Why Your Therapist Should Go "Back to the Future"

Patients would benefit if their therapists reclaimed a key insight from long ago

Posted Jan 19, 2014

I recently spoke to psychology doctoral students about the innovative contributions of some pioneering psychoanalysts in New York and Washington and who collaborated during the 1930s -1950s. Several found commonalities in their work to expand traditional psychoanalytic understanding about emotional conflicts and their treatment.  Some were European, having fled the Nazis; others, American. Among the most prominent were Erich Fromm, Karen Horney and Harry Stack Sullivan. Their ideas were often rejected—or attacked—by the psychoanalytic establishment back then.

After I spoke to the students about the contributions of those three, it struck me that both the emerging generation and current psychotherapists could help patients by reclaiming their legacy. And not just their creative mindset, but an overlooked, core part of their contributions. 

That is, most therapists today recognize the significance of interpersonal and relationship issues that those three contributed: that our sense of self and much dysfunction is rooted in the web of relationships we experience from birth. That part isn’t overlooked. What many ignore is that Fromm, Horney and Sullivan also drew attention to social and cultural forces in our “outer” world, forces that shape—for better or worse—who we become: Our values, attitudes, personalities and level of emotional health or dysfunction. That dimension of their work became increasingly marginalized and disregarded over the decades, with few exceptions. That loss diminishes therapists’ capacity to discern the roots of patients’ conflicts and provide effective help.

Ironically, those early analysts’ insights about social conditioning are highly relevant to life conflicts in this second decade of the 21st Century—a time of great transition and turmoil affecting peoples’ relationships, career and life challenges. It would benefit psychotherapy patients if more therapists went “back to the future” in two ways:

First, commit to building more of the exploratory spirit and inquiring mind that characterized psychoanalysts in the early 20th Century in general, not only the innovative trio. Most had a broader education than practitioners today; well-read in literature, history, culture and philosophy. That expanded their outlook and perspective about life. In our present era, one way to do that is for therapists to read more serious fiction. It enhances empathy and understanding of human lives within their social and historical context. And recent research confirms that.

Unfortunately, the views of mainstream psychoanalysts back then were also warped by culture-bound assumptions about gender and psychological health. The New York-Washington trio exposed and critiqued those assumptions, explaining that they reflected the prevailing values and norms of post-Victorian, early-20th Century society: A largely patriarchal culture that equated psychological health with being well-adjusted to those norms.

That critique segues to the second path “back to the future:” Apply the overlooked insight of Fromm, Horney and Sullivan to life issues of the 21st Century; not just the insight about relationships, because that’s the least disruptive to our own cultural assumptions. 

To explain: First, all three emphasized—radical at the time—that your sense of “self” and emotional conflicts are rooted in an interwoven web of relationships—parents and family, social, cultural, political. We’re always embedded in them; shaped by them. They affect your sense of security or fears; what you envision is possible to become or achieve; your political views; and even your belief in whether you can overcome negative patterns in your life.

In brief, Sullivan emphasized that anxiety and insecurity that arises within a context of childhood relationships; Horney exposed unhealthy gender assumptions and described relationship patterns of “moving towards,” “moving away,” or “moving against” others, which anticipated current views of insecure vs. secure attachment disorders.

Fromm emphasized how social-cultural forces shape your personality, positively or pathologically, as you unconsciously adapt to—or conflict with—social conditioning into dominant cultural values and attitudes. He argued that health includes expanding your emotional and creative capacities, and greater freedom of expression, which can circle back to influence the social-cultural environment. Fromm became the most known of the three to the general public through his many widely-read books, such as his still-classic The Art of Loving.

Many therapists today embrace the “interpersonal” or “relational” orientation. But they give scant attention to the important insight that social conditioning contributes to emotional conflicts and health. Yet it interacts with your mind-body system to shape your self-definition, including your sense of possibility for becoming more of your “true self.” That influence becomes visible when, for example, your intimate relationship choices, innate talents or career opportunities may pull you towards a life that becomes “successful,” well-adapted; yet remains unfulfilling or empty, emotionally or creatively.

Awakening to social-cultural conditioning is important for helping people become healthier in today’s world. Contemporary relationship, career and life conflicts arise in a context of disequilibrium, uncertainty, rapid technological change and general upheaval—socially, politically and economically.

In relationships, affairs are virtually an accepted norm. Even polyamory is more openly touted. Regarding careers and decisions about lifestyle and values, many confess to feeling too trapped; confined within the person they’ve become. They may express a lament of an unlived life. Becoming constricted by your acquired self-definition prevents other dimensions of your personality from emerging. For example, creative capacities, or growing and acting upon your “true,” more authentic self.

Karen Horney’s daughter, Marianne Horney Eckardt, who became an eminent psychoanalyst herself (and, at 101, remains professionally active!) has emphasized that creative dimensions of your self can remain suppressed and blocked through adulthood. She’s written, “Neurosis is often unlived creative life. Many innate inclinations, talents, artistic endowments remain dormant. Given opportunity or encouragement, however, these inclinations may or will flourish with a rather remarkable effect: We observe a kind of transformation. Eyes shine, the voice gains in expression, a sense of excitement and of being alive exists.”

Her views align with recognizing that who you have become is not fixed or frozen. Relevant, here, is epigenetic research showing that the expression of your genes isn’t fixed, but altered and shaped from interaction with your ongoing life experiences.

Continuous interplay occurs between your biological and your social-cultural environment. You evolve from that interplay of your biological system—brain, body, physiology, temperament and genes—with experiences in the “outside” environment. The outcome is who you are at this point in time—your mentality, emotions, values, beliefs, and state of health.

A broad understanding of who you are and how you got that way is essential for building greater psychological health and growth. But without that perspective, the meaning of  symptoms or dysfunctions remains unclear. One consequence is that practitioners focus on diagnosing and treating whatever appears at the end of the pipeline: overt symptoms. (and an increasing range of normal behavior is being redefined as pathology).

But the same symptom—say a panic attack, or depression, may have different origins: Perhaps harmful parenting or trauma; learned personality traits that became self-undermining; or situational reactions. Each points to a different path for healing. In reverse, a particular childhood experience—say, unempathic or indifferent parents, can lead to different psychological outcomes in different people: serious psychiatric symptoms; relationship failures; or high functioning in others, depending on the person’s social-cultural experiences. Failure to understand this complexity makes it unclear when and how therapy, medication or both will be the most helpful. 

It would benefit both practitioners and patients to apply the core insights of Fromm, Horney and Sullivan to today’s life conflicts, and join those insights with contemporary scientific knowledge. Both biological and psychological research demonstrates that people can awaken to and grow beyond the confinements of who they’ve “become” at this point in time.  A few examples from empirical studies:


Center for Progressive Development

Blog: Progressive Impact

© 2014 Douglas LaBier

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