’s the question of perverse economic incentives. I’d better side step that one for now.
Also, theories in psychotherapy are very difficult to verify. It is less so now, but in the not-so-distant past, theorists were much more prone to conjuring up intrapsychic dynamics that were quite metaphorical, but were treated like actual things. This puts the therapist on the slippery slope of reification. (A great word to look up in the Wikipedia.)
Consider energy psychology. There is an emerging collection of non-metaphysical theories as to why these therapies are turning out good results in research. But the theoretical basis most commonly held among the public and therapists who use the techniques is a vague collection of beliefs from traditional Chinese medicine and western folk beliefs about transpersonal energy. If I were putting myself on the line in favor of such beliefs, I’d feel a lot of pressure to have more than great stories, but most therapists in that camp don’t seem to feel that obligation. Is it patent religiosity? Is it that their experiences are so compelling? Or are they having too much fun to care?
I have used energy psychotherapy techniques, and I could tell some great stories about them. But I’m more concerned with results that the theory du jour. After all, in therapy, much of what moves people is the story they tell themselves. Metaphor is a powerful way to enhance and expand that story. Perhaps with energy psychology, the theory can be part of the treatment; at least with people who are inclined to believe.
Try this just for fun. Rub your hands together briskly for about thirty seconds. Now feel the tingling in your hands and fingertips. Tell yourself that you are feeling your aura and that it is made of cosmic energy. It’s fun, no? Now go to the New Age Fair. Get a photo of your aura. Be careful not to lean to one side, so that your head will be inside the aura in the picture. (I once saw a very disappointed person at a New Age fair who had gotten off center in the photo.)
Okay, I’m getting carried away as usual. Maybe it would be better to do some sit ups or eat some broccoli. While your enjoying that, I’ll be writing some blogs about innovations in psychotherapy that are more optimistic that this one.
What do you feel are the biggest innovations in psychotherapy, from any perspective?
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