As an idealistic Catholic boy growing up in Philly in the 1950s, I saw just two pilgrim paths to the consequential life I wanted to live: become a priest and save souls, or become a therapist and save minds. After a stint in a seminary, where the celibacy requirement and I had a disagreement, I entered the therapy field in the early ’70s, when the slow, archaeological-dig approach of psychoanalysis was being challenged by a new tribe of humanistic therapists and encounter-group leaders, who went for quick breakthroughs.
The Gestalt therapy experiential training groups I later joined were skillfully conducted. Through enactments and open-chair work, we learned to get unblocked and open up our core emotions and desires. I had one of those powerful moments when I used the open chair to challenge, first cautiously and then loudly, a father figure from my seminary days, after which I felt a visceral release from guilt and resentment. We watched videos of Fritz Perl doing sadistic-looking confrontations of emotionally stuck clients whom he called fakes and frauds. After first responding with intellectualizations, these clients would eventually get angry and scream back at Perls—who’d then turn gentle and say, “Now you’re here with us.” Watching this was ghastly but fascinating for those of us familiar with unconditional positive regard.
For many of us, this way of working was about more than individual and group therapy: it was about social change. We were challenging the strictures of psychological oppression that infected society: rigidity, either/or thinking, conformity rather than authenticity.
The Coming of the Liberated Self
Eventually I (and lot of other therapists) came to see these intense therapeutic encounters as a kind of sugar high, with a crash afterward—or at least a return to baseline functioning. I also came to see the humanistic psychology movement as having lost its intellectual moorings with the waning influence of people like Carl Rogers and Rollo May. And I saw it as not relational enough—too much about the individual client and not the extended emotional web of the client’s connections to others.
In forging an alternative to psychoanalysis, the humanistic therapy movement was offering a new idea of the self in modern society. Therapy movements are more than a set of theories and techniques—they’re about what it means to be a human being at a particular time and in a particular culture. Psychoanalysis had offered up the idea of the Complex/Conflicted Self, the psyche full of ambivalence and contradiction. Successful therapy aimed to help people understand and accept their basic needs and desires, many of them socially unacceptable, and integrate them in a complex sense of being, never entirely free of internal conflict, but combining love and hate, attachment and fear of engulfment, responsibility and self-indulgence, insight and self-delusion.
Despite what our therapy textbooks imply, ideas like this don’t just spring purely out the heads of founders of therapy models, or just from distinct scientific breakthroughs. Social historians and writers like Adam Curtis, author of The Century of the Self, have shown how this conflicted Freudian Self fit with the darkness of World War I and the Great Depression, followed by the horror of Nazi genocide. The era between 1920, after Freud landed on American shores, and the 1950s, when psychoanalysis flowered among cultural elites, was mostly a time of survival and living with limits. Indeed, James Strachey, Freud’s translator and editor, wrote that one of Freud’s enduring themes was “the irredeemable antagonism between the demands of instinct and the restrictions of civilization.” Sometimes the instincts won out.
Baby Boomers in the Age of Aquarius wanted nothing to do with this mindset. An unprecedented economic boom and a rising educated middle class set the stage for the social revolutions of the 1960s. The world was being recreated, and what emerged was a new image of the self—I’ll call it the Authentic/Liberated Self. It appealed to pent-up desires to be self-determining, self-actualizing, individuated from overbearing families, and not boxed in by expectations of social conformity.
While underlying conceptions of the self loom far in the background for most clinicians, they’re at the heart of what shapes the way therapists practice. For me, during the 1970s and early ’80s, when a client would bring a conflict between needs of the self and responsibilities to others, I reflexively, at times blindly, would side firmly with the self. This would show up with clients making decisions during the big divorce revolution. I used to recommend that clients considering divorce think about four things: how would leaving help you, what would leaving cost you, how would staying help you, and what would staying cost you? In retrospect, this was a classic cost–benefit analysis, which left out any other stakeholders in the decision. When clients introduced concerns about their children, I (and many other therapists) reassuringly urged them to focus on what they needed to do for themselves: the children would be fine if the parents were fine.
I recall a client, Maureen, who had four teenage children and an alcoholic husband who was emotionally checked-out but a good breadwinner. She was unhappy in her marriage, and her husband wouldn’t work on his drinking problem. Despite my urging her to focus on the implications of her unmet needs in the marriage, she decided to stay until the last child left home, because she wanted to launch the children from a stable, economically sound family—and because she thought her husband wouldn’t be a competent single parent when the children were with him. I accepted her decision, but inside I felt she was selling herself short, betraying her authentic self. I now understand that she was doing a complex juggling of her personal needs and parental responsibilities.
Some of my new perspective comes from more decades of life experience, including 45 years of marriage and seeing in my clinical practice as many casualties as success stories from decisions to leave marriages. But at the time, my membership in the Liberated Self club didn’t allow me to validate Maureen’s sense of moral responsibility as a legitimate consideration in her divorce decision.
The Family Systems Movement
Around the time that therapists were pulling back from the excesses of the human potential movement of the ’70s, some of us began a love affair with family therapy and systems theory. This was the new road on my pilgrim path. It turned out to be an even more definitive break with staid old psychoanalysis. First of all, family therapy was grounded in cutting-edge cybernetics, which eventually brought the digital revolution, and in general systems theory, challenging the field of biology. It was about interdependence in the here and now. The clinical dramas that pioneers like Salvador Minuchin, Carl Whitaker, and Virginia Satir created were breathtaking. Even though nobody on the faculty in my graduate program was particularly into family therapy, in the intellectually fertile atmosphere of the field in the mid-’70s, I could learn from going to workshops, watching videos of these masters, and reading the torrent of literature that was being generated by the family therapy movement.
Psychotherapy Falls from Grace
All too soon, this blissful era of enchantment ended. The optimistic, even messianic, spirit of the 1970s gave way in the ’80s to an awareness of the dark side of family life (abuse, secrets, sexism) and how societal oppression could be enacted in the therapy room. Incest in particular was a game changer, both as a symbol of male domination and a horrible pathology that therapists had ignored since the time of Freud. The “pass” that therapy had somehow received from social ferment about gender (and race and sexual orientation) expired in the mid-’80s. Erstwhile, gurus were now accused of being patriarchs. Searching articles by therapists like Virginia Goldner questioned whether, rather than transforming therapeutic practice, feminism had merely been co-opted and defanged.
At first I followed the critiques of the therapy field with wounded interest. I hated the attacks on my therapy masters (I hadn’t noticed that they were mainly white men like me), and I worried that therapy was becoming “politicized.” But I came to realize that my field, and my own practice, weren’t immune to the pathologies and power imbalances of society. I’d accepted traditional gender roles, ignored racial injustice as a therapy issue, and embraced a systems view of domestic violence that ignored the fact that injuries and fear were usually one-sided.
The only path of integrity was to agree that my beloved profession sometimes caused harm, both to marginalized clients and also to the fabric of society—and that we had to change. Chastened by the vehemence of some of the critiques, I hoped our well-intentioned profession would make some collective headway toward a more socially conscious psychotherapy.
The Consumer Self
Fortunately, I wasn’t alone in my discomfort. By the end of the ’80s, the Authentic/Liberated Self was due for reevaluation. Although it’d been a powerful antidote to the post-World War II era of button-down conformity, it now looked out of balance, with too much self-absorption and freedom to manipulate others, not to mention ignorance of institutional forms of oppression. The broader society itself was now mired in identity politics and a conservative backlash against the liberationist movements of the ’60s. Reagan’s election in 1980 ushered in 12 years of conservative political leadership as political liberals struggled to find a way to replace the now-defunct New Deal coalition. Funding was slashed for the National Institute of Mental Health. In this environment of skepticism and retrenchment, psychotherapy lost its confidence as an expression of larger human purposes. It left us with a call to consciousness, but not a call to action or to a new formulation of the self.
In the midst of psychotherapy’s cultural purgatory, a new image of the self was taking hold in the wider American culture: the Consumer Self. As documented by Harvard social historian Lizabeth Cohen in her book A Consumers’ Republic, the consumer culture had kicked into high gear after World War II, when the US government had asked Americans to spend their way out of the aftereffects of the Great Depression. It was augmented by the unprecedented economic boom of that period, when so many Americans moved into the middle class. The psychologically self-absorbed Me Decade of the ’70s morphed into the greed-is-good economic Me Decade of the ’80s, and continued its ascendance in the ’90s.
Psychotherapy Turns Inward
Of course, therapists didn’t stop producing new ideas and healing practices in the ’90s and 2000s. We rediscovered trauma as not just the product of violence and war, but as a widespread human experience. After the national trauma of 9/11, we got new insight into the sources of human resilience. The neuroscience fields gave us new insights into emotion, self-regulation, and interpersonal attunement. Along with our fellow Americans, we discovered mindfulness as a way to cope with an era of anxiety and social media saturation.
But for me, even with all these gains, we lost something that had inspired many therapists in the earlier decades: attention to the larger context and a sense that we could make a difference outside the consulting room. We became more focused on individuals and couples, losing sight of families, social networks, and communities. We concentrated on diagnosing discrete disorders and treating specific conditions. We lost sight of public mental health and social conditions. We got small and surrendered any pretense that we offered the world a vision of the healthy, fully functioning self beyond being symptom free. We stopped claiming a place in the big, contentious conversation that every society must have about what human flourishing should look like at a particular time in history, and how to promote it.
Therapy in the Modern Age
At this time of fragmentation and division, we need to recognize that we’re in the glue business. We know something about helping people connect, about how to form a healthy “we” out of self and other. We also know something about how to depolarize conflict. But first our society needs us to recover our conviction and passionate intensity as a profession, our belief that we have something to offer beyond symptom reduction, something that embodies wisdom about what it means to live a fulfilling, purposeful life in healthy families and communities. We need a new image of the self to counteract the Consumer Self of hyper-individualism, which, because the individual alone is impotent in a mass society, easily falls prey to tribal loyalties.
This blog is excerpted from "Psychotherapy's Pilgrimage" by William Doherty. The full version is available in the January/February 2017 issue, The Connected Self: Psychotherapy's Role in the Wider World.
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Topic: Professional Development