Wednesday, June 10, 2009

Treatment models

"Beware of Geeks bearing formulas," Warren Buffet advises. He was speaking of formulas accepted whole hog by bankers, financiers, and mutual fund operators to predict such arcaic outcomes as how high interest rates will rise, when the housing market will bottom out, how to carve up derivative instruments such as asset liability swaps to maximize profits (to the carver) and minimize risk. The problem is such fourmlas have flaws as witnessed by the present financial crisis.
It seems to me that psychotherapists do the same thing. Today most psychological healers claim to be a cognitive therapists. Years ago it was psychoanalysis, client centered therapy, humanistic approaches, Gestalt thereapy, and so on. All of these models, even in the best trained hands, may be helpful but they are not paneceas for emotional health. All have limitations, even those with solid empirical (evidence based) backing. They don't work for every condition or every client. They don't take into account less tangible and measureable factors such the relationship between therapist and client. They are not complete theories of personality (Psychoanalytic models come closest because of developmental concepts that are intrinsic to the model. However they can be used to explain anything by the those who speak the langauage fluently, and therefore have little predictive value.) My point is that these models provide tricks (OK tools) of the trade. They bring some order out of chaos and a comfort level to the therapist. But the most honest of us will admit that there is more going on when outcomes are positive or negative than merely the particular stratgey the therpist believes he is employing. Gabriel Byrne, the Irish actor/therapist, Paul, on HBOs In Treatment, who explains everything in a psychodynamic targeting parents as villains, said it best to his own therapist, Gina, when he lamented that therapists don't cure people, they merely walk with them through their problems for a while. Gina didn't buiy into that idea. We are all more holistic and humanistic than we often care to admit.

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