Customized treatment

Therapy is not just a profession, an occupation, it is an art. And as with all art, only few reach the highest levels. That is fine. We also need people who write advertising bulletins, newspaper reports and online posts, not just Dostoevskys. Many decent therapists who do their jobs well are needed, even if they lack genius.

It seems that one of the genius therapists was Milton Erickson. In his original thinking capacity, Erickson offered an innovative model of therapy: a treatment that is completely adapted to the patient, rather than to predetermined rules. He was able to see the patient, to formulate his or her problem deeply, and then think of the quickest way to solve this problem, a way that was almost always unexpected (since the patient has apparently tried all the expected ways, unsuccessfully). 

Erickson’s approach is instructive – the therapist should be the one who directs the encounter. Karen Horney once said: “Patients come to therapy not to cure their neuroses but to perfect them.” If the patients are the ones who determine what is happening in the therapy session, almost everyone will unconsciously do everything necessary to prevent real therapeutic change. When a patient goes about in a useless way, Erickson said, the therapist has to distract him, for example by making an irrelevant remark, such as “I know what you think. I like trains as well.” Then the patient can be directed to a more fruitful path. 

Erickson quoted Adler as saying: “Therapy is like spitting into the patient’s soup. He can continue to eat it, but he can no longer enjoy it.” An example of such a ‘spit’ is to take a symptom and turn it into a task; Instead of trying to fight it – actually reinforce the symptom absurdly. Thus, for example, Erickson weaned a 15-year-old girl from sucking a finger – by making thumb-sucking obligatory. 

The reading of Erickson’s heroic stories arouses much appreciation, as well as a measure of despair – his way of action requires a rare talent. Nevertheless, he provides exceptional inspiration for seeking a different approach to treatment problems. It should be remembered that one of Erikson’s main teachings to his students was: “Do not try to be like me, be who you are, at your best.”

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Psychiatrist Paul Lucas, the protagonist of Roderick Anscombe’s The Interview Room, said: “I believe in telling the truth. In my opinion, it is an enduring force that cannot be stopped. With time, it will penetrate into every lie, every self-deception, any attempt at repression. It manages to seep through somehow.”

Truth is one of the most powerful tools the therapist has. If she manages to maintain a policy of telling the truth without deviating from it, it can lead to release in the patient. This is not simple. Countless times during therapy there is a temptation not to say everything, to hide, diminish importance, paint a pink picture. But in the long run, the policy of telling the truth is the best one, for the patient.

Wilfred Bion quoted a letter by Samuel Johnson, which, to him, expresses the essence of “the psychoanalyst’s view”:

Whether to see life as it is will give us much consolation, I know not; but the consolation which is drawn from truth, if any there be, is solid and durable; that which may be derived from errour must be, like its original, fallacious and fugitive.

Releasing early pain

When an amoeba is placed in a water solution contaminated with ink, it will absorb the ink and store it in small spaces in its body. Thus, the harmful material becomes part of the physiology of the cell. When the amoeba is transferred to clean water, the ink cavities migrate to the cell wall and are emitted. Thus the amoeba returns to her healthy state. In The Primal Scream, psychotherapist Arthur Janov wrote that the same happens with humans, as basic processes of striving to homoeostasis are common to all forms of organic life. When there exists early pain, the memory and the accompanying emotional baggage are stored within the cells of the centers of the emotional brain (the limbic system) waiting for their release. When the environment becomes warm and affectionate, and encourages the display of emotions, the old pain begins to be emitted from the body.

Photo by Tim Trad on Unsplash.jpg
Photo by Tim Trad on Unsplash