Friday, October 7, 2011


Cooking and the Therapeutic Recipe

          After years of study and experience with psychotherapy, regardless of the mode I use with my clients, my initial analysis of problems persists in probing early experiences and relationships because I believe the clients’ beginnings are the bases for understanding their dysfunction and discomfort. Unless this point is reached, psychotherapy seems to be more of a hit-and-miss proposition with therapists attempting to guide clients by feeling their way through the dark, hoping that something, anything helps clients, regardless of whether they understand the reasons for that “something” working or not.

An approach that does not include a base of understanding the roots, the foundation of clients’ beings feels almost unethical. Why take the time and effort to try to help clients when therapists’ recipes for assistance are like a soup to which therapists add different ideas and sprinkles of modes of theory here and there, crossing their fingers that the soup will turn out to be at least palatable? Yes, the individual ingredients may be tasty and nutritious but unless they are paired, harmonized, and bound together with a secure basis of truth, a basic stock, the resulting recipe for treatment will probably fail.

Is it not better to be more direct, less time consuming and painful in the long-run by identifying the dysfunctional beliefs at the core of clients’ issues as soon as appropriate? Then therapists can use that knowledge as a compass or a recipe book to help ensure a safer, more secure return to mental health.

Therapy should be more like baking bread. Baking even simple bread requires very careful measurement and basic ingredients. Leave out the main ingredients, the flour, the yeast, the timing, and the bread fails. Yes, different kinds of bread recipes exist as do different kinds of people with many different kinds of problems; so therapists can learn to alter some of the ingredients to suit clients; however, the addition or subtraction of ingredients must still be carefully measured and include foundation ingredients that resemble the original goal of the intended creation.

I believe in creativity, but only creativity with care, creativity with truth, creativity with a secure base from which to start. To do otherwise, therapists risk playing with the lives of clients and violating the main ethic of psychotherapy: do no harm.

Attachment Theory Beckons

How did I become attached to attachment theory (AT)? As a natural outgrowth of my belief in some basic tenants of psychoanalytic theory, logic supported the premise that early attachments are responsible for the health of individuals. Bowlby (1988), a former psychoanalytic therapist, found this to be true in his breakthrough Attachment theory. AT supported Freud’s initial theory (that he later, unfortunately, revised) that how people are treated in infancy and early childhood influences their lives and relationships.

The tenants of AT include the premises that parenting behavior is learned and influenced by evolution.  Knowledge of parenting failures is valuable when understanding clients’ issues and struggles, and clients use many types of defense mechanisms to avoid confrontation with painful memories. Many aspects of psychoanalysis and AT diverge and connect.

 One similarity is that AT uses transference to help understand clients’ attachment issues and the uses the therapeutic relationship as a new attachment with a “secure base” from which to help heal clients. Ultimately, my natural inclinations to approaching human problems from a psychoanalytic stance evolved easily into accepting and valuing AT.



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