Specialization or common factors?

to point out the modern problem of overspecialization, or the tendency of different theorists and research traditions to stay confined within a very narrow niche or perspective, while tending to ignore what others are doing. Overspecialization manifests itself in many ways in our field and beyond. In psychotherapy, one negative consequence has been the proliferation in the number of available therapeutic modalities—some estimates are as high as 400 different systems (Garfield & Bergin, 1994; Karasu, 1986). Often, people who create new approaches try very hard to distinguish what they are doing from pre-existing approaches without attempting to incorporate or account for the value of what has come before.

Forman, Mark D.. A Guide to Integral Psychotherapy (SUNY series in Integral Theory) . State University of New York Press. Kindle Edition. 

Much of psychotherapy has been based on trademarking and branding. CBT, DBT, EMDR, EFT, SFBT, Jungian, Family Systems, Client centered, Humanistic, Existential, Primal scream, etc. 

Workshops, certification programs, and other forms of credentialing separate and divide therapists so they can capture a market. However, what we know is that psychotherapy works and is beneficial because of its common factors, not its specialized techniques and models.

The common factors are: 40% of a good outcome are related to external circumstances that have nothing to do with the therapy itself, 30% of a good outcome are related to the quality of the helping relationship, 15% of a good outcome are related to hope and expectancy, and 15% of a good outcome are related to the skills of the therapist.

People come to therapy looking for various things such as “tools” to cope with their stress, and advice about how to resolve certain problems, but the most common thing people are looking for is someone who will listen to them and understand their situation and be there for them. From this listening the person gains a sense of emotional relief and enhanced well being and comfort.

Therapeutic listening is not easy. It takes discipline, skill, wisdom, and above all else an attentive non anxious presence. 

Psychotherapy is not simply personality adjustments.

Put simply, an understanding of the depths of human suffering and anxiety, the paradoxes and contradictions of the individual psyche, and the heights of spiritual knowing are not simply gifted to us through our socialization or upbringing—nor are these understandings the likely outcome of an otherwise sound, conventional training as a clinician. They must be understood first within the self if they are to be fully understood in others. And they cannot be understood in the self of the therapist without time, effort, and strong attention to therapist development. Integral Psychotherapy offers the therapist a map with which to cultivate these insights. It is an approach to therapy that aims to both serve the client and develop the self.

Forman, Mark D.. A Guide to Integral Psychotherapy (SUNY series in Integral Theory) . State University of New York Press. Kindle Edition. 

There are four kinds of intelligence: PQ, physical intelligence, IQ, cognitive intelligence, EQ, emotional intelligence, and SQ, spiritual intelligence. A competent psychotherapist should be an expert on all four with an emphasis on the last two, EQ and SQ.

Unfortunately, not many psychotherapists are well trained in SQ and haven’t necessarily mastered the basic skills of SQ, Spiritual intelligence is the basis of good psychotherapy and not simply coaching on techniques and tips for personality adjustments.

Therapist: Know thyself.

An additional feature of Integral Psychotherapy, one just as important as its inclusive theoretical stance, is that it strongly emphasizes the therapist's personal development. Whereas many systems call for therapists to be aware of their own cultural biases and countertransferential tendencies—or to more generally engage in self-care—Integral Psychotherapy goes far beyond this. Specifically, it brings the understanding of the therapist's role into line with constructivist–developmental theory (Kegan, 1994), which is an important, emerging approach to human knowing. This theory posits that, as humans, we actively construct our experience of our world and ourselves. Yet it also suggests that the depth and comprehensiveness of the reality we construct is set or limited by our individual development. This idea has deep implications for a therapist who wants to understand the full range of human experience.

Forman, Mark D.. A Guide to Integral Psychotherapy (SUNY series in Integral Theory) . State University of New York Press. Kindle Edition. 

What are the tools of the psychotherapist? A carpenter has a hammer and saw, a seamstress or tailor their needle and thread, an accountant their spreadsheets, and what is the main tool of the psychotherapist? Their personality.

A psychotherapist must use their personality in a purposeful and deliberate way to help their clients meet their goals.

What activities and experiences help the psychotherapist become more self aware so they can use their personality purposefully?

Cultivating wisdom

Often, if we are honest, it is precisely our theory of therapy itself that limits our ability to understand the client.

Forman, Mark D.. A Guide to Integral Psychotherapy (SUNY series in Integral Theory) . State University of New York Press. Kindle Edition. 

As therapists we need theories to understand the problems which clients present to us. To be well trained in a certain theory or technique is the basis for many workshops, CE classes, and certifications. However, when the only tool in your tool box is a hammer, everything starts looking like a nail.

I asked a colleague one time what he thought the most important quality was in a good therapist and he said, “Wisdom.” Having my BA in Philosophy I felt a warm glow with this answer.

I have spent my career reflecting on how one cultivates wisdom?

Book discussion - A Guide To Integral Psychotherapy by Mark D. Forman

 I am studying the book, A Guide To Integral Psychotherapy: Complexity, Integration, and Spirituality In Practice by Mark D. Forman. There will be many posts over the next few months about ideas from this book. Please, if you are interested, get a copy and follow along and comment on our discussion.

Suicide rates by country

The suicide rates by country in 2019 per 100K were 

Jamaica = 2.3

Italy = 4.3

Israel = 5.2

UK = 6.9

Germany = 8.3

Ireland = 8.9

France = 9,7

Canada = 10.3

Australia = 11.3

Japan = 12.2

U.S. = 14.5

Russia = 21.6

The US has twice the rate of suicide as the UK and 3 times the rate of Italy.

Grief - The body dies but the spirit lives on in the stories we tell.

 

The body dies but the spirit lives on in the stories we tell about the values, opinions, beliefs, and practices of the body which has died.

I had a dream last night about my paternal grandmother who died when I was 21. My aunt, her daughter, complained to me that I had not visited her and that she missed seeing me. I defended myself by telling my aunt, "But I thought she died?" My aunt repeated her statement, "No, she is alive and well and wants to see you."

"Okay," I said, "I'm sorry. I guess I was mistaken. I will go and see her."

I did go to see her and apologized. I said to her, "Grandma, I thought you had died."

She said, "No, I've been here and I've missed you."

She was quite different in that she seemed very happy and enjoying her life and I was very happy to learn she was alive and I could visit her now. We had a delightful visit and I look forward to many more. It was a joy to reconnect.