We could all use a little help

Psychotherapist's couch
Image found on Pinterest. If you own it and would rather it not be here, let me know!

I read a piece this week in The Philosophers’ Mail called Why you need to go and see a therapist. It’s a really good piece, but it’s a bit narrow in scope. The basic premise is simply that “thinking about our lives is so hard,” that “getting therapeutic help should – ideally – be an ordinary and wholly unsurprising thing.” The article also discusses how most of us see therapy as something for the crazy and traumatised, and certainly not for all of us so-called ‘normal’ people. (Who, honestly, can say they’re ‘normal’?) Well, I agree that therapy has this image, that it has stigma associated with it, but that isn’t a fluke. It’s not some uncharitable misunderstanding on the part of the public. In the twentieth century, professionals who were developing the techniques and theories we now call therapy quite deliberately chose this name. It comes from the Greek  therap?a, and means ‘healing’. This is echoed in other names professionals give themselves like clinical psychologists (clinic comes from the Greek for bedside) and psychiatrist (i?trikos means medical).

See that photo at the top? I have shown it to classes of final year psychology students and asked whether it’s a reasonable representation of what therapy is about. They say it is. So if this image is undeserved, we have a huge problem because even the psychologically educated then validate it.

Despite their desperate cries that they reject ‘the medical model’ of mental disorder, by and large, mental health professionals do often act like physicians. They work with people who are functioning less well than is average in some respect — perhaps due to chronically low mood, hearing voices, or disabling anxiety — and they aim to ‘fix’ this issue. (Some would say they aim to support the client to fix his own issue.) Quite a few schools of therapy say they reject the medical model, and in a sense they do, as these therapists won’t give a diagnosis and a treatment plan, but even here the attempt is to ‘fix’ something. I really like the process of Brief Solution-Focussed Therapy. (I’m not sure how much evidence there is for its effectiveness. I’m just saying it feels right to me intuitively. It feels like clients are making progress) The idea is that the therapist doesn’t ask about the problem and instead explores with the client what the solution would look like. One of the developers of solution-focussed therapy has been quite open that this is only really a more creative way of using language. Even the use of the word ‘solution’ implies that there is a problem to be fixed.

I agree with the premise that we could all do with a little help, and I have a huge amount of respect for mental health professionals, but even the most optimistic and positive of the therapeutic approaches make it clear that they deal with ‘problems’. There’s the rub. It’s a natural human tendency to think of people in three groups, those who are really really good at something, those who struggle with it, and the majority in the middle who are just average. Let’s take those people who are already highly successful, making considerable contributions to society and earning handsomely in the process. Does it seem right that they should benefit from a relationship with the same professional who normally deals those who can’t make it out of bed in the morning? Of course in truth, they might, but it doesn’t feel right. Though it’s a terrible analogy, and breaks down on analysis, it feels like asking a university math professor to re-take kindergarten algebra in case he can gain something from it.

Of course, this analogy is crude and rather silly. There is a hint of logic in it though. Some therapists, though by no means all, are themselves only averagely good at living successful lives. They may be able to guide someone who’s struggling to a higher level of functioning, but can this ‘average’ therapist do the same for the client who is already highly successful? Let’s assume they can. Are they going to be able to inspire their client to reach higher and higher goals? After all, we most learn from people we look up to.

Since before the First World War, applied psychology has had three broad aims. To cure mental disorder, to help ‘normal’ or ‘average’ people to live better lives, and to identify and nurture talent and genius. The first aim received much more attention in the latter half of the twentieth century. This shouldn’t be a surprise. People who are really struggling with various aspects of life engender sympathy and compassion in us, and cause hard-hearted politicians to use words like ‘unproductive’. Society has a set of reasons to want to help those who are struggling, whilst nurturing the already able, the successful and the talented is a rather utopian dream we have decided should be the responsibility of the individual.

The winds of change are blowing. Since Martin Seligman’s address to the American Psychological Association in 1998, a huge momentum has built up in Positive Psychology, which aims to apply the latest psychological research methods and theories to those two aims we’ve neglected in the last half a century — helping all those people who are already fairly (or very) successful to live even better lives. Alongside this movement, has been the development of Coaching Psychology, which is partly the application of the theories from positive psychology in one-to-one work with clients.

Positive psychologists have already made significant progress in revising ancient debates about what it is to live a good life, and they’re doing this from a scientific rather than a philosophical perspective. Coaching psychologists, such as myself, meanwhile, are assembling packages of techniques that can be scientifically shown to help clients in actively changing their lives to be the way they’d like them to be.

So yes, Philosophers’ Mail, we could all do with a little help, but therapy? I’m not so sure. I too wish more people would seek therapy, but there are also other types of help out there which might fit better with some people’s current needs and wants much better.   P.S. I feel I should say that my own idea of ‘successful’ is definitely not just about money.