(In the Wrestling Pigs post, I said that psychology as a therapeutic practice had been hi-jacked by an unholy trinity of the pharmaceutical industry, the budgetary constraints of the NHS, and a tendency to manipulative middle-class, liberal-feminist values, to the point where the appalling propaganda of the Lockdowns was considered to be a triumph of the art. Nothing so corrupt is worthy of philosophical analysis. However, my inner philosopher rebelled. This and the next post discuss some issues facing so-called "high-functioning" individuals, not the poor sods who are stuck on regimens of disgusting psychiatric drugs, and for people who can afford private therapy, not the poor sods being fobbed off with ten sessions of CBT to tick boxes and manage budgets.)
All of us have to deal with the insults and upsets of everyday life, from getting a bad cold to being laid off from work for no fault of one's own, from the kitchen misplacing our order to getting a parking fine, and from the irritation of not being able to find our keys to grieving for the loss of a loved one. Everyone reacts and recovers differently to these: some people can bear a grudge for a lifetime, and others seem to shrug off almost anything in a day.
These experiences are "everyday" because they can and do happen to everyone, involve no shame or guilt and so can be publicly admitted, the event is not usually directed at us because of who we are, have no significant lasting effects, the temporary effects are understood and allowed for by almost everyone.
Some people need to deal with the after-effects of an experience that leaves a permanent negative effect, or an effect which is not understood or allowed for by others, and which may have been directed at us because of some aspect of our character, and have likely resulted in possibly undeserved shame or guilt. Amongst the obvious ones are divorce, being laid off from work for no fault of one's own, or being bullied, abused, or stalked. There is the litany of faults of family and upbringing, or having a singular and shocking experience, or a consistent pattern of treatment which, taken individually may be bearable, but over a longer period is harmful.
Some people also need to deal with maladaptations and kinks. A maladaptation is a behaviour that "made sense at the time" to cope with a particular situation, but has been applied outside that situation or carried on past its time. The behaviour must have been reasonable and effective - given the resources available to the person at the time. A kink is a preference or ability that leads to behaviour that is uncommon, some of which may be socially unacceptable or otherwise dysfunctional, and the most obvious example are the addictions. (A trivial example is: just because you can crack your fingers, doesn't mean you should.)
The purpose of psychotherapeutic explanation is not to provide an explanation of why the patient is experiencing distress or reduced functioning. The truth is too complicated and rarely delivers the emotional satisfaction needed. Instead, it is to provide a story that helps the patient make sense of themselves, and especially to remove feelings that were put there by other people. (Too often that story is about mothers, as if fathers played no roles in their children's upbringing, and not often enough does it look at schools, peer groups, and the books, movies, stories, art and so on, the patient was exposed to.) If that story continues to make the patient make sense to themselves, then it is good enough.
Helping the patient make sense of themselves (these are the 40-somethings who say "I got this diagnosis and I'm so relieved") and to untangle twisted knots of emotion, lies, mis-direction and denial, are what television and movies would have us think are the basic tasks of psychotherapy. But the story-construction is only part of it, even though it may be so much that both patient and therapist fall down in exhaustion when it is done.
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