{"id":3051,"date":"2010-02-12T15:10:00","date_gmt":"2010-02-12T23:10:00","guid":{"rendered":"https:\/\/blatner.com\/adam\/blog\/?p=3051"},"modified":"2025-08-31T15:06:40","modified_gmt":"2025-08-31T23:06:40","slug":"beyond-psychotherapy","status":"publish","type":"post","link":"https:\/\/blatner.com\/adam\/blog\/?p=3051","title":{"rendered":"Beyond Psychotherapy"},"content":{"rendered":"\n

As mentioned in the paper (also posted on this website) titled\u00a0\u2018Shrink\u2019 or \u2018Expander,’<\/a>\u00a0the field of psychotherapy has emerged and gone through at least two phases: In the first phase, the model of dis-ease and healing involved opening to the powers of the unconscious mind. Such practitioners imagined themselves as expanding the options available to people through the power of truth, of knowing the issues involved in the pitfalls and temptations of self-deception.<\/p>\n\n\n\n

However, as fields develop, it is common that earlier theories and sets of assumptions come to be thought of as being too limited. To the extent that some professionals sought to explain their patients\u2019 problems according to these early theories, the slang term \u201cshrink\u201d functioned not only to reduce the status gradient and degree of vulnerability of patients in the mid-late 20th century, but also to express how the \u201cold-fashioned\u201d therapists\u2019 work appeared in the eyes of the next generation, which was more integrative, eclectic, and open to the human potential. <\/p>\n\n\n\n

Yet, ironically, even this generation of psychotherapists with their wider range of ideas about what made people \u201csick\u201d and what could be done to help them might be viewed as still restricted by their role and world-view, might still be thought of as slightly shrink-like, because many of the actual factors in psycho-social dis-ease require diagnosis and remediation at the level of the culture, the body politic, the overall social system of norms and expectations. Such a challenge is vastly more difficult, and no single person can do all that much. (The line, \u201cIt takes a village to raise a child\u201d may illustrate this problem.)<\/p>\n\n\n\n

The key is the word \u201chygiene,\u201d which means preventive medicine, activities the individual, family, or the whole society can do to prevent disease before it even happens. (There are other gradients of prevention, too: Early and prompt treatment can prevent complications; and adequate treatment of complications can prevent even more problematic secondary and tertiary complications. So, for example, early stroke treatment with physical therapy can often reduce long-term disability.)<\/p>\n\n\n\n

Still, it seems valid for me to at least begin the process by attempting to name the issues, to identify and clarify the nature of the problems involved. The key is to recognize that cultural factors can affect mental hygiene as much as public health measures (which often involve fundamental political activities) may be necessary to affect physical hygiene. The following themes are among those that I imagine will become recognized as being factors in psycho-social distress and dysfunction:<\/p>\n\n\n\n

Ignorance and Education<\/h3>\n\n\n\n

I\u2019ve been impressed in my over forty years in clinical practice and teaching that most people lack what I consider to be fairly basic information about the nature of the mind and relationships. I think these ideas should be taught in the mainstream curriculum, especially in the middle and later years\u2014from middle school through college. I think that many problems arise because folks have just never heard certain themes being talked about, discussed, clarified, informed. I consider this a kind of \u201cpsychological illiteracy.\u201d <\/p>\n\n\n\n

About a century ago, in the shift from a more rural and agrarian culture to a more urban and industrial society, learning how to read and write\u2014acquiring literacy\u2014became increasingly necessary for economic success. I think that today knowing how to develop the skills of self-awareness, communications, and interpersonal problem-solving are becoming as necessary for adaptation in a postmodern world as learning to read, write, and do arithmetic was a century past. I call these types of skills \u201cpsychological literacy.\u201d<\/p>\n\n\n\n

While some of this may be learned in therapy, I believe most should have been learned in school as a matter of public policy. It involves the way we (collectively) run public and private schools, and progress in this direction needs to recognize the prevalence of barriers of prejudice towards psychology! 

It\u2019s not just a matter of learning information. Skills need to be developed, practiced, and this also entails a shift from mere instruction to experiential practice. For example, I envision young people role playing situations that involve the exercise of tact, diplomacy, good manners, and more subtle communications skills. <\/p>\n\n\n\n

It still is widely assumed that ordinary adults were adequately self-aware, but this is not so. Psychological literacy doesn\u2019t come naturally with age, but needs to be learned specifically\u2014again like reading and writing. As another analogy, for much of history it used to be thought that the average diet that didn\u2019t starve one was therefore adequate\u2014but that was before research had been done on vitamins, essential minerals, and other subtle nutrients.  Again, these are matters that involve not only education, but the general public that would support such policies, as expressed in the political and economic arenas.<\/p>\n\n\n\n

Economic Injustice<\/h3>\n\n\n\n

Dare we propose that there could be a middle ground between the folly of state communism and exploitative capitalism? I think we need to recognize that political and economic systems that leave large numbers of people unnecessarily disadvantaged and poor tend to create a variety of consequences in terms of morale, the strength of the family or parental responsibility, peer group values, and so forth. It\u2019s clear these contribute to higher degrees of social pathology, crime, cheating, addiction, and so forth, which in turn generate occasions of trauma and a far more pervasive incidence of post-traumatic reactions among victims and their families than might otherwise occur.<\/p>\n\n\n\n

Not All Problems Can Be Solved Through Social Action<\/h3>\n\n\n\n

At this point, I think it\u2019s necessary to note that of course there are many psychosocial  problems that will inevitably arise as part of the human condition. I think that people tend to retain childish attitudes and personal maneuvers, and these will need to be worked out as part of maturation. (See paper on the primal illusions<\/a>.) Some anxiety, depression, and other symptoms accompany the mere process of adjusting to the realities of life. This happens even if parents are perfect in their role performance in every way. Given that, the goal of mental hygiene is not perfection, any more than the goal of physical hygiene would prevent every possible infection. (Indeed, a certain amount of infections of different kinds may actually strengthen the immune system and be necessary for optimal health, and, similarly, a certain amount of stress and distress may be optimal for helping people to learn to be optimally resilient.) Nevertheless, I am sure that there are also a great many sources of unnecessary stress, trauma, and folly, and I think that addressing these challenges to mental health also belongs in a realistic review of what might be the actual causes of psychiatric symptoms and socially destructive patterns.<\/p>\n\n\n\n

Identifying Forms of Oppression<\/h3>\n\n\n\n

I define oppression as a situation in which the negative impacts are denied by certain key people, or the whole problem is ignored. The key is the mixture of denial and mere unconsciousness: Many people grew up in that value system and it has never occurred to them that it should or even could be different.<\/p>\n\n\n\n

An oppressive system evolves into a controversy when a certain critical mass of critical people have been able to voice their criticism so that many if not most others at least have heard of their objections. Then there may be a period of years or decades (or centuries) where that new or alternative idea gradually gains enough reputability so that new norms become established.<\/p>\n\n\n\n

Someone once said that a new idea is at first received with incredulity\u2014those questioning the system must be mad or very wicked\u2014; then contempt\u2014those questioning the system are wrong-headed, merely childishly rebellious, or in other ways demonized. Finally, the idea that, say, women should vote or slavery is a bad thing becomes a norm.<\/p>\n\n\n\n

What happens with each breakthrough, though, is that most people revert to feeling that now that this wrong has been righted, everything else is okay. The scarey truth is that there are many other oppressions that remain taboo and unconscious. <\/p>\n\n\n\n

So, beyond psychotherapy, a higher consciousness approach includes addressing number 5, extending the list started in the previous section, working to clarify and justly ameliorate all potentially oppressive situations!<\/p>\n\n\n\n

Subtle Oppressions<\/h3>\n\n\n\n

Once the idea of oppression is absorbed, along with the idea that there may be widespread social practices and attitudes that only benefit the more privileged\u2014and sometimes even then not that much\u2014, then one begins to wonder about our society:
    A. Appearance, the need to fit a rather narrow range of the sense of being attractive, involving hair, cosmetics, body build, clothes, fashionable accessories, tatoos, etc., leads to all sorts of syndromes that are not infrequently carried to excess\u2014sometimes by the most high-striving of society (e.g., anorexia in dancers and models; plastic surgery in aspiring actors or media celebrities). Books are being written about this, but incredible amounts of money are being spent, and energies expended, and psychological distress experienced, for those for whom the ideal doesn\u2019t come easy.
    B. The theme of uncomfortable clothing is worth mentioning, for men as well as women\u2014clothes that are insufficient for when it\u2019s cold, or too stuffy when it\u2019s hot, too tight or bulky, that interfere with using the toilet, too sexy when one might not want to be seen in that role, and so forth. 
    C. I think the dominance of the realm of imagination by the media and toy manufacturers, like competition, goes too far. There needs to be more time and activities that allow kids and adults to cultivate their own inner potential for imagining, rather than having the images packaged and delivered to them. I call this \u201cimaginative oppression.\u201d 
     D. In the same sense, the commercial availability of games, social media, and distractions has made it difficult to discover the rewards of some degrees of solitude, which then confer some degrees of a sense of self-sufficiency. (I\u2019m really talking about letting there be some balance in systems that may have become unbalanced.) <\/p>\n\n\n\n

Need for a Realistic Philosophy of Life<\/h3>\n\n\n\n

Philosophy for a few centuries became the domains of religion, where it operated within a context of certain given assumptions; or the domain of academic philosophy, where professors and graduate students attempted to address the broadest problems in the most thorough fashions, which made the subject too dry, way too thick, and irrelevant to the general population. Of course there were implicit philosophies of life as played out in the major institutions and general culture, but few people were aware that they were using, struggling with, or disagreeing with the core issues involved.<\/p>\n\n\n\n

I think that many people today who suffer even a little from the more common psychological symptoms are often stressed also by a confusing, misleading, excessively and un-necessarily guilt- or shame-producing, or inadequate philosophy or set of beliefs about what life is about. Their sense of meaning and what their purpose should be is correspondingly confused, watered-down, or even lacking. My impression is that this is pervasive, but if life is not particularly stressful, for many they go on, not for the moment needing the consolations of a more resilient philosophy.<\/p>\n\n\n\n

For those under stress, though, the lack of such a philosophy can make a big difference in how well and with what effectiveness they can marshal their other psycho-social resources. (In medicine, to show an analogy, there is evidence that certain kinds of nutritional deficiencies can weaken the immune system\u2019s effectiveness. So although it is the immune system that is the first level of defense, the overall nutritional status in turn affects the immune system. Similarly, the effectiveness of the cultural morale may affect personal psychosocial resilience.)<\/p>\n\n\n\n

Work on generating a more effective popular philosophy may be a realistic goal for those thinking about mental hygiene in the broadest terms. (Again, from that standpoint, even the most broad-minded, most modern and eclectic psychotherapists are, relativistically speaking, \u201cshrinks.\u201d<\/p>\n\n\n\n

Spirituality<\/h3>\n\n\n\n

For many people, a philosophy of life, their spirituality, and their religion are not significantly different, so the point to be made here is a further extension of the idea of addressing the transpersonal or spiritual dimensions in psychotherapy\u2014but applying this beyond the therapeutic context. <\/p>\n\n\n\n

I define spirituality as the activity\u2014not a state of being, but an activity, a doing\u2014the activity of developing a relationship with and\/or deepening one\u2019s sense of connectedness to the Greater Wholeness of Being. This Greater Wholeness may be symbolically personified as God or one of the other names for Divinity, or it may be non-personal, a set of cosmic and moral ideals or principles. The associated belief is secondary. People can be spiritual without adhering to this or that belief system. <\/p>\n\n\n\n

The key, though, is that this greater relationship works to offer some sense of significance withing a grander system. Human life is not just getting by and getting what you can in the process. Nor is it just about the individual. A psychotherapist who represents a psychology that over-emphasizes individuality is almost by definition a shrink. Certainly I am, and promoting some degree of individuality is useful; but also we are, and a psychology and philosophy that doesn\u2019t take that wider dimension into account is inadequate. <\/p>\n\n\n\n

It used to be that this job was delegated to the minister. People were assumed to be affiliated with a religion that satisfied their existential questions. This turns out to be so wrong. Some people (perhaps most?) who are religious\u2014in that they feel affiliated with an institution that tries to organize the spiritual impulse\u2014have no idea how to go about becoming more spiritual, how to deepen or develop their connectedness. For them, mere membership suffices. And for some, certain religions don\u2019t work insofar as truly helping them to find the solace and meaning that they hope to achieve.<\/p>\n\n\n\n

The idea that religion and a full psychology can be separated is quickly becoming as untenable as the idea that body and mind, or mind and society can continue to be adequately thought about in separate compartments. Our present era is deeply inter-disciplinary, even if many of the practitioners of different disciplines, specialities, departments, and so on haven\u2019t caught on yet.<\/p>\n\n\n\n

Reducing Fear-Based Motivations<\/h3>\n\n\n\n

One of the more pervasive patterns in our culture has been its reliance on fear-based motivation. This takes a variety of forms, and the point here is that unless the culture as a whole rises up to challenge these types of oppression, they will continue to generate psychological distress.\u00a0<\/p>\n\n\n\n