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Technology, Conditioning, And The End Of Long Term Therapy

Conditioning is why you need therapy, and are too impatient for it to work.

Before the focus on the negative, perhaps it is best to look at ways technology has helped those seeking happiness (one of the major goals of psychotherapy). Beginning with the technology of printing, books spread ideas about philosophy and how it can be applied to create a better life. Today there are millions of books readers can use for self-help.

“The talking cure,” has been discussed since Roman times, but the term “psychotherapy” came into use in 1853 (Haggerty, 2006). Freud then developed psychoanalysis, the therapeutic session, which began in the 1890s. Since then, new approaches to therapy and empirical testing of therapies have led to better and more diverse treatments.

In recent years technological advancements including the ability for face-to-face interaction across distances, as well as mobile phones and the ability to text, have allowed therapists to be available when they previously were not. Video chat has allowed for people in remote areas to receive therapy. Those with more pervasive disorders that benefit from more availability of his/her therapist can have their needs met with the ability to reach their therapist via cell-phone or texting. In fact, in Dialectical Behavioral Therapy, an empirically tested successful treatment for several disorders (most notably Borderline Personality Disorder), one technique is the therapist being available for phone coaching or consultation.

Today, the answer to any question you might have is only a computer, phone, or tablet away. In a culture already primed for and accustomed to immediate gratification, this pushes the expectation further. I have students who, if I haven’t responded to their email within a few hours, begin calling me. Keep in mind there is no emergency; it has simply become an expectation that a response will be given nearly immediately. With many capable of receiving and answering emails from their phone, there is decreased tolerance for delay.

This intolerance for delay has affected therapy. Therapy has become briefer as a result of managed care. Empirically there has been little evidence longer term therapies are more effective than short-term therapy. However, there are a few who still feel longer term therapy that allows for therapeutic bond, and possibly, the corrective recapitulation of the parental process, is more effective for many issues. Irvin Yalom, a famous psychotherapist who has written more than 5 non-fiction books on therapy, and more than 8 fictional books based on existential issues in psychotherapy, is an advocate of longer term psychotherapy. In “The Gift of Therapy”, Yalom argues that the seeming benefits of empirically based treatments aren’t all they’re cracked up to be. He points out some of the false assumptions of empirically validated therapy:

That long term problems can yield to brief therapy; that patients have only one definable symptom, which they can accurately report at the onset of therapy; that the elements of efficacious therapy are dissociable from one another; and that a written systematic procedural manual can permit minimally trained individuals to deliver psychotherapy effectively. (2002, p.223).

Psychotherapy isn’t about providing answers for clients, as many think it is. For most issues, clients have the answers; therapy is about helping find them. But in this culture of instant relief, many don’t care to spend the time to thoroughly work through their issues. Once some relief is experienced, therapy is ceased. This works well with managed health care. It may seem like a win-win situation, and perhaps at times it is. Maybe everyone isn’t seeking insight. Today, however, those who are willing to take the time to focus on themselves is growing smaller. I believe this is to our detriment.

Technology is furthering this mistaken desire for immediate solutions. But life isn’t as simple as that, despite having many answers at our fingertips. Therapy is similar. It has many complexities, and despite our desire for simple answers, that isn’t enough.

Individuals are being conditioned, through the use of technology to expect everything, now. We expect instant relief from our boredom, instant relief from any existential angst we might experience. (See this interview where Louis CK discusses this topic comically but poignantly with Conan O’Brien”). This culture wants things to be black and white, wants simple answers to life’s complexity. Therapy, though, is not meant to be instant. It is a time to entirely focus on oneself. Not in some Instagram, Facebook, or Twitter, self-aggrandizing manner, but with a concerted effort toward changing for the better. Hopefully, it is a modality that doesn’t die out.

Copyright William Berry, 2014

References:

Haggerty, Jim; 2006; The History of Psychotherapy; retrieved from: http://psychcentral.com/lib/history-of-psychotherapy/000115

Kabat-Zinn, John; 2005; Coming to Our Senses

Yalom, Irvin; 2002; The Gift of Therapy

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