Psychotherapy: Needs Reboot? or Just Boot?

The word “reboot” assumes a prior boot.  You can’t reboot something that never booted up in the first place.  The American Psychological Association is calling for “rebooting psychotherapy.”  Is it even booted up?  The press release begins with an admission that questions whether psychotherapy ever got powered on.

The damaging quote from the American Psychological Association is right in the first paragraph:

Psychotherapy has come a long way since the days of Freudian psychoanalysis – today, rigorous scientific studies are providing evidence for the kinds of psychotherapies that effectively treat various psychiatric disorders. But Alan Kazdin, the John M. Musser Professor of Psychology at Yale University, believes that we must acknowledge a basic truth – all of our progress and development in evidence-based psychotherapy has failed to solve the rather serious problem of mental illness in the United States.

If a reboot would simply get the solution software running again, all would be well.  But this statement calls it a “basic truth,” one that must be acknowledged, that “all of our progress” has failed to solve mental illness.  Was that not ostensibly its goal, its mission?

To be sure, the remainder of the press release focuses on problems with getting the goods to the patients that need help, but nine months after Kazdin dropped his bombshell, he is challenging his colleagues “to rethink the current mental health system in order to make adequate treatment available and accessible to all who need it.”  This is followed by three bullet points on improving the delivery of psychotherapy.

But nowhere is there affirmation that the treatments actually cure anyone, even if “rigorous scientific studies are providing evidence for the kinds of psychotherapies that effectively treat various psychiatric disorders.”  It would seem that if the rigorous studies are such a good mousetrap, the world would beat a path to psychotherapy’s door.

Indeed, just before the bullet points, another damaging admission was made: “Now, in the latest issue of Perspectives on Psychological Science, several eminent scientists have come forth in response to Kazdin and Blase’s article, highlighting important points that will need to be addressed before the mental health care system can be overhauled….”

The last sentence is a distraction: “United States Department of Veterans Affairs has already developed and implemented new and innovative programs to address the mental health of its veterans.”  Innovative is nice, and addressing a problem is praiseworthy, but no evidence was provided the VA has any better a track record at solving mental illness.

This makes psychotherapy sound like a government project gone wrong, a bridge to nowhere, a design plan that never produced a working prototype.  If serious points must be addressed before the mental health care system can be overhauled, the software isn’t up and running, and there is no way to reboot it.

See also “Psychotherapy Struggles to Demonstrate Scientific Validity” from 11/13/2005 and three prior articles about psychotherapists struggling to define what mental illness is (2/17/2010, 2/28/2010, 4/21/2011).  Did the brain evolve?  See 11/09/2007 and 10/22/2010.

Did you notice the oblique slam at Freud?  He was the king of the hill in his day; now he is a joke (4/27/2011).  Psychotherapy has undergone so many revolutions in its brief history it is unrecognizable.  Now they tell us that in 2011 it has still ”failed to solve the rather serious problem of mental illness in the United States.” But they want to improve the delivery of this failure!  The chaotic history of psychotherapy, from couch talk to mythical unconscious divination to electric shock to drugs to non-directive counseling to whatever is the fad today, is enough to warn the wary to keep away from the charlatan industry with its self-admitted failure to achieve its own goals.

The human mind is too complex an entity to submit to the pseudoscience of psychology, and the mixed bag of psychotherapy.  A psychotherapist can never get into a patient’s mind, or understand all the complexities of causes and effects that produce outward symptoms.  The best that can be done is external observation: such-and-such a drug makes Joe less violent, an electric shock makes him forget his paranoid delusion, a horror movie makes Joe (but not Sam) sleepless, calm music relieves manic depression.  Some things might work in some patients as far as improving outward symptoms, but they can never prove that the psychotherapist has addressed the root cause. A lot of treatment reduces to common sense (2/21/2010), without the need for a shrink to tell you the obvious.

What if sin is real? What if sin produces real guilt, not just feelings of guilt?  Giving the patient a drug or calm music will only put a band-aid on the surface.  By ignoring the spiritual and moral dimensions of human beings, secular psychotherapists are limiting themselves to partial toolkits at best.  What if the necessary therapy for the “mentally ill” patient is forgiveness of sin that gets at the root cause?  Pastors have numerous true accounts of transformed lives, criminals turned into saints, addicts into missionaries, wolves into lambs, when they faced their true guilt and kneeled at the foot of the cross of Jesus Christ.  Talk about empirical evidence!

What if “mental illness” is an oxymoron?  There is physical illness, and everyone acknowledges that brain damage can lead to bizarre behavior.  These can be treated as physical illnesses, not “mental illness.”  In many Christian churches, there is a whole movement called Biblical counseling that, in contrast to psychotherapy, treats the root cause of behavioral problems (the ones lacking a physical cause) as sin.  Their patients often reach a profound sense of relief when they get straight talk about their sin problems, instead of the runaround about “mental illness” the shrinks offer with their pseudoscientific band-aid solutions.

Psychotherapist, heal thyself.  Show the goods, or you don’t get a reboot.  You just get the boot.