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Pacifica Graduate Institute
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"2013-12-17 18:37:55"
Psychotherapy Based on Depth Psychology is a Superior Approach (Full Length Version)
\\psychotherapists who were interested in depth psychology are living in a professional world will do that dominated by cognitive behavioral approaches and what a cold empirically validated or evidence based therapies and most mainstream psychologists believe that these off the gold standard of scientific psychotherapy but I'd like to do now is tell you the other side of the story including it shadow side and explain why psychotherapy based on depth psychology if I had to summarize the situation of the beginning I'd like to point out that everyone who psychotherapy is and we can never fully understand human suffering using using quantitative scientific empirical methods because the human being is really too complicated for a simplistic empirical approach there is a good deal of empirical evidence for the value of debt psychotherapy but it's based on a different kind of evidence then we finding quantitative methods a great deal of so called scientific psychology is actually never used by students once they graduate because it becomes irrelevant to the kind of suffering that is the daily experience of the psycho therapist many of the problems we see in psychotherapy much of the suffering we try to alleviate requires a response which could only emerge from the fundamental humanity of the therapeutic couple from my understanding of the complexities of relationships and from an appreciation for the depth of the soul is a very complex uniquely individual matters and they don't lend themselves to the application of specific laws of learning what to some other empirically derived approach that is set to apply to everyone human relationships are much too complicated to be fully contained in the net of empirical research measurement is certainly not an appropriate approach to the unconscious the unconscious is much too slippery for quantitative methods and it's certainly no use in the spiritual dimension which is the guy mentioned that young in psychology is concerned with it's important to remember that whole theories of psychotherapy are based on a certain view of human nature and the certain worldview and I believe the practitioners who work within any particular approach on making a commitment to the underlying philosophy of that approach whether or not they're doing so consciously so it's important to understand this otherwise one is unwittingly committing oneself to a view of humanity that may not be in accord with one 's real families many approaches to psychotherapy which consider themselves to be scientific or unconsciously assuming a materialistic and the reductionist philosophy I mean by that that they assume that human behavior is nothing but the result of evolution genetic endowment brain processes and culture these approaches tend to ignore other important realms the realm of meaning the domain of spirituality of the intellect and artistic concerns and self awareness much empirical psychology is based on what school find traffic physicalism the doctrine of reality is entirely based on the physical properties of objects but also on naturalism the doctrine of science must confine itself to the study of natural causes which excludes anything that might be called spiritual a lot of psychology is based on positivism which is the philosophy of science now rather old fashioned but a search for the only empirical information derived from systematic observation and experiment provides invalid knowledge positivism rejects intuitive for it it prospectively obtain knowledge but this we find is a much too restrictive approach to human knowledge the humanities are literature religion mythology old teachers a great deal about the psyche and that's what depth psychotherapy takes into account it's also clear that our intuitions may be correct even if they are unprovable for example how moral and ethical intuitions about right and wrong may be very hard to prove empirically but we couldn't live without them personal meaning is very important to us but meaning is impossible to validate empirically subjective there are many important experiences like love which cannot be rigorously tested even though they're very useful and important to us but often the gap between what we can demonstrate scientifically but what we must actually do in the therapy room in the absence of any empirical data about what would be helpful there is no scientific answer to questions about whether to leave a marriage or change jobs or how to deal with a major loss for how to deal with loneliness alienation so when these a rock we issues arise in psychotherapy they demand the entire post and if the therapist everything he or she has learned about being a person from day to day life experience the attempt to squeeze the practice of psychotherapy into a scientific model sometimes the defense against the difficulty of working with severe emotional pain for which there is no obvious remediation painful life dilemmas produce intense suffering and it's naive to believe that the therapist control was be helpful by using empirically validate it'll positivist approaches to them we need several types of observation to understand reality positivists remember cannot prove that there are no principles beyond what we can observe so they cannot even prove their own assertion Bertrand Russell the British philosopher pointed out that if the positivistic correct there's no end to the verification process we have to keep verifying the methods we use to verify each proposition then verify that method ad infinitum so there are no authoritative grounds for insisting on empirical verification now some psychologists believe in objectivism the notion that people in the world in general of objective meanings independent of the ways we think about them so therefore a patient in distress is distorting his perception of a single objective reality and the therapy is has to help the patient to perceive more accurately these kind of approaches assume that they're all empirical experimental methods which will lead to universal truths all laws which I value free but these kind of approaches and not helpful when trying to understand the complexities of personality some levels of personality are very hard to quantify and simply not amenable to this kind of consideration think of compassion or other spiritual dimensions of the person positivism often ignores the issue of the subjective meeting of events to a person human beings trying to make sense of the world they don't just behave mechanically according to universal laws of behavior so human behavior is often completely unpredictable as well a strictly empirical approach cannot decide between right and wrong except maybe relatively or in terms of contemporary social standards traditional empiricism itself is the only what is observable is real on cognitive behavioral therapy based on empiricism urges us to think rationally about the world but our experiences that the world is both mysterious and often non rational many psychotherapy training programs teach students reductive cognitive behavioral or biological views of the person because these are recognizably scientific so they make an unspoken unspoken philosophical commitment that this is the best approach to the person but in the process these these training programs gloss over some intractable philosophical problems for example we often hear the phrase cognitive neuroscience there was a very long standing problem of the relationship of mine to drain and this problem appears to have been solved just by joining these 2 words together but when this kind of terminology is the lingua franca of the training program the unsuspecting student is led to believe that brain processes coals rather than correlate with mental events or even the brain processes and mental events often animists a student may not be told that this is a very controversial even metaphysical opinion and the court the question is by no means settled the student may not be told that the conceptual problems involved such is the nature of consciousness rather than the question of how the brain produces consciousness cannot be solved by empirical me the student may not be told that the laws that govern your logical systems in the brain do not apply at the level of a person's psychology a person psychology has new emergent levels of complexity which and not present at the level of the brain to the psyche requires its own approaches that doesn't mean the brain isn't important of cooperative but it doesn't mean that on account of behavior and thoughts and feelings only in terms of the brain leaves out the person who has the brain it's far more important to understand the person empathic way but the human level than it is to have an explanation of the level of neurophysiology or scientifically derived loss of behavior which I very often much too abstract to be any use in an individual case psychotherapist deal with human suffering and the experience of suffering is complex and mature and mysterious it requires taking into account all the sources of wisdom but all part of our human heritage we have to borrow foreign religious traditions on great poets or writers are historians artists as well as adept psychologists like young and Freud in that tradition in the practice of psychotherapy the scientific method is not the only valuable approach to the human condition over wisdom traditions literature and the humanities must not be ignored in the service of dogmatic cultic scientism the notion that the scientific outlook is the only valid one the therapist must inquire deeply into the human condition must value mystery develops self awareness imagination and compassion these are important but difficult or impossible to measure student of psychotherapy may not be told that there are alternatives to the view of human nature that underpins the training program in which the student is enrolled this is a very important situation today because increasing numbers of people are now taking that spiritual and existential problems to psychotherapists rather than to clergy so many contemporary psychotherapists have become defacto spiritual directors in the sense that they provide a contemporary form of caribou so the attempt to squeeze the practice of psychotherapy into a scientific model is often a defense against the difficulties of working with severe emotional pain for which there is no obvious remedy and I think this is one reason that many psychotherapists still read research journals what kind of questions that arise when dealing with suffering people a novel was dealt with by researchers who were interested in generalize Asians on large scale theoretical question many training programs in psychotherapy teach in a way that is directed to passing standardized exams but there may be little or no correlation between being a good psychotherapist then the ability to pass exams our accrediting agencies impose a regimented series of mandating courses but without much development on the personal development of the student as a result some training programs turnout practitioners who have a good deal of theoretical knowledge about behavior and they can pass exams but they're not equipped to put human level to deal with that patients it's quite difficult to measure a student's capacity for compassion and empathy and Ethan novel was stressed and academic psychology departments which stress experimentally validated approaches to emotional distress in practice these approaches will often fall short of helping with suffering when they are deployed by fallible human beings with poor empathic capacity and inadequate relationship to their own psychological difficulties one cannot do psychotherapy using a paint by numbers approach many students a well meaning but they've never suffered serious hardships in their personal lives so they cannot empathize with the level of pain and suffering that that patients are experiencing I kind of experimental research carried out by graduate students in psychology may also be irrelevant to the problem of helping the suffering post as a result some of these practitioners superior in that training sites to be ineffective or even harmful because they've had academic training which is paid insufficient attention to that relational ability their emotional maturity that self awareness and overall self development licensing exams and the type of degree one has on no guarantee of psycho therapeutic aptitude all therapeutic intelligence and there are wide variations in individual ability among psychotherapists with the same academic training in psychotherapy take practice there are times when theories helpful and other times when we are out on the limb with no attic with fairly insight then we have to improvise and feel our way along using all humanity and our own subjective judgment about what to say and we have to live with great uncertainty this situation can produce considerable anxiety and that seems to be one of the reasons that students gravitate to approaches to psychotherapy that purport to be scientific only to learn that theoretical approach is often inadequate the issue of evidence and cognitive behavioral evidence based psychotherapy is the next subject but I'd like to address evidence based practice has obvious value in terms of finding effective therapies clinical deficits of pointed out a shadow side of this evidence based approach it is rigid it leaves little room for variation from patient to patient and it serves for corporate interest cost containment and efficiency by standardizing care the insurance industry uses the notion of empirical evidence basically in order to control costs cognitive behavioral therapy privileges quantitative an experimental approaches to suffering the student therapist may not be told that like any theory cognitive behavioral therapy is full with biases with ideology and with hidden assumption and all of these imply values and beliefs for example if we assume that a quantitative empirical or experimental approach a human beings as the best one we're unconsciously adopting positivists philosophy and then objective theory of knowledge these all reductionist they ignore the complexity of the person reductionist interpretations of human beings lead to that being treated in a very restricted manner sometimes when one reads the cognitive behavioral literature one gets a very narrow sense of the person because the person is only described in terms of phantom feelings behavior thoughts the patient has been treated as if he or she is expected to follow instructions based on the treatment protocol which may not attend to the complexity and the launch of convicts the person's life cognitive behavioral approach you see the symptom of the problem and the therapist and doesn't need to take into account the person's ethnicity gender socio economic status and other aspects of the person's life which is very important people live complex lives they have complex emotional states and some of them are constructed by that because by that culture and the social situation oppression is not always the result of faulty thinking sometimes it's the result of being in a difficult situation approaches which used a fixed protocol or a manual don't encourage the patient to talk about his or her life in a broader context in the center and they restrict the psychotherapist creativity and autonomy now it's often claimed that the efficacy of empirically supported therapies validates the underlying theory people can recover for reasons other than the reasons given by the fairy which underlies the particular therapy which is being used there's a difference between showing that a treatment works and knowing how it works both schools of thought have their own theory of how therapeutic change of clothes but the actual process of therapeutic change is still not well with clear because there are many non specific factors which a common to old school of of full these commonalities all those such as the patient and therapist characteristics quality of the therapeutic relationship shared expectancy the benefit of facing emotional pain while being supported by another human being overcoming demoralizing ation providing an experience of mastery stimuli isolation of the patients hope self healing ability so we cannot pinpoint any single factor as responsible for change the cognitive behavioral therapist may believe that his or her technical interventions have hope from the patient's point of view the therapists empathy caring and capacity for relationship maybe even more valuable the notion that all forms of psychotherapy are equally effective has been referred to as the dodo bird verdict from Alice in Wonderland where the dodo bird says all have one all must have prizes the use of a specific manual to treat an emotional disorder which is embedded in all the complexities of a person's life tries to full psychotherapy into a medical model in which a particular medicine is effective for a particular symptom but 5 adept psychologist who takes into account beyond conscious the presenting symptom is not the main problem the symptom is the attempt of the personality deal with the problem that's a deeper level of problem unless the patient is able to place the phantom in the larger context of his or her life including his or her relationships family a patient a life spiritual life the symptom cannot be understood the toll deeply complex human life cannot be reduced to small units it can be measured if we try and do that we lose a sense of the whole human beings it's important to remember that culture bound assumptions can masquerade as a value neutral why middle class male standards cannot be used as a standard of healthy psychological development but some cognitive behavioral therapy perfumes these kind of standards to be normative criteria the patient should conform to them this is a very socially conservative philosophy which risk splitting the patient putting excuse me putting the therapist into the position of promoting conformity to the social order as if that kind of adaptation equal psychological help however some people are not willing or not able to adapt their behavior to the standards and values of the dominant culture it's important that the psycho therapist not unwittingly serve the socially dominant power group rather than the individuation process of the individual who may want to swim against the tide liberation psychologists have long pointed out the cultural factors such effective sexism and the devaluation of women have a very important role in the development of difficult things such as the borderline personality disorder no word about the question of evidence some kinds of evidence are needed for the practice of psychotherapy we need to be sure we doing something helpful but what I'd like to do is discuss the question of what we actually mean by evidence because evidence is a notoriously ambiguous term the question of the nature of evidence is a long standing discussion among philosophers of science we're looking for ways in which we can support or discount our belief in the hypothesis so evidence must have some bearing on the truth or falsity of a theory the conceptual problem is to decide what counts as evidence how to decide when data hope clinical findings become evidence in favor of a particular theory whether some kinds of evidence carry more weight than others and if so who decides which kinds of evidence which it's also important to look at the ways in which evidence is actually used in practice we have to remember that rule data themselves and not evidence data has to be interpreted and data only become evidence in the light of a pre existing paradigm will fairly or even a metaphysical framework to a large extent the response to the question of evidence depends on the type of problem with trying to study we need the right kind of evidence for the right kind of questions we are asking some questions lend themselves more to qualitative and quantitative approaches the type of evidence we need within the natural sciences is different than the type of evidence we need with in depth psychology that psychology doesn't have the rigorous laws of the kind found in Newtonian physics empirically based psychology requires that evidence can be independently observed unverified and this feel pretty has a preference for quantifiable measurements but we need different kinds of evidence to decide that psychotherapy based on depth psychology is effective empirical research based on quantitative evidence is only one kind of evidence but with the dept psychologist have no reason to privilege in this rather than other types of evidence we think it's a mistake to insist that only what can be measured counts as evidence there is evidence based on systematic observation single case studies he's also forms of evidence they give us knowledge or information about the question at hand the relationship between the psychotherapist and the patient is another important source of evidence the practitioners personal life experiences evidence clinical experience and pass it knowledge based on years of practice opal forms of evidence these forms of evidence can be made explicit they can be articulated that can be debated and they can be verified or discounted by the community of the psycho therapist peers the evidence from the accounts of patients who've been in this kind of psychotherapy is also important these are qualitative forms of evidence but they often devalued by empiricists who believe that they're just anecdotal but just to idiosyncratic and to subject to personal bias but in medical clinical situations that's all we have in all cases empirically derived research evidence to merge with the practitioners knowledge and with clinical experience and not all of that is empirically based some researchers are interested in what works but in this case a lot depends on what we mean by works for whom it works and in what context something works if we consider a symptom removal of the treatment of a particular syndromes such as depression that empirical validation means showing that one form of treatment leads to a better outcome than another but for depth psychology the situation is more complicated when not just interested in changing behavior or removing symptoms for young hints for example depression is a signal from the unconscious or from the transpersonal self something needs attention and from this point of view depression may lead to an important course correction and the person's life for the dept psychologist therapy that removes the symptoms of depression without attention to the underlying message doesn't work at all so partly based on experience with that personal psychotherapy partly based on the qualitative evidence that I've talked about that psychologists believe that dept psychotherapy foster's personal development and self understanding as well as producing symptom relief these are in no way different goals since the effects of this therapy on the individuation process of the individual can unfold over many years and may also affect members of the person's family when should we judge its effects how could we fetch hope we find a matched controls them if we were to apply the question of the efficacy of dept psychotherapy studies of large populations of people who've been in this kind of therapy we would find results in these have been found that apply to particular individuated in particular individuals but not to others whether or not the results often difficult impressive for the whole population would be irrelevant to the individual for whom the therapy has been helpful statistically derived knowledge always have to be interpreted in terms of an individual posts what is called statistically may not be good for a particular individual advice of us remember that the managed care industry has a vested interest in controlling the type of psychotherapy movie in books even though that's a good deal of evidence that different types of psychotherapy produce similar results the implication of insisting on a specific approach is that all patients with the same diagnostic labels such as depression require the same treatment this is manifestly not true given the uniqueness of the individual and the need for therapeutic flexibility many people with this exactly the same DSM diagnosis on the same list of symptoms maybe a very different developmental levels and may have very different personalities structures and need different approaches the value of psychotherapy based on depth psychology is that it takes into account the unconscious takes into account the spiritual dimensions of life complexity and mystery the evidence that it helps it's found in our greatest self understanding and deeper connection to this mystery thank you //

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