Saturday, November 28, 2009

Psychotherapies

On Wednesday, Thursday, and Friday, Gilles and myself have reviewed and discussed psychotherapy for our upcoming book The Meme in Psychology. It was a mind-opening experience (a form of psychotherapy I guess :-) in the sense that I was able to see the wide range of psychotherapy approaches, and I am now able to see what has been done to me in the various stuttering therapy!

Clearly, psychotherapy is in a state of chaos, conceptual fuzziness and deprivation of a unifying framework (which we will of course provide in our book! ;-). Every psychotherapy seems to have created its own universe, seeing disorders through their lenses and treating accordingly. However, I have to revise my view that they kind of do the same thing. In fact, every psychotherapy is acting on a different dynamic of our complexity for change. Have you heard of the elephant and the blind people? Everyone describing the elephant in a completely different way: long tube, big trunk, bushy snake, massive surface. Each psychotherapy makes the elephant move in a different way: show him a mouse, shout a command, make a loud noise, pull his tail, and so on. I would also argue that not all psychotherapy are useful for all disorders.

And here comes the biggest danger. I grant psychoanalysis that some psychological issues are due to deferred childhood trauma and associated unconscious influences. However, the big question is to decide which one is. Of course, you can take all disordered behaviours and experiences and construct a theory based on some childhood and unconscious influences. However, that does not mean that it is the right causal theory! And that also explains the wild and idiotic psychoanalytic interpretation of stuttering being some kind of repressed needs and so on. Some guy gets paid to explain everything psychoanalytically. Having said this, if as a person who stutter, you sit done and do psycho-analysis, I am sure you will develop as a person and you will understand yourself better. And you might be able to better cope with stuttering. The same is true for behavioural therapy which assumes that normal learning processes led to disordered behaviour or experiences. For example, the brain has learned to fear spiders, and so we need to use the same processes to unlearn the fear. A not-very-bright and badly-informed person can come up with the theory that stuttering is all learned, which is clearly not the fact. However, this does not mean that some secondary stuttering is not receptive to behavioural techniques. In fact desensitization, unlearning secondary symptoms, and more do work for a committed hard-working patient.

And here is the critical issue. There is a big big big difference between the theory underlying a psychotherapy and the associated treatment techniques. As I said several times before, a technique might help but the theory used might be wrong or incomplete. So I would say that all psychotherapies can help for some people in some situations, and even if it is just for personal development. Of course, some will help more and more on the speech fluency side because they are closer to the causes of stuttering. However, don't talk to me about them giving a good theory of why people stutter in the first place. They don't. The practioners mostly create a theory based on their approach's focus on humans.

5 comments:

Anonymous said...

So are you now an expert in, and regarding, psychotherapies as related to stuttering and people who stutter?

Pam said...

Hmmm, I have been seeing a psychotherapist for the past two years, and it has been a positive growth experience.
I think its not wise to generalize when we discuss psychotherapy. There are many, many different approaches, and the decision to use which one needs to be mutually decided upon.
Person-centered therapy is the best.
If you or anyone feels their psychotherapist is ever doing more harm than good, simply leave and find another.
But in itself, psychotherapy is not bad. I am not an expert in this, only in my own personal experience with a very good therapist who has always had my well being as his number one priority.

Ora said...

FYI - There's an article in the current issue of the Journal of Fluency Disorders titled "Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists" - http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8H-4XCJ4JR-1&_user=10&_coverDate=09%2F30%2F2009&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=ec0019b004864b72577a457422fc4177

It might be relevant to what you're studying.

Anonymous said...

Tom,

I think I understand why you are so negative about psychoanalysis. Many years ago, you used to be a scientist, so you probably expect the same scientific rigour to apply to psychoanalysis. Unfortunately, psychoanalysis is not science. We can test Newtonian physics by observing the motions of planets; we can test Darwinism by observing species and their environments, but we cannot test psychoanalysis by observing patients or groups of patients. Contrary to Freud's claims, psychoanalysis is not science, but it has taken off and has been successful for a lot of people. Science has not been able to solve the problem of stuttering; this is due to a combination of factors - i.e. it's a difficult problem, the researchers are generally incompetent, and people with influence are more interested in defending their "treatments". The result of this is that there are many alternative therapies for stuttering - including hypnotherapy, CBT, and psychoanalysis - which have limited success. Where science fails (for whatever reason), non-scientific methods fill the gap. You only have to look at string theory with its cosmic landscape; science has failed to find a unique solution, so string theorists have resorted to the unscientific anthropic principle.

Anonymous said...

"Being Human doesn't cure anyone. Science does."