mtl3p

The Gift of Therapy: An open letter to a new generation of therapists and their patients

“But offering guidance and inspiration to the next generation of psychotherapists is exceedingly problematic today because our field is in such crises. An economically-driven health care system mandates a radical modification in psychological treatment and psychotherapy is now obliged to be streamlined — that is, above all, inexpensive and, perforce, brief, superficial, and insubstantial.

I worry where the next generation of effective psychotherapists will be trained. Not in psychiatry residency training programs. Psychiatry is on the verge of abandoning the field of psychotherapy. Young psychiatrists are forced to specialize in psycho-pharmacology because third-party payers now reimburse for psychotherapy only if it is delivered by low-fee (in other words, minimally trained) practitioners. It seems certain that the present generation of psychiatric clinicians, skilled in both dynamic psychotherapy and in pharmacological treatment, is an endangered species.

What about clinical psychology training programs — the obvious choice to fill the gap? Unfortunately, clinical psychologists face the same market pressures and doctorate-granting schools of psychology are responding by teaching a therapy which is symptom-oriented, brief, and, hence, reimbursable.

So I worry about psychotherapy — about its deformation by economic pressures and about its impoverishment by radically abbreviated training programs. Nonetheless I am confident that, in the future, a cohort of therapists coming from a variety of educational disciplines (psychology, counseling, social work, pastoral counseling, clinical philosophy) will continue to pursue rigorous post-graduate training and, even in the crush of HMO reality, will find patients desiring extensive growth and change who are willing to make an open-ended commitment to therapy. It is for these therapists and these patients that I write The Gift of Therapy. … Throughout these pages I advise students against sectarianism and suggest a therapeutic pluralism in which effective interventions are drawn from several different therapy approaches. ”

it’s really good. lots of stuff on the “here and now” of the theraputic relationship, transference and counter transference being “grist for the mill” of therapy, and about mastering the tools so that intution can play a role. i’m pretty much finished. I’ve had to make sure not to read it too quickly.

and Out of the Flames by Lawrence and Nancy Goldstone.

“Both a scientist and a freethinking theologian, Michael Servetus is credited with the discovery of pulmonary circulation in the human body as well as the authorship of a polemical masterpiece that cost him his life. The Christianismi Restitutio, a heretical work of biblical scholarship, written in 1553, aimed to refute the orthodx Christianity that Servetus’s old colleague, John Calvin, supported. After the book spread through the ranks of the Protestant hierarchy, Servetus was tried and agonizingly burned at the stake, the last known copy of the Restitutio chained to his leg.

Three copies of the Restitutio managed to survive, despite every effort on the part of his enemies to destroy them. Out of the Flames trackes the work’s history, examining Servetus’s life and times and the politics of the first information revolution during the sixteenth century. It is an extraordinary story providing testament to the power of ideas, the enduring legacy of books, and the triumph of individual courage.”

This review sold me on reading it:

“Though once an influence on Voltaire, Jefferson, and Emerson, Servetus has received little attention in recent decades. This fascinating study should help remedy that neglect.” -Booklist

This book, more than any other reading/learning I’ve done in the field of the history of communication technology, has given me reason to persist in my work as a communication activist. I’ve read and been part of many failures to advance public interest through ICT, but the story of the effect of the gutenberg press on protestantism (in terms of allowing it to happen) is amazing. The power it gave people to learn about alternatives and to speak to each other literally changed the world, and in some wonderful ways. And what’s important to me is that I can connect my own practice of reading to a really positive impact on my life, as opposed to my practice of interneting (mixed good and bad) and watching television + video (more bad than good).

The idea that there are people who can track the flow of intellectual thought in that way is amazing. I want to be one of them one day.

I like this quote by Calvin against blogging (well, against using the new power of the printing press to publish for the sake of it - ie: I write, therefore I am):

“Whoever in this day has been born with more than average ability … generally rushes out with it into the world, fired with the ambition of getting fame, so that posterity may venerate his memory with monuments to his greatness … Hence the insane passion to write something … Publishing inchoate books the writers often plead the inexperience of youth, or the wanton entreaties of their friends, and chatter I know not what triffles to escape the imputation of having committed a mistake. As for me, I should want to bring forth no embryos at all if I could produce only premature ones; in fact, I should rather abandon them as abortions than bring them forth before their time. My purpose is not so much to commend myself to the benevolent reader as to the critical one, the more so since I come from the common class of people and even if I should be gifted in erudition to a moderate degree, I have nothing that could excite any hope of fame.”

;-) erm, yeah. (feeling sheepish).