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.

“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.

Tidying up

Those of us who’ve read Marie Kondo’s book The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing, were perhaps both amused and inspired by her ideas on organizing our “stuff” and surrounding ourselves with only the things that bring us joy. Now, a local money coach, Mikelann Valterra, springboards on Kondo’s theme to write about how to manage our parallel financial clutter, address the stress it causes, and simplify our lives.

It’s a nice followup to this month’s interview with Jan Bucy, MA LMHC.