Psychology Shifts From Past Trauma To Present Dysfunction

A long shift against talking endlessly about childhood traumas and "confronting" old issues in favor of simply dealing with current problems:

Professor Norcross has surveyed American psychologists in an effort to figure out what is going on behind their closed doors.

Over the last 20 years, he has documented a radical shift. Psychotherapeutic techniques like psychoanalysis and psychodynamic therapy, which deal with emotional conflict and are based on the idea that the exploration of past trauma is critical to healing, have been totally eclipsed by cognitive behavioral approaches.

That relatively new school holds that reviewing the past is not only unnecessary to healing, but can be counterproductive.

Professor Norcross says he believes that cognitive behavioral therapy is the most widely practiced approach in America.

The method, known as C.B.T., was introduced in the late 1960's by Dr. Aaron T. Beck. The underlying theory says it is not important for patients to return to the origins of their problems, but instead to correct their current "cognitive distortions," errors in perception that lead them to the conclusion that life is hopeless or that everyday activity is unmanageable.

For example, when confronted with severely depressed patients, cognitive behavioral therapists will not ask about childhoods, but will work with them to identify the corrosive underlying assumptions that frame their psychic reality and lead them to feel bad about themselves. Then, systematically, patients learn to retrain their thinking.

The therapy dwells exclusively in the present. Unlike traditional psychoanalytic or psychodynamic therapy, it does not typically require a long course of treatment, usually 10 to 15 sessions.

When cognitive therapy was introduced, it met significant resistance to the notion that people could be cured without understanding the sources of the problems. Many therapists said that without working through the underlying problems change would be superficial and that the basic problems would simply express themselves in other ways.

Interestingly, the shift is partly due to actual science, or at least as close as one can get to science in this psuedoscientific venture. Randomized clinical trials -- eschewed and denigrated by classical "tell me about your father" psychologists -- established that CBT was more effective, especially among two key institutions: the academy and, crucially, insurers, who have to foot the bill for all this blather.

posted by Ace at 10:16 AM

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