Dr. David Crowe’s Clinical Focus
Logotherapy, or Finding Meaning
The approach to therapy most consistent with my own is logotherapy, developed by Viktor Frankl. His essential presuppositions are that life has meaning at all times and that individuals are intrinsically motivated to find meaning in their life. Frankl believed that a “will to meaning” is the individual’s central motivation, in contrast to Adler’s “will to power” (cf. Nietzche) and Freud’s “will to pleasure,” for example.
Personalism and Existential Theory
Generally speaking, existential theory and personalism form the philosophical foundations of my approach to therapy. As it would relate to psychology, personalism suggests that the dignity of the human being as “person” is the starting point for all philosophical analysis or, in fact, all research. Much of modern-day research is reductionistic. While reductionism has its advantages in specific circumstances, such as identifying the enzyme deficiency in PKU, the value and understanding of “person” have become eclipsed by the overwhelming struggle to produce “fact” or “proof.” This is perhaps because the focus of personalists on questions of subjectivity, objectivity, unicity, relation, freedom, moral action, and ethical decision-making does not so readily lend itself to inferential research models or empirical validation, as it were.
I believe that any responsible and ethical professional should respect efforts to show proof of any treatment’s efficacy. I am concerned, however, that argument by reason has seemingly fallen out of favour with professional psychologists. Even the University of Ottawa, where I studied, has long since abandoned its previous orientation, “Christian Personalism in a Pluralistic Context,” in favour of the more modern emphasis on providing guidance to students according to standards of so-called empirical validation.
Interpersonal, Existential, and Attachment Theories
My treatment approach does have other important influences. These include Harry Stack Sullivan’s interpersonal theory, Rollo May’s existential therapy, and even more recently, attachment theory.
I also regularly recommend to my patients books that are more specifically focused on strategies for managing intense effects, such as Christine Padesky’ s Mind Over Mood and David Burns’ The Feeling Good Handbook. Jeffrey Young and Janet Klosko’s Reinventing Your Life is very readable, and many patients tell me they have found it helpful. Young’s approach, schema therapy, is founded upon cognitive behavioural therapy (CBT). I also often recommend couples John Gottman’s Seven Principles for Making Marriage Successful or Sue Johnson’s Hold Me Tight.
Interpreting Poor Choices
A common element to all therapies has to do with choice. In fact, Frankl is credited with once having said that between stimulus and response, there is a space, and in that space, one has the power to choose, and in that choice lies our freedom. I believe that the goal of psychotherapy is very well described in this statement.
Approaching our understanding of choice without feeling disappointed in ourselves for the poor, often self-sabotaging, choices that we all inevitably make can be difficult. Therapy must, therefore, be a safe place where a person can examine their choices without negative, moralistic judgement and be free from blame and recrimination. Therapy should be about gaining a better understanding of how we inadvertently block or obstruct the discovery and affirmation of meaning in our lives. I generally assume that the person in front of me seeking help and support, just by being there, is making a choice to better understand how to live according to values that give their life meaning.
“Mistakes,” or poor choices, represent blind spots, so to speak, evidence that we missed or overlooked some stressors or threats that temporarily derailed us from the goal of living more consistently with meaningful values.
For example, despite a genuine commitment to balanced and loving parenting, if I nevertheless become impatient and harsh with one of my children, I might still maintain my belief that I am committed to the goal and value of being a loving parent. The moment of impatience was a poor choice, but not necessarily evidence of insincerity or inadequacy. If I take for granted that I am committed to a meaningful goal, then I might better understand the impatience as resulting from a brief “loss of faith,” a momentary suspension of my belief in the value and importance of being a loving parent.
When accumulated, these “mistakes” might result in the sense of being “lost” and cause feelings of despair, anger, or cynicism. Therapy helps patients explore their “mistakes,” those “momentary suspensions of belief” that result from fears that are often unconscious and triggered by similarly imperceptible threats. That’s why it’s so valuable to speak with a therapist who understands the meaningfulness of your commitment to value, a commitment Frankl might argue is a will to meaning and freedom. Through dialogue, your therapist can help reveal the threats and fears that challenge your commitment and help you experience more fully your freedom to love.
