How Do 200,000 Shrinks Miss the Point About Primal Pain?

(from: The Rise of the Caring Industry.   R.W. Dworkin.  Hoover Institution, June 2011)
Today in the U.S. there are 77,000 clinical psychologists, 192,000 clinical social workers, 105,000 mental health counselors, 50,000 marriage and family therapists, 17,000 nurse psychotherapists, and 30,000 life coaches. Most of these professionals spend their days helping people cope with everyday life problems, not true mental illness. More than half the patients in therapy don’t even qualify for a psychiatric diagnosis. In addition, there are 400,000 nonclinical social workers and 220,000 substance abuse counselors working outside the official mental health system yet offering clients informal psychological advice nonetheless.  This is to say nothing about the number of psychiatrists.

How do these hundreds of thousands of mental health professionals miss the point about primal pain?  I mean pain is central to mental illness.  How can it be ignored by the very people commissioned to solve neurosis and psychosis?  It is like studying physics and nuclear energy but never mentioning atoms.   Implicitly, it means that they do not consider emotional pain to be at the root of emotional/mental illness.   So what do they think?  I have to go back to my psychoanalytic days to see how I was thinking.  And all we all thought about was the symptom and how to cure it.  Not curing the human being who carried the symptom and the individual who was responsible for the symptom.

   I am not decrying the fact that professionals do not embrace Primal Therapy, but simply trying to understand why they cannot see the pain.  It is there in every patient I have ever seen.  Why is that? Because I have found a way to dig deep in the human unconscious, otherwise you simply cannot see it, even though it is right there before your eyes.   And there is the pain bright and cheery (or not so cheery).   I had a patient (a mother) today who felt deeply.  Afterwards, she had all kinds of insights about how she treated and ignored her daughter.   And the question is, how did she see something so clearly after feeling her pain, that she could never see before she felt her feelings and needs.

    Currently, in the name of progress, psychotherapy has become a here-and-now affair.  As if to say the patient has no history. We are now in the same boat as creative intelligence, psychoevangelicals who say there was no history beyond that of a handful of years.   We can find no real justification for this approach.  Yet, shrinks are implicitly stating this in every therapy session.     They ignore causes and origins.   All that is left is the present.  It certainly simplifies matters.  The problem is that it becomes simplistic and bypasses historical truths.  It eliminates  complexities, of which we are prime examples.  It forces us to ride along on the surface; and we couch our results on surface phenomena.   And then we tailor our therapy to fit into the simplistic scheme.  And we are the last to know about feelings and needs.

    One of the problems here is that therapists are the tool bearers; they take what they have learned and apply it to the patient, thereby learning nothing new; and certainly nothing about the patient.   All they are really doing is refining their tool, whether it be EMDR with its wand to wave in front of the patient or a biofeedback machine  to hook -up the patient, or the ideology of Freud about sexuality, and so on.   It is the apotheosis of the tool and tool-bearer.  And all this prevents the therapist from really inquiring into the patient and her history.  In this case the therapist is seeing herself or himself; how good she is doing or not doing.  The patient is something of an afterthought.   This seems an exaggeration but it is basically the implication of today’s psychotherapy.  Bringing the tool into the session means the therapist has already made up her mind.  She has already decided how the session will go; and it is she who decides the goal of the session, not relying on the systematic unraveling of the unconscious.  The session will go at the therapist’s pace and not that of the patient.  So now we begin to understand why the doctors do not see the pain.  They leave no room for it, no room for any surprises in the therapy.   They leave no room for a change in philosophy or in technique.  They don’t have to change at all.  That is not science; where each new bit of information can change how we go about doing therapy.  They are sure that it all is fine, and that all that has to happen is the patient fit himself into the theoretical scheme.  The doctor needs to analyze your dreams or have you do certain exercises and rituals;  the currency the patient must pay is with insights.  The greater the number of insights the better the patient is, they say.

 The article about the number of shrinks goes on to discuss the following:  “People want to be able to go about their daily lives with the knowledge that someone is there for them.”  So that is the role of the shrink? If you had someone there for you in the beginning of your life you would not need it from a shrink. When you get it from a shrink it is known as symbolic acting-out; the all-wise therapist will watch out for you, protect you, read your mind and keep you safe.  And the problem is, and what makes therapy so addicting, is that the patient is getting what he can from the shrink to make up for what he did not get from his parents. But as we know, once the critical period of need is gone it can never be retrieved.  After the period is over all fulfillment has to be symbolic; and that is why therapy is often interminable; because it is never truly fulfilling.  It is a palliative that we require over and over again.

     And here is more of the Dworkin piece.   “Traditional long-term psychoanalysis, where a therapist spends years poring over the most insignificant details of patient’s life, has given way to what is called “short-term therapy” — therapy conducted over a period of 20 sessions and typically lasting no more than six sessions. Traditional psychotherapy seeks to explain a person’s problem in depth; short-term therapy seeks only to solve that problem, whether or not an explanation for the problem can be found, and so requires less time. Most psychologists, social workers, counselors, and life coaches operate these days within the short-term therapy framework. By focusing on a person’s problem, short-term therapy mimics the experience of real friendship. People don’t expect a real friend to psychoanalyze them when they have a life problem; they expect a friend to suggest a course of action, or to at least raise their spirits. They expect a friend to advise them or help them feel better.

In fact, this new therapeutic style is key to understanding the growth in the number of caring professionals and, indeed, the rise of an entire “caring industry.” Today’s caring professionals offer the same service to lonely, unhappy people that friends and relatives once did. They do so because so many Americans are lonely and unhappy.”

   We do need someone to talk to in life, and for that a shrink can be helpful; and my guess is that if they just talk about life and not spread around insights the session would go just as well if not better.  There is a lot of loneliness out there.  One reason that it becomes embedded and shrouds us is because it is something that may have set in very early in life when the baby was not held and caressed after being born; nor was she held and kissed enough in her infancy.  Here an aloneness sets in; a profound alone/loneliness is engraved.   It can be a feeling brought forth through the process of resonance where being alone for a few hours can elicit that deep aloneness where early human contact was essential for survival.

   In the article they say that half of all Americans feel lonely and, also a bit unhappy.  Where as twenty percent are either depressed or anxious.  These are like unforced errors in tennis; nothing seems to provoke it but there it is.  But we have a good idea of what is causing it.   And look at this.  “An estimated 95 percent of Americans have low self-esteem. Consistent with these trends, at least 15 percent of Americans are now on a psychoactive drug at any given moment.”  Why is it that we all have low self-esteem?  I just wrote on this; a few of the reasons have to do with being ignored as a child, not listened to or respected when we spoke.   It can begin when we are crying out in the crib and no one comes.  Some of us learned to let the child cry. The result is low-self-esteem; I am not worthy of people coming to help and soothe me.    And it is magnified many times over when you say “mommy, mommy,” or “daddy, daddy” and no one is listening.  No one understands your moods, your feelings or energy levels.  Or the parents live on another planet of rules and regulations, of traditions and moral codes but never feelings.  They live within their own history and pain, and cannot pay full attention in the present.   Emotionally, they are somewhere else.  It is compounded when you eat what your are given and do not have the right to dictate what you will have for dinner.  Low self-esteem.   You are not very important.  You obey or else.

  The article goes on “Under our very noses a revolution has occurred in the personal dimension of life such that millions of Americans must now pay professionals to listen to their everyday life problems.”  And why is that? Because so many parents are so preoccupied with making a living, paying bills that they not only don’t have time but don’t have the mental freedom to focus for very long on anything outside of themselves.  They are prisoners of pain and the children are the one’s in prison, an emotional prison where there is no one to talk to, no one who understands (that is the ultimate loneliness).   There is no one to go to who can help.  The child is surrounded by unfeeling robots who go through the motions of parenting, who need to read books and how to act with children, as if they never had  a childhood themselves.     Unfortunately, they are so alienated from their past that they forgot what it’s like to be a child.  The point is that very early gestational trauma, the mother anxious or depressed is sufficient to cause it, gets compounded as the child grows up and experiences neglect and lack of touch and love.  All this needs to be taken into account.