The On-Demand Culture and Therapy

by Judy Koven, WTRS Coordinator

We in Seattle live in a busy city, with its strong economy, burgeoning population, changing demographic, and the many challenges these bring. The corporate technology culture that’s become predominant in central Puget Sound exerts a powerful influence on our sensibility, values, and priorities. I call it the “on-demand culture”.

Want to buy something? Order it from Amazon Prime and it shows up in a few hours. Hungry? Find something that looks good on your restaurant app and a delivery person is at your door with an insulated bag, dinner at the ready. Need to get somewhere quickly? Get on your smart phone and Lyft will be there.

As someone who educates and matches clients looking for a therapist, I often see the ripple effect from this on-demand worldview. People now come to the search for a therapist with similar expectations, foregrounding convenience and immediate results. These are understandable requests but not necessarily realistic, nor are they reliable determinants for successful therapy.

Therapy entails a different mindset. Research has repeatedly shown that a good match in a therapist is essential for a positive outcome. When we’re in distress, it’s understandable that we want relief now, and it takes courage to reach out for assistance. But convenience doesn’t guarantee productive and successful therapist-client collaboration over time.

An on-demand culture may work efficiently for meeting practical needs but doesn’t translate well for our deeper well being. In fact, it is a significant source of stress. Therapy provides an opportunity to slow down, reflect, and create new ways of understanding and interacting with the self and the world. The result is deeper, more lasting transformation.

Self-Care in Turbulent Times

by Brandy Parris

In the current political climate, many of us find ourselves switching between wanting to know everything that is going on and desiring nothing more than tuning out all political news and conversation.  While there are multiple factors that can contribute to such mixed feelings, we can point to few elements.

First, as social beings, we are all susceptible to anything that hints at or announces expulsion from a community, also referred to as “belonging threats.”  A broad range of groups have been targeted by the current administration — women, Muslims, people of color, LGBTQ individuals, immigrants, disabled people; none are welcomed in the new version of America, and many feel their rights and safety are threatened.  Disenfranchised groups are suffering more.  Some are fighting with conservative family members, others are facing increased hate in the streets, most are consuming news about such threats.

In addition, the new administration’s rhetoric, with its “alternative facts,” and the preponderance of fake news have the same effect as gaslighting, a device of psychological control common in abusive relationships.  Gaslighting involves manipulation to induce heightened doubt in the victim.  Creating multiple untruths and promoting them as true causes people to question their own sense of reality.  Adding to that fear and confusion, the rapid and dramatic changes being implemented may create a frantic desire to track every new dictum, appointment, or tweet.

Fear of the unknown and a sense of overwhelm can result in heightened anxiety while feelings of powerlessness and worthlessness can lead to depression.  No matter how much or little you may be struggling yourself, you can counter these effects by experimenting with some of the following recommendations.

1)  Limit your consumption of media.  This might mean limiting your news to one or two trusted sources, limiting the amount of time you spend reading the news each day, or some mixture of these.  It might also entail reading only two or three political articles a day and following that up with a palate-cleanser of something more uplifting, such as the features offered on this site — https://www.positive.news/

2)  Limit your social media activity.  While social media can provide a way to connect with others, it can also be a source of intense frustration, fruitless conversations, and fake news.  If you find your interactions with social media are creating more stress in your daily life, consider giving yourself time limits, customizing your feed, reducing weekly use, and/or limiting yourself to one platform.

3)  Stay connected in real life.  Talk to friends, family, and co-workers.  Say hello to people on the street or chat with your bank teller, your barista, your grocery cashier.  This can directly counter those belonging threats as well as keep you grounded in the realities of everyday life.  Some further suggestions along these lines can be found here — http://gratefulness.org/blog/five-small-gestures-gratitude-counteract-fear-violence/

4)  If you are feeling overwhelmed and helpless, choose a cause and spend time connecting with organizations who support that cause:  donate, volunteer, make phone calls.  Trust that there are people fighting on all fronts, so you don’t have to do everything.  You can pick your battles.  Here’s one place you might start — https://loveisaction.us/Resources/

5)  If you are frightened and confused, educate yourself.  Authoritarianism thrives on fear and misinformation.  You can find many excellent resources online that explain our legal system and government structure.  Here are two to get you started: https://www.talksonlaw.com  and  https://www.lawcornell.edu

6)  Keep laughing.  It’s especially important during difficult times to find space for joy, for play, for humor.  Watch videos of baby animals, try laughter yoga, go to a comedy show, read a humorous novel.  There’s a reason satire and political comedy are so popular.

7)  Seek experiences of awe and wonder.  These experiences remind us of beauty and help us continue to find meaning in our daily lives.  Go for a hike, look up in the trees as you walk through a park, read poetry, go to the art museum, see live music, theatre, or dance.  

We all need encouragement and greater self-care when our stress increases.   It can help to write reminders in your calendar or on your to-do list.  However you do it, whether in the forms suggested above or in some other way that speaks to you, make time to give yourself the support you need.

Worried About the Election? You’re Not Alone.

In a recent New York Times article, “Talking to Your Therapist About Election Anxiety” , therapists weigh in about how the current election is impacting their clients.  People on all sides of the political spectrum are feeling anxious, afraid, and less safe. Our relentless news cycle exacerbates the hypervigilance many are experiencing.

We, too, have seen this happening with our clients; election anxiety is in the air. We find the advice given by the therapists in the article – take breaks from the news and social media – to be especially helpful.

Anna Freud, her Father, and Gay Conversion Therapy

by Anne Ihnen

I came across a post in the Ms. Magazine blog today, about Rebecca Coffey’s 2014 debut novel, Hysterical: Anna Freud’s Story. Based on historical accounts, it tells the story of Anna’s analysis by her father, Sigmund Freud, which included attempts to “cure” her lesbian tendencies.

According to Coffey, the analysis actually happened. At the time, Sigmund was universally acknowledged as the leading expert on sexuality, and he considered lesbianism to be a highway to mental illness that, fortunately, was curable by psychoanalysis.

This sounds like a fascinating and entertaining read – a glimpse into an early attempt to treat homosexuality as a disease (an idea that has been soundly debunked) along with an exploration of the questionable ethics of working on sexual transference with one’s own daughter.

It’s an especially timely read, too, with many US cities and states banning gay conversion therapy and a woman being chosen as the democratic party’s candidate for president.

I am definitely adding this one to my reading list!

“Therapy Wars”: Some thoughts about current psychotherapies

by Judy Koven

In Therapy Wars: the Revenge of Freud (theguardian.com, January 7, 2016), Oliver Burkeman details the shake-up caused by recent research challenging the assumption of the superiority of cognitive behavior therapy (CBT). He cites several examples, including Norwegian research that found that the effects of CBT wore off over time, a large British National Health Service study that found an 18-month course of psychoanalysis more effective than CBT, and a Swedish media report that auditors there revealed expensive investment in a CBT methodology to be ineffective.

For the first time in years, the primacy of this modality is being questioned. Neuroscience discoveries support the idea that the brain processes and integrates information more quickly than we’re consciously aware of; this suggests that not everything can be known and measured quantitatively.

Because CBT is a quantitative approach that treats symptoms, it’s easily measurable. For example, you can keep a journal of your negative thoughts and episodes of physical symptoms of anxiety and measure your progress by looking at changes after you’ve cognitively reframed a thought or applied a behavioral technique. It’s much harder to assess changes such as an increase in one’s internal experience of self-satisfaction or healthy engagement with the world.

It would seem that fewer psychoanalysts, at least here in the western US, still practice in a classic Freudian mode. Analysis has blossomed in many directions, and the emphasis has shifted to other ways of understanding our psyches. The psychodynamic therapists I know focus on the connection between mind and body, “relational” work using the therapy relationship as a framework for exploring our experience of self and other, and the various ways our early life experiences impact our attachment styles. I don’t hear anyone talking about penis envy or such.

We live in a culture that values quick fixes, easy results, and action, and we are more comfortable doing than being. I think CBT speaks to that habit. Exploring and understanding the underpinnings of what makes us tick seems a more lasting approach to how we express our difficulties, but it’s work that can unfold slowly. That being said, I think CBT and related approaches have a real place in the healing modalities. For some people, it’s all they want or can tolerate. And what’s wrong with finding tools to manage or alleviate emotional distress? I just don’t think it’s the panacea that our medical, academic and health insurance systems seem to think it is.

Here’s what psychiatrist Jerome Frank (“Case Study”, Psychotherapy Networker November/December 2015) lists as the essentials for therapeutic success:
• Confiding relationship with a helping person
• Healing setting
• A rationale or mythology that accounts for the client’s symptoms
• Plan that both client and therapist believe can work

These ring true to me and I think argue for no one method being the magic pill. That’s why Women’s Therapy Referral Service emphasizes goodness of fit and congruence of values.

Niche Market Therapy?

A story in the February 7 New York Times Style section highlights the relatively recent phenomenon of therapists gearing their practice to a specialized, and sometimes narrow, demographic, e.g. LGBTQ clients, newly married clients, or those in the tech industry, the last especially prevalent in urban centers such as Silicon Valley and metro Seattle.

The piece concludes, though, with what we in the therapy field have long known, that the crux of successful therapy is the power of the healing relationship between therapist and client.