Psychotherapy as a Cult

Maybe you think this is just a ploy to get your attention, or an exaggeration to ridiculous lengths but let us examine what a cult is and see if psychotherapy fits.  (Some of these ideas were inspired by a new book by Kramer and Alstad: The Guru Papers, and from my own forthcoming book: Beyond Belief).

  So what are the markings of a cult and a guru who runs it?  Absolute authority and someone without faults.   The leader is a know it all,  who runs your life and tells  you how to live.  Who demands obedience.  Someone who does not trust you thinking for yourself.  Someone who knows what is in your unconscious and interprets it for you; this teaches you to mistrust yourself and doubt your previous thoughts;  submission to the leader’s thoughts.  Never to question him or his beliefs even though it can lead to your deterioration…. A military mindset.   Accepting a new moral orientation.  An absolute belief in the leader’s theory. Believing he has a special wisdom and knows the secrets of the universe.   Best if you know nothing of the leader’s life so that he remains a mystery (nearly always a “he”).  Even if the theory makes no sense (as in Freudian theory) there is a need to believe and submit.

  Does this sound familiar?  Yes there are the cults and then there are therapies that fulfill nearly all of the requirements of  a cult. No matter what therapeutic approach it is nearly always the same.. A knowing doctor who knows what is best for you and will either tell you how to live, to find “wholesome thoughts”, or will do something to you to change your life. And what they do is based on a theory with little science behind it but lots of  free-form speculation masquerading as theory.  By and large, as with cults, we are renting a daddy or mommy who will tell us how to live because we feel so lost. They will protect and guide us, love us, be concerned about us and our future, and all they require is obedience; never said as such but implied.  But you do have to pay because the doctor says it gives value to the therapy and helps you treat it seriously.  This is what I was told when I came back from the war a complete wreck and needed help.   I was of course broke and could not pay.  The doctors who stayed home during the war wanted me to value their therapy when I felt I was dying.   And by the way most of them were Freudian psychoanalysts.   And when they gave speeches it was always, “A Psychoanalyst looks at blah blah”. They were Gods, cult leaders in every sense of the term; and my professors expected obedience at every turn and never to question their theories.

  The unspoken contract between patient and doctor is that they know what is best for you. No matter what kind of therapy it is always "I know what is best";   but they don’t.  That is the tragedy, and the patient stays for years thinking the therapist knows best. Since he makes his money keeping you in therapy he has an interest in the therapeutic longevity of the patient.  It is never expressed or even acknowledged but it is there.  Again, guru or therapist, the dynamics are largely the same.  Except in the cult it becomes dangerous to quit and the group can be threatening. That is not the case in therapy except the doctor warns about leaving therapy too early.  It seems to always be too early.

  We have had the experience of patients telling their doctor about Primal Therapy only to be pooh-poohed as a cult and worthless.   This often happens when the doctor knows nothing of what we do.  And what we do is the opposite of a cult.  We teach the patient what we do and want him or her out of there as soon as possible.   The only authority is the patient who knows best what is wrong and what is in their unconscious.    There is no great leader who demands obedience and insists on not being questioned.  Too often in patients, there is this search for certainty and we want a therapist who looks like a doctor and who speaks with an air of authority.  We do not want a hesitant doctor.  We do not want a doctor who is not completely sure of himself.  We want the rock of Gibraltar.  Why?  So we can relax, submit, be guided and taken care of.  Lovely.  And when we get that daddy and mommy that should have been,  we stay in therapy.  It is then a permanent act-out on both their parts.  The doctor gets the glory and adulation, while  the patient gets a kind,concerned doctor/parent.
It is addictive for both and that is why it lasts and lasts.  And never does the doctor call the patient on his act out; he encourages it; you must come three times a week instead of two, blah blah.   It encourages dependence, which is not what we want at all.

   More and more we come to trust the doctor’s advice and he readily supplies it.  We go to find out if we should get married, change jobs, go to school, leave this person, etc.  In our therapy we rarely if ever give advice; we believe in self-determination.  We want the patient to trust himself and not be infantilized.  By the way I finally found an Analyst to treat me for battle fatigue and what did we do? Dream analysis because that was his specialty.

    When your whole world is invested in your doctor you keep on going and do not question.  Your whole world is wrapped around him.  What does he think of my decision?  Would he approve of this or that?

  There are some in cults who change their names and become Swamy da da da.  It is as if  they had no history. But in current cognitive therapy there is also no history;  it is more and more a therapy of the here-and-now.  History doesn’t account for much.  Not a big difference.

  Here is the diabolic part in all this; once we spin a web of belief in our followers all we have to do is manipulate the beliefs. We have control.  Our beliefs/theories are now deeply inside the patient/follower and his life is in our hands.  He believes in the Id or Ego or Shadow Forces and other nonsense.  He has no other frame of reference.   In the cult they keep others away so that you will not have a contrary frame of reference; you are now a true believer.  The cult says the beliefs are our stairway to heaven while the doctor says you are on the way to more healthy beliefs and a stable way of life; ergo a stairway to heaven.