Reflections on General Issues Discussed During Psychotherapy

In order that I might, from time to time, offer my thoughts on issues that arise in therapy sessions as well as generic issues shared by many of my patients —without any personal reference, of course—I have shared a few reflections on this page. I hope that they may be of some benefit to you.

Lessons from George

These reflections are based on a dialogue I had many years ago with an Inuk friend, George. We would discuss many things, including issues of mental health, but even discussions on other subjects would inevitably be applicable to my work with patients.

My friend lives approximately 2000 miles north of Ottawa in the Canadian Arctic, and we haven’t been in touch for many years now, but I still hold very dear the “jewels” in his many stories about life in the Arctic. I could share many of George’s stories, and I might do so over the coming years; but for now, I’ve included only a few below:

Homesickness

George explained to me that grandparents have a significant role as teachers for Inuit children as parents are often busy attending to necessary day-to-day activities to sustain their family. Grandparents often teach through storytelling and help children experience their environment through an intense focus on sensation and perception. Children are taught to learn with all their senses. For example, if someone were to present an Inuk person with something that was very new to them, they would very quickly name five things the new object feels like, smells like, looks like, tastes like, etc. Another example would be that people of the North have many different words for snow, each referring to differences in texture, weight, and density, for instance.

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I entered the field of psychology at a time when existential and humanistic philosophy and psychology were very popular, as well as both Freudian and Neo-Freudian approaches to understanding psychopathology and treatment. Consequently, I became well-versed in humanistic and psychodynamic theory and practice. At the same time, a proliferation of studies using a learning theory model of human psychology suggested a more concrete or empirical approach to treatment, resulting in a treatment that might be more readily measured and more standardized in delivery. There was also a rapidly growing interest in Albert Ellis and rational emotive therapy, Carl Rogers and person-centred therapy, and even Fritz Perls and gestalt therapy. These approaches represent sharp contradistinction, not only to the Neo-Freudians (including Adler, Jung, and later, May, Kohut, Kernberg, Winnicott, and even more recently, Sullivan and Horney) but also, more significantly, to the emerging popularity of behaviourism (founded upon the philosophy of Logical Positivism). The latter was supported by Learning theory and its product, Behaviour therapy, another rapidly expanding and increasingly popular therapeutic approach and the ancestor (so to speak) of the now predominant approach in psychotherapy, cognitive behaviour therapy (CBT). These were very compelling times in psychology, with a great diversity of approaches to understanding and helping the human person. On one hand, positivists would complain of the idealism and questionable science of the psychodynamic and humanistic and existential approaches; on the other hand, idealists and realists would complain of the reductionist materialism of the positivists, who might consequently “lose sight of the forest for the trees.” The advantage of being in the centre of these controversies was the opportunity to derive what was beneficial and realistic from all these points of view, which inclined many psychologists of the time, including myself, to adopt a so-called eclectic approach to treatment.

Addiction

Once, George and I were discussing the terrible affliction that many people in the North are faced with: addiction. George appeared uninterested in the suggestions that constitutional predisposition or other physical or genetic factors were responsible. His focus was on the intense feelings of shame and humiliation experienced by Inuk, who use any substance whatsoever, even the first time. He explained that experiencing such feelings is overwhelmingly devastating for an Inuk person because of the way their community would react toward them.

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I entered the field of psychology at a time when existential and humanistic philosophy and psychology were very popular, as well as both Freudian and Neo-Freudian approaches to understanding psychopathology and treatment. Consequently, I became well-versed in humanistic and psychodynamic theory and practice. At the same time, a proliferation of studies using a learning theory model of human psychology suggested a more concrete or empirical approach to treatment, resulting in a treatment that might be more readily measured and more standardized in delivery. There was also a rapidly growing interest in Albert Ellis and rational emotive therapy, Carl Rogers and person-centred therapy, and even Fritz Perls and gestalt therapy. These approaches represent sharp contradistinction, not only to the Neo-Freudians (including Adler, Jung, and later, May, Kohut, Kernberg, Winnicott, and even more recently, Sullivan and Horney) but also, more significantly, to the emerging popularity of behaviourism (founded upon the philosophy of Logical Positivism). The latter was supported by Learning theory and its product, Behaviour therapy, another rapidly expanding and increasingly popular therapeutic approach and the ancestor (so to speak) of the now predominant approach in psychotherapy, cognitive behaviour therapy (CBT). These were very compelling times in psychology, with a great diversity of approaches to understanding and helping the human person. On one hand, positivists would complain of the idealism and questionable science of the psychodynamic and humanistic and existential approaches; on the other hand, idealists and realists would complain of the reductionist materialism of the positivists, who might consequently “lose sight of the forest for the trees.” The advantage of being in the centre of these controversies was the opportunity to derive what was beneficial and realistic from all these points of view, which inclined many psychologists of the time, including myself, to adopt a so-called eclectic approach to treatment.

Rescue

Knowing how to help someone who’s in distress is not always easy. Often, their distress causes us distress, and then it can become quite confusing as to whom we’re trying to help: them or us.

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I entered the field of psychology at a time when existential and humanistic philosophy and psychology were very popular, as well as both Freudian and Neo-Freudian approaches to understanding psychopathology and treatment. Consequently, I became well-versed in humanistic and psychodynamic theory and practice. At the same time, a proliferation of studies using a learning theory model of human psychology suggested a more concrete or empirical approach to treatment, resulting in a treatment that might be more readily measured and more standardized in delivery. There was also a rapidly growing interest in Albert Ellis and rational emotive therapy, Carl Rogers and person-centred therapy, and even Fritz Perls and gestalt therapy. These approaches represent sharp contradistinction, not only to the Neo-Freudians (including Adler, Jung, and later, May, Kohut, Kernberg, Winnicott, and even more recently, Sullivan and Horney) but also, more significantly, to the emerging popularity of behaviourism (founded upon the philosophy of Logical Positivism). The latter was supported by Learning theory and its product, Behaviour therapy, another rapidly expanding and increasingly popular therapeutic approach and the ancestor (so to speak) of the now predominant approach in psychotherapy, cognitive behaviour therapy (CBT). These were very compelling times in psychology, with a great diversity of approaches to understanding and helping the human person. On one hand, positivists would complain of the idealism and questionable science of the psychodynamic and humanistic and existential approaches; on the other hand, idealists and realists would complain of the reductionist materialism of the positivists, who might consequently “lose sight of the forest for the trees.” The advantage of being in the centre of these controversies was the opportunity to derive what was beneficial and realistic from all these points of view, which inclined many psychologists of the time, including myself, to adopt a so-called eclectic approach to treatment.

Not Taking Things Personally

There are a few concepts that create more consternation for patients than the concept of not taking other people’s behaviour personally. “How can I not take my wife’s affair… my boss’s harassment of me… my friend’s betrayal...personally?” To be sure, these behaviours are painful, sometimes devastating, and often blamed on the victim. “I wouldn’t have had an affair if you had just made yourself more appealing… I wouldn’t have to yell at you if you would just do your job properly. And besides, this is normal in the industry, so suck it up… If you weren’t so sensitive, I would have included you.”

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I entered the field of psychology at a time when existential and humanistic philosophy and psychology were very popular, as well as both Freudian and Neo-Freudian approaches to understanding psychopathology and treatment. Consequently, I became well-versed in humanistic and psychodynamic theory and practice. At the same time, a proliferation of studies using a learning theory model of human psychology suggested a more concrete or empirical approach to treatment, resulting in a treatment that might be more readily measured and more standardized in delivery. There was also a rapidly growing interest in Albert Ellis and rational emotive therapy, Carl Rogers and person-centred therapy, and even Fritz Perls and gestalt therapy. These approaches represent sharp contradistinction, not only to the Neo-Freudians (including Adler, Jung, and later, May, Kohut, Kernberg, Winnicott, and even more recently, Sullivan and Horney) but also, more significantly, to the emerging popularity of behaviourism (founded upon the philosophy of Logical Positivism). The latter was supported by Learning theory and its product, Behaviour therapy, another rapidly expanding and increasingly popular therapeutic approach and the ancestor (so to speak) of the now predominant approach in psychotherapy, cognitive behaviour therapy (CBT). These were very compelling times in psychology, with a great diversity of approaches to understanding and helping the human person. On one hand, positivists would complain of the idealism and questionable science of the psychodynamic and humanistic and existential approaches; on the other hand, idealists and realists would complain of the reductionist materialism of the positivists, who might consequently “lose sight of the forest for the trees.” The advantage of being in the centre of these controversies was the opportunity to derive what was beneficial and realistic from all these points of view, which inclined many psychologists of the time, including myself, to adopt a so-called eclectic approach to treatment.