Why standard treatments don’t work

Now don’t get me wrong. Standard, cookie-cutter treatment does work. For cookies. Are you a cookie?

I hear time and time again that a person tried one thing, tried another, tried another, and still, I hear about struggles and heartbreak. What went wrong?

What I know about most therapies is that the aim is to replace your current beliefs with new beliefs. Therapy has “succeeded” if you embrace the new beliefs as your own. Therapists rarely admit this, of course. They’d give away that they’re on big power trips if they did. But let’s look at some of the standard responses that therapists might give to their clients. I will use as example a person who suffers from binge eating.

“You are bingeing because you can’t cope. You need better coping skills.”

Have you heard something like this from a therapist? Let’s break down this statement and see why, exactly, this approach tends to fail.

The first statement, “You can’t cope,” is a statement of incapability. It says, “You can’t.” It immediately puts the therapist above the client, because the assumption is that the therapist, of course, can cope. (They are often far more messed up than their clients.)

The assumption that a person binge eats due to poor coping is overreaching and possibly untrue, but there’s no room for anything else in this statement. Client, you are incapable, and your bad coping is to blame for all your problems. I know better!

So now, the blame is turned back on the client’s deficiency, which is quite typical of the various therapies out there. The therapy is supposed to “fix” the client’s deficiency, which the therapist has identified (and may not exist) with the therapist’s superior way of life. The balance of power is clear here if only you take a step back and see what is happening.

The client leaves with a sense of inner weakness. “I need to learn better coping skills. The therapist is right. I am a poor coper. Just like she says.” The aim of therapy from then on is to knock down everything the client does and says because the therapist’s ways are superior.

This would be great if there really were these totally superior, benevolent, perfect human beings out there. Unfortunately, very few therapists fit the mold.

I think the problem is the identify-and-fix approach. This means the therapist decides what your problems are, or, rather, disorders, and then, “treats” the supposed defects. Identify and fix.

This is the basis for every treatment plan out there. Have you ever seen one? There might be one column for a diagnosis, and another for action plan. How about this….

Problem: Patient restricts her intake.

Treatment: Patient will contract to following a meal plan.

If you ever fall totally off the bandwagon, you probably got blamed by your therapist, who turned all alarmist and even incarcerated you for it. This is how therapy works. But truthfully, what happened here? The therapy failed. You didn’t.

Time and time again, I hear patients saying, “I failed. I have to go back in.” Really? I don’t see it as failure of the individual, but failure of whatever identify-and-fix plan fell through.

Today is the day for no more identify-and-fix. I don’t want to hear about any more therapy failures.  Today is the day for starting to work on realistic and achievable goals that YOU set for yourself. Today is the day to start asking yourself what you really want to do, and how you are going to go about achieving those goals. Whatever it is, imagine it now.

I think many times we sidestep away from our lives and go into black holes (such as an eating disorder) because we have lost the passion we need to drive forward. So we get stuck in the hole. We are almost protected by that hole. It serves a purpose, maybe even for a long time. It might be comforting there. Oddly, once stuck in the hole, we forget about the outside, about the path we were on.

I do not see that as poor coping. After all, the hole is useful and most likely, you’re using it to its full capacity. Why? Because you cope very, very well. Shame on those therapists who knocked you down and told you you can’t cope!

I know all kinds of black holes I’ve seen people in. I’ve seen people stuck in the bad marriage hole for a decade or more. They keep spinning their wheels, trying and trying. They forget about the job promotion, about that gardening hobby they loved so much, about the ski vacation they hoped to enjoy in the winter.

Passion will bring a person out of the hole. Here are some examples…..

Jack got sober after many years. After many years of failing at the very same things his siblings were so good at, such as academics, (which he really didn’t like anyway) he found his sobriety something he could be truly proud of. Finally, he wasn’t a loser at something. He found others who had also found sobriety, and he realized his past drinking life wasn’t a waste after all. He began to use his story to help other people. He found he loved doing what he was doing. He was valued at gatherings of former drunks. He belonged now. He began to expand the horizons of his spiritual faith which he found helped him relate to other people on many new levels. He didn’t want that drink in his hand anymore.

And then there’s Kathy. Kathy kept trying to kill herself. She couldn’t stop. She also cut herself, which she called a mini-suicide. She couldn’t stop thinking about death. She focused on death and was caught up in that cycle. Each time she tried, she got put into a hospital, where, for a short time, she swore she’d never ever do it again. But she did. People were afraid the next time would be her last.

What happened? Kathy was centered on her desire to die. This is a black hole that will seriously fester and won’t stop unless that nasty thing passion breaks the cycle. Kathy will likely resist becoming passionate about the rest her life again, because that will take her out of the comfort of the hole. If I were to challenge Kathy, she’d tell me it’s forever. She’d get mad, insisting her “illness” can only be managed. She’d insist on the permanent brain disease theory. Why? It protects her, it keeps her inside the comfort of the hole, so she clings to the false belief of permanence. The false belief works for her and reinforces the comfort and security of the hole. Right now, she thrives right where she is. But she might agree it’s not really productive.

I can challenge her all I want, but that’s going to lead to a dead end. What could, in fact, happen, will be that Kathy will cling even harder to the permanence myth if I push her too hard.

Therapy will both push Kathy, since it’s a therapist’s job to fix problems, and also, reinforce her tenacity. This leads to the “roller coaster” effect that can even mimic bipolarity, but actually therapy causes it.  So in and out she goes, round and round, and who profits? The mental health system, since they have a great customer who uses up a lot of “services.”

What will break this awful cycle? I don’t know exactly how, but Kathy will. She’ll get fed up, my guess is, and I can only hope that she gets fed up very soon, before she ends up in a state institution or…dead. We don’t want either of those things, right? If you ask Kathy, you’ll get an ambiguous response about State, since she wants to let everyone know she has no desire to help herself. And again, I ask who is benefiting?

These terrible cycles don’t happen for no reason. Someone really is benefiting, whether it’s a doctor, therapist, the patient, school, the family, or even an abusive husband or boss. Traditional mental health care doesn’t want to admit this. Therapy rarely addresses the benefit concept. If it does, it often horribly misses the boat, and does more harm than good with its goofed identify-and-fix protocol.

Kathy was going to a therapist named Joel for a while, who, without even asking, blamed her parents. Joel insisted on grueling family sessions. Kathy is in her 40’s, and her parents are elderly and were confused over the necessity of the “sessions.”. The continued blameful attitude of the therapist, sadly, broke up the family and none of them are even speaking to Kathy right now. After the last family session, Kathy attempted suicide again. While she was recovering in ICU, she got a call from Joel saying he wasn’t her therapist anymore. Just what she needed. The call came while she was still on oxygen.

Kathy’s friends blamed Kathy for Joel’s very quick exit, and also blamed her for the split in the family. All this dug her deeper into the hole.

I hope she makes it. In my opinion, she’s going to have to take control of her life. If you want to be in the driver’s seat (think: driver’s license) you have to earn that place in the front seat. You’re not going to be able to keep it if you lack a sense of responsibility. And there’s the key. Gaining control means you take responsibility for your actions. This is an extremely tough concept for someone like Kathy who has been listening to therapists continue to ramble on about her disease controlling her.

No no no no no. I don’t know of any disease that has a persona. Therapists love to do this, though. They’ll tell you your disease is a person that talks to you and tells you to do stuff. Here I gotta laugh because they literally push voice-hearing on people. I think they do this out of desperation since they don’t want to admit they don’t know what else to do. “It was your illness that made you do it.”

But what’s in this statement? An excuse, really. You didn’t do it, the Devil made you do it. I’ve heard this so, so many times, and varieties of it, enough to really make me…excuse me….puke.

You didn’t do it. It wasn’t your fault, it was your mania. It was your chemical imbalance that caused you to purchase an airline ticket and fly to Los Angeles and then, try to catch the attention of a movie star you were sure was in love with you. You’re not responsible for the thousands of dollars you’ve now charged to your credit card. Oh no, we’ll get you disability and you’ll get a huge sum, after a while, and you can use that to pay off the bill.

Officially off the hook.

Do you hear what I hear? And I’ve heard that in the mental hospitals time after time. “You weren’t really responsible for beating your kids. You have a chemical imbalance.” Officially excused!

You don’t have to clean the house, since your chemical imbalance makes it oh so hard. We’ll send state services in to clean it for you. And if that doesn’t work, we have a nice halfway house where all your meals will be cooked for you. You don’t have to work, you’re excused. We’ll hand you tutors and ridiculous accommodations because your permanent brain disease impedes your ability to cope with school and you love being singled out and called “special” anyway. It’s so helpful.

Yes I am having loads of fun here, looking back on the insane illogical shit they fed us in the System. A lot of the patients just needed to grow up and realize THEY were the ones who needed to take care of themselves. Not “services.” They did. I can’t believe how some would demand everything be done for them, like spoiled children. Of course, the System teaches this, thrives on the You Can’t mentality, and wouldn’t even last without it.

What does it take to get someone motivated to get to that point? I think we have a Yin and Yang here. We have a person who, likely, wants more freedom and choice in their lives, but doesn’t understand that freedom cannot be obtained without maturity and responsibility. So they aren’t given much choice in their lives because they haven’t yet sat very well in that driver’s seat. They have to realize they need to earn that choice, speak up for themselves, and take charge.

Agreeably, the use of force is not at all helpful, since it impedes a person’s freedom and choice no matter what, and takes away any chance to be an adult. I am not in favor of the use of force and I don’t think it solves anything, although someone out there is going to tell me about the one person, out of hundreds who were harmed, who did indeed benefit. So be it.

By the way, Kathy, Joel, and Jack are compound characters, disguised to oblivion but I think you know folks JUST LIKE THAT.

Ah, I have much fun being a writer. See you later.

Feedback and comments welcome!