I’m not a psychologist or therapist, and I haven’t made much use of their services in my lifetime. But I still try to keep up with what goes on in “shrink world”, i.e. within the realm of the mind and brain, with the theories on how they work and the practices meant to help make them work better. From what I can see, one of the biggest fault lines and sources of tension in the whole field right now revolves around the old classic \u201cnature versus nurture\u201d issue. And it’s not just a dry, academic debate amidst the trained elite anymore; it’s becoming a matter of what the consumers of these services demand from shrink world. <\/p>\n
For most of the time since Freud, psychotherapy and applied psychology has mostly involved talking; i.e. the good old “couch method” where the therapist and patient discuss what’s going on in the latter’s head, e.g. fears, compulsions, desires, frustrations, envy, attraction, etc. Sure, psychologists also perform some behavioral observation studies and surveys, plus they administer and analyze the results of standardized written tests as to gauge what is going on in the minds of their subjects. But for the most part, the whole thing revolves around Freud’s paradigm of “the talking cure”, i.e. a long-term interactive process through which the therapist figures out what the patient’s hang-ups are, and slowly directs the patient toward attitudes and behaviors meant to overcome negative, harmful patterns (neuroses), so as to develop healthy patterns that allow personal growth and positive achievement. At least that’s the theory.<\/p>\n
In the past generation, talk therapy has become less and less prevalent<\/a>; aside from public reservations<\/a>, the insurance companies and government agencies that pay for most therapists’ professional fees have noticed that<\/a> professional talking (“counseling”) is quite slow and expensive, even though it generally does benefit patients who complete it (studies indicate a fairly high therapy drop-out rate<\/a>, between a third and a half of therapy patients voluntarily end their participation). Meanwhile, neurobiology and neuropsychology have made great advances in understanding the brain, mind and body processes that lay at the root of much (if not all) psychological dysfunction. In addition, medical doctors and specialists have developed more and more pharmaceutical interventions that help control the worst aspects of psychological behavioral dysfunction (psychopathic violence, extreme depression, hallucinations). Today, even the more mundane syndromes (common depression, anxiety, addictions) can be addressed with drugs. As such, the demand amidst potential consumers of psychotheraputical services seems more and more focused upon nature-based explanations for who they are, how they act, and what they think.<\/p>\n For the major mental and behavioral conditions like schizophenia and sociopathology, it has been clear and well accepted for a long time that deviant brain structures and processes involving hormones and neurotransmitters are at the core of the dysfunction. But for more run-of-the-mill conditions like shyness, social mis-adaptation, and common phobias, the emphasis was on using talk therapy to ferret out sub-conscious patterns that drive attitudes and behaviors causing unhappiness. <\/p>\n Why favor brain structure and process over sub-conscious “neuroses” that grow from short-term stresses but cause long-run unhappiness and disorientation? Because, it helps to see one’s own personal behavior a bit more respectfully; it moves away from the “you’re still hung up on something from your past” implication, and instead views personal behaviors more as alternative ways of being, i.e. just who you \/ I am. It allows more relativism and less judgment as to what social norms are or should be, i.e. what is to be considered “NORMal”, versus what is deviant or at least negative. What seems like neurosis to one person may be positive and creative to another. There are goods and bads to this trend.<\/p>\n The demand for and “trendiness”<\/a> of an Aspergers Syndrome diagnosis (or self-diagnosis<\/a>) in recent years is perhaps an example. Admittedly, it went too far; the top researchers, academic practitioners, and insurance companies responded with the Autism Spectrum concept to replace Aspergers. It was a way of kicking the many “slightly weird” and somewhat unusual people (like myself) off the boat, as to control insurance costs, and at the same time halt the move away from sub-conscious explanations (i.e. Freudian, even Jungian) and towards of inherent brain structures and processes. It helps insurance companies, but at the same time helps to put therapists back in control as the refuge for people who seem slightly weird or mal-adapted. I.e., don’t blame Asperger’s; if you’re not truly autistic, then it’s your own neurotic sub-conscious that needs fixing!<\/p>\n Let’s take a situation that I ran into about 20 years ago. I had been working for several years for a non-profit agency, where most of the staff got along quite well, including myself. One day, someone well-intentionally thought to plan a surprise birthday celebration for me (this office was really big on buying cakes and celebrating most any personal event possible — hardly a week went by without you being passed a paper plate of cake with plastic fork). I honestly didn’t see this coming; it truly was a surprise when I was called into a conference room for a meeting and opened the door to find about 20 people seated around a decorated table yelling out “SURPRISE” at me. It was a bit too much . . . I felt disoriented, overwhelmed, almost dizzy, somewhat in shock. And it wasn’t pleasant; for me it was something like having a camera flash go off right in your face. I actually walked back out the door and stood in the hallway, as to catch my breath and regain my composure. After 10 seconds or so, I went back inside and made a little joke of it, and we got on with the cake-eating. But everyone could tell that I really did not appreciate what had happened; they never had another surprise birthday party for me again.<\/p>\n Was my behavior in that situation a function of sub-conscious motivations, of attitudinal and behavior patterns rooted in some forgotten childhood experiences? (Most obviously, a putative bad experience with parents at a long-ago birthday party.) Or was it because of sensory processing dysfunction<\/a>, sort of an emerging replacement for the role that pre-spectrum Aspergers was playing? Would I be better off with a therapist who might ask me “how old did you feel when that happened”? Or by an analysis of my tactile sensitivities, my physical coordination traits, and potential telltale adaptations such as embracing the mechanical \/ systematic things of the world for their reliability?<\/p>\n Obviously I favor the latter approach. A person favoring this “natural behavior for myself” viewpoint might also disdain the application of any drugs or therapies to change him or her — which the insurance companies surely will agree with! Although, such a person (including myself) might still want some level of analysis and therapy so as to help better understand one’s self, and thus help the self to grow in one’s own way. I.e., get out your Jung and update it a bit with cerebral wiring diagrams, chaos theory and neural networking cybernetics. <\/p>\n But of course, there are limits and dangers to this. A brain-processing focus can go too far; it can be a crutch to say “hey, that’s just how I was born, can’t do anything about it”. This trend could be abused by those who would argue that the world needs to respect my own peculiar ways and stop calling me neurotic, stop being so judgmental. Less social judgment might be good, but we still can\u2019t respect the sexual preferences of child molesters and predatory pedophiles. Child pornography is still wrong, it’s not just an alternative expression of human physical desire. <\/p>\n And another possible side-effect and danger to those like me who do favor brain-condition analysis is the notion that any slight deviations from normal behavior (which I myself have plenty of) can be seen as “curable” through a therapy that changes how the brain works. Neuropsychology should not become the tool of the majority to re-wire anyone who is somehow different; only when there is clear suffering, significant loss or danger to others should drug therapies be imposed (or even recommended), subject to legal guidelines and protections. We need to respect the fact that weirdness and peculiarities are sometimes the breeding ground for creativity and (occasionally) genius.<\/p>\n Several months ago, I said in one of my posts<\/a> that <\/p>\n there should still be room in a DSM for \u201cAspergers lite\u201d or \u201cAspergers dynamic\u201d, for \u201csituational Aspergers\u201d. Not so much as a diagnosis, not as a way to get government or insurance money, but more as a means for all of us to understand each other; and most importantly, to understand our own selves better.<\/p><\/blockquote>\n Well, I don’t believe that DSM 5 does this. But as I mentioned, sensory processing disorder has been getting more public attention as an alternative to the “autism spectrum”. One web site Google herald<\/a> says “it ‘s not autism — it’s sensory processing disorder”. I’m not an expert, but SPD does perhaps give some leeway for an “Aspergers lite” mechanism, in situations where children or adults do not suffer the multiple breakdowns that are implicated by autism, but still have some inherent mental differences that affect their behavior and socialization. (SPD is also excluded from DSM 5, but unlike Aspergers it is a relatively new candidate that arguably awaits further research and documentation<\/a>.) <\/p>\n The ultimate goal, I would think, is to apply what is being learned about how the brain functions through “hard studies” in neurobiology, and apply this to the more common situations in daily life, to the human struggle to get by in the world, make some sense of it, and get along with one another. Up to now, this realm has been mostly the providence of the talk therapists. I’m not saying that classic psychotherapy should go the way of leech therapy, but it definitely should make a lot more room for inherent brain\/mind differences. It needs to stop assuming that anyone with any sort of behavioral or relationship issues automatically hates at least one of his or her parents. Even thought I don’t like surprise parties, I liked my parents just fine!<\/p>\n","protected":false},"excerpt":{"rendered":" I’m not a psychologist or therapist, and I haven’t made much use of their services in my lifetime. 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