One Hundred Years — And Counting
I’d like to say that it is an essential part of psychotherapy to contribute to making the world a better place.
A few years ago now James Hillman and Michael Ventura published a book called We’ve Had a Hundred Years of Psychotherapy — And the World’s Getting Worse [Amazon-US | Amazon-UK].
It was an attempt to ask whether psychotherapy has achieved what it set out to do: to make the world a better place. I think this is both a fair and important question.
I have a few problems with this question and answering it.
How do we assess the state of the world? The values we use are implicated here. If we value leisure, then many a medieval farmer had more free time than an office worker — how many office workers get to stay home through winter? If we value health, then public health has made huge strides in the last hundred years. If we value happiness, then material abundance (once we are out of poverty) is largely beside the point.
One of the big values: what status does the individual and their happiness have? We can do psychotherapy with individuals living under tyranny. Does it matter what type of government people live under — as far as psychotherapy is concerned?
To put the question of the role of psychotherapy most sharply: does psychotherapy have any business trying to change the world? Perhaps psychotherapy is to help individuals live more enjoyably, whatever shape the world is in.
Hillman and Ventura don’t lay out their case for why psychotherapy should change the world. They largely assume this is the value.
I’d like to say that it is an essential part of psychotherapy to contribute to making the world a better place. In this post I’m going to make an argument for this value — hopefully making a case for what Hillman and Ventura (to me at least) seem to assume.
1. People live in and respond to their situations. Some situations tend to lead to one type of response, other situations lead to a different response. Different situations are conducive to different behaviour.
If I turn up to a building with a high ceiling and poor heating, if I sit on a hard and uncomfortable seat, if I sit through a ceremony largely without meaning to me but which I do because I believe it is right to do so — this will usually lead to particular kinds of experience. Going home from this situation, I find my lover in bed; they invite me to join them. This situation will usually lead to different behaviour.
The way people behave is more or less a response to their environment (I don’t see how it would be possible for their behaviour to have nothing to do with their environment). The distress and pain for which people seek psychotherapy has something to do with their environment and their response to it.
In this way, psychotherapy is concerned with people’s situation (their part of the world) at its very core.
2. Psychotherapy is value laden.
My value is that psychotherapy is to do with awareness — awareness of ourselves, others and the world around us. To my way of thinking, psychotherapy has preferences: psychotherapists want people to have enough to eat and drink, adequate shelter, health care, education, loving touch and so on.
3. Having values can promote freedom.
I don’t think that having values is necessarily impinging on other’s freedom. I think that valuing the nurture of people’s health over random violence promotes freedom.
4. People have important similarities.
People’s physical, psychological (and I would argue spiritual) needs are much the same. Few people live a long and happy life in a war zone. A person (offered a safe alternative) doesn’t choose to stay in a family where physical and sexual abuse is common.
5. That people are similar means that situations often lead to similar responses (point 1 above).
That there are different reactions to some situations doesn’t threaten this proposition. Most people like the smell of fresh bread, but I know one person who hates it. This is a Dutch friend of mine. This is because his mother smuggled fresh bread to people when Holland was occupied. The smell of fresh bread is associated with anxiety for his mother’s life. I don’t think this in any way does away with the similarities that my friend shares with the rest of the human species.
6. Individuals respond to others and their environment. All of us are shaping our world to a greater or lesser extent.
To the extent that psychotherapy changes behaviour (and it would be a pretty useless enterprise if it didn’t), it is involved in, to a greater or lesser extent, changing the world.
7. There is no neat dividing line between helping a person leave an abusive family and establish healthier relationships, helping an individual find a house, and helping an individual found a housing co-op.
A person may find it far more therapeutic to start a housing co-op than many a psychotherapy session.
My argument is that individuals act on and are acted on by their environment. They both receive and shape their context. Psychotherapy does shape the world.
The question then is this: why hasn’t psychotherapy been more effective? My answer:
Psychotherapy has (with some notable exceptions) remained concerned with isolated individuals and not seen it’s task as building coalitions of people to achieve a healthier environment (for themselves and the rest of us).
There are many aspects to this: our individualistic view of the human person, our view of the person as unaffected by their environment, the social organisation of psychotherapy (professionalism), the moral failure of individuals, the need for therapists to make a living, the failure of therapists to use better forms of organisation, the neurotic nature of some therapy…and many other aspects too, no doubt.
I realise that this may be a controversial position. It is very debatable in a number of ways. So let’s have the discussion. Do you think it is the job of psychotherapy to change the world? How would you like the world to change? How do you think psychotherapy should contribute to this change? I’d love to hear your views in the comments.
[Editor's note: Our review of Colin Feltham's book What's the Good of Counselling & Psychotherapy? covers some related work on this topic.]
8 Responses (4 Discussion Threads) to “One Hundred Years — And Counting”
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Q:Do you think it is the job of psychotherapy to change the world?
A: I don’t necessarily depend upon a practice, but more the willingness to want to practice within the person. There is potential in all of us, but some people in my opinion want there to be change (within themselves), and know that the rescourses are all around them, but because of the willpower many people have these days don’t have much ardency to even try make the change.
How would you like the world to change?
Well, I figure the world to be like one big relationship, and to my understanding, a healthy relationship have pretty much equivolent up and downs. I feel that’s the only way of learning, through past mistakes. just think that were in a big argument right now as far as the world, but when we get back on track, we’ll be our relationship will be stronger than the last time we rectified a major situation.
How do you think psychotherapy should contribute to this change?
I think that if it was advertised more, more people would get into it. you only get what you give, and you must give to get, ya dig.
Thanks Tyron. I do dig your emphasis on relationships.
Willpower is a tricky one I think. I think desire needs to be there but I don’t go with the self-punishing approach to willpower. I hope this makes sense.
First, “A person (offered a safe alternative) doesn’t choose to stay in a family where physical and sexual abuse is common.” is absolutely false in most cases. Most people who find themselves in abusive situations as adults were abused as children. They have come to expect it, don’t believe they deserve better, have a high tolerance for abuse and will NOT leave the vast majority of the time….without some sort of major shift in their thinking, which Psychotherapy can assist with.
Secondly, “Do you think it is the job of psychotherapy to change the world?” YES!
Finally, “How would you like the world to change? How do you think psychotherapy should contribute to this change?” One person at a time. Psychotherapy can assist individuals with re-examining their entire belief system and understand where their behaviors and reactions come from. As knowledge is power, they can then make major life changes. On a societal level, the more enlightened folks we have out there, the less likely there will be such focus on greed, power, fame, war and abuse and more focus on peace.
Thanks for your comment. I’m glad you think that psychotherapy can contribute to changing the world.
I do understand that people stay in abusive relationships. I was thinking about children when I was writing. I do think more adults would leave if options that were (perceived as) safe were available.
I keep thinking of the joke, “How many therapists does it take to change a light bulb?”
Answer: “One, but the light bulb has to really want to change.”
Therapy can help people change but they have to do the work, and they get to decide just how they want to change.
Hi Jean,
The joke highlights the contradiction doesn’t it? If all it takes is people wanting to change then therapists aren’t needed.
Thanks for your comment.
Evan,
“The joke highlights the contradiction doesn’t it? If all it takes is people wanting to change then therapists aren’t needed.” I don’t see it that way. Therapists can teach people tools for change, help them gain perspective and offer support in their journey. I think of therapists as midwives…they can help but they’re not producing the baby.
Hi Jean,
I also think that therapists have something to contribute. (The viewpoint of the joke is too simplistic I think. When we go to a therapist we are often torn between wanting to change and not wanting to).
I like the image of the midwife. My image has been that of a catalyst but I think midwife is probably better.
Thanks for your comment.