Essays on the Edge

David Begelman Ph.D.

Description

"Essays On the Edge" is an anthology of articles on several different topics, including Psychotherapy, The Mental Illness Myth, Freud, The Unconscious, Method Technique, Ingmar Bergman, Stanislavsky, Psychiatric Misadventures, Abortion, Animal Rights, False Confessions, Immortalist Dreams and Art Unbound.

Sujets

• Practical Guide
• Personal Guide
• Essays
• Reference
• Dialogue

Informations

• Publié par: Xlibris US
• Date de parution: 31 août 2022
• Nombre de lectures: 0
• EAN13: 9781669844921
• Langue: English

Extrait

ESSAYS On the EDGE
 
 
 
 
 
 
David Begelman Ph.D.
 
 
 
Copyright © 2022 by David Begelman Ph.D.
 
ISBN:
Softcover
978-1-6698-4493-8

eBook
978-1-6698-4492-1
 
 
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.
 
Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.
Certain stock imagery © Getty Images.
 
 
 
 
Rev. date: 08/31/2022
 
 
 
Xlibris
844-714-8691
www.Xlibris.com
846248
 
 
 
 
 
 
 
 
To the fragile and disempowered everywhere.
Contents
The Four Faces of Psychotherapy
The Mental Illness Myth
Freud, Psychoanalysis and The Unconscious
A Dangerous Method: Blowing The Cover on The Shrinks: A Review
McHugh’s Psychiatric Misadventures 1
Some Remarks on Sacred Cows: Revisiting Method Technique
The Idea of Audience: The Elephant in The Room
An Ingmar Bergman Trope
Stanislavsky Revisited
A Dialogue (with apologies to Diderot)
Moshkeleh Ganev
Abortion, Church Law, and The Endless Controversy
Animal Rights
Now and Then: False Confessions, Beliefs, and Memories in The Modern and Early Modern Eras
Immortalist Dreams: Before and After
Art Unbound: Once More Unto The Breach
The Four Faces of Psychotherapy
Many things might be said about psychotherapy, including where and how it originated as a professional tradition. It might be tempting to locate its beginnings in the 19 th century with Sigmund Freud and his disciples, although this hunch runs the risk of ignoring seeming harbingers of the practice figuring in other institutional vehicles. For example, the Catholic confessional might be one instance, and although it admittedly served a religious purpose of forgiving sins and encouraging patterns acceptable in the light of church doctrine, it incorporated components of a therapeutic-like process in what it provided parishioners. After all, the confessional embraced a context in which one authority listens to the unburdening of another and supplies a means by which personal guilt may be alleviated. The ritual likewise illustrates interactions between someone who comes for help and an authority who supplies it. The structure parallels other transcultural forms with a shamanistic flavor that might be seen as precursors to psychotherapy. Obviously, were we to expand our understanding of what is essential to psychotherapy, similarities could be found in a wide range of traditional practices, not to mention the form it illustrates currently.
When it comes to identifying separate dimensions or layers of psychotherapy as practiced nowadays, we can designate at least four distinguishable facets, and there might be others. The four we have in mind are its behavior-changing , status-affecting, meaning-imparting , and value-laden aspects. Let us flesh out what these amount to.
The behavior-changing aspect of the profession pertains to its most widely publicized feature: the reduction, amelioration or “cure” of specific psychological problems. The function consists in the removal of symptoms, or the facilitation of psychological goals through the application of certain techniques or, alternatively, reliance on personal interactions between therapist and patient, however undefined or non-specific they may be.
For example, a patient or client (as this term is the preferred one for specialists wishing to distance themselves from what is called the medical model) is referred to a psychotherapist for a drinking, marital, sexual, affective, cognitive or impulse control problem. It goes without saying that such referrals to non-medical practitioners are made when the possibility of an undisclosed medical problem is not deemed to be the origin of the condition in question. But we have to be careful here, because it’s a mistake to assume that because a problem has a biological component or basis, psychotherapy should be ruled out as either an essential or supplementary treatment option.
There are many conditions for which a biological factor is causally involved and for which psychotherapy still remains an appropriate modality of treatment. Examples would be serious diagnoses like schizophrenia and bipolar disorder. And there are other disorders with an indisputable organic or neurological basis for which a psychological or psychoeducational approach is the only treatment option. Among these are conditions in which cognitive limitations are especially noteworthy, as in Down’s Syndrome and neurodevelopmental disorders like autism.
Most of the time medical evaluations prior to referrals to practitioners in non-medical professions are routinely conducted in order to determine whether a possible biogenic factor would intrude on the treatment process, making medical care—usually involving a psychopharmacological approach—advisable or necessary, either as an exclusive treatment emphasis or as a collateral intervention.
Yet on the psychiatric level, a patient who has uncontrollable mood swings and who would benefit from a mood stabilizer, anti-psychotic and/or antidepressant medication may also benefit from scheduled psychotherapy sessions in order to regularize approaches to life problems left in the wake of unpredictable cycles of behavior. So when medication is appropriate in sundry cases, so too is the assistance of a counselor who, for example, can help the patient manage credit card use in a more moderated way, since debts of a runaway character may often be a symptom of the patient’s disorder when he or she is subject to manias.
Not all symptomatic patterns are as easy to pin down as those well-defined entries listed in manuals like the DSM-V. A person may seek help for a problem he or she nonetheless finds hard to formulate, as in the so-called “existential neuroses”: or experiences of anomie, alienation or aimlessness. I suspect that such bouts of self-doubt—when they are not symptoms of depression—were more widespread in eras in which a drive toward conformity encouraged everyone to accommodate to conventional or preordained social molds. I daresay such complaints led to more referrals in the forties and fifties in this country, possibly because many persons, especially college students, felt any old grumble about life made one a candidate for long-term psychoanalysis. This therapeutic approach was more of a thriving industry in yesteryear than it is these days, and I venture to say that undergoing orthodox psychoanalysis to the tune of several sessions a week for extravagant fees is nowadays much less likely, or at any rate last on a list for most problems.
I remember college peers of mine who felt they should be psychoanalyzed because they had nothing to complain about. For them, this amounted to a chronic condition resolved by spending years on the couch several times a week while reporting dreams to analysts who were for the most part silent partners. As was indicated, this version of care appears to have undergone a diminuendo of popularity over the years, confining its public appearances to such venues as Alfred Hitchcock films like Spellbound , or in a lighter vein, Mel Brooks’ film High Anx iety.
Eradicating the unwanted aspects of a problem through behavior-change techniques hopefully involves replacing it with a more desirable pattern. Accordingly, behavior-changing not only implies remediation; replacement by desirable patterns is likewise a collateral goal. It may in many cases be an inevitable one. After all, the reduction of symptomatic behavior often means leaving in its wake patterns that have more to recommend them than simply the absence of what they replace. For example, continued sobriety in career drinkers may mean more to them than just the cessation of bouts of inebriation; the termination of hallucinations in a young adult is more than merely an end to mental destabilization; and relief from post-partum depression in a young mother means more than just the end of her dysphoria. So getting rid of the unwanted symptom often ensures a positive consequence, although enhancing the latter may not be an additional technical step to be undertaken within behavior-change program techniques.
Behavior-change as I understand it is not restricted to overt patterns exclusively. Such things as thoughts, feelings, hopes, wishes, desires and intentions are also subclasses of behavior included in the realm of consideration. A constricted definition of behavior may be at the bottom of misinterpretations of the therapeutic compass of the Cognitive-Behavioral approach to deviancy by its practitioners. The latter use the term “behavior” in a much wider sense than that attributed to them by their psychodynamic colleagues. The latter sometimes fault behavioristic modalities for ignoring the inner life of patients, of not treating “the whole person,” as it were. One psychodynamically-oriented specialist describes Cognitive Behavioral Therapy as a “cookie cutter” or “manualized” approach to treatment, as though a truly humanistic or searching avenue in psychotherapy were being side-stepped or short-circuited. Yet as I understand its applications, behavioral practitioners of whatever stripe insist that their methods may be adapted for any human problem, not merely the distress of persons who don’t know what to do