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A Brief History Of Psychotherapy - Page 3

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Clinton Becomes Therapist-in-Chief—1993

It would be hard to underestimate the sense of identification within the mental health field that accompanied the election of Bill Clinton and Al Gore, both of whom seemed steeped in the language and sensibility of pop psychology in a way that was unprecedented for our national leaders. As the first boomer president, Clinton, with his celebrated ability to “feel your pain,” embodied a style of leadership different from that of anyone who’d previously occupied the Oval Office. Here’s an entry from March/April 1993 at the very beginning of the Clinton administration, that captured the sense of new possibility of what now seems like a long-ago era.

It is no secret that President Clinton and Vice President Gore bring to office a familiarity with the language and concepts of psychology, as well as a deep interest in the welfare of children. Clinton, it has been noted by the media, not only participated in a therapeutic family intervention with his substance-abusing brother, but even speaks with some fluency the language of popular psychology. At times, he worked his successful presidential campaign less like an old pol than like a John Bradshaw clone. Clinton spoke publicly about his stepfather’s violent alcoholism, and often used themes from the recovery movement (the phrase, “the courage to change,” for example, from the Serenity Prayer used by Alcoholics Anonymous) in campaign speeches.

–Mary Sykes Wylie

The False Memory Controversy—1995

By the mid-1990s, it was becoming increasingly clear that the therapy field that had started out with such promise, creating a haven to talk safely and openly about previously ignored or taboo topics like gender inequality, incest and sexual abuse, violence in the family, and racism, might have seriously overreached itself on the issue of recovered memories of childhood abuse. At the height of the controversy, “Divided Memories,” a four-hour PBS Frontline documentary on the subject, coming on the heels of an avalanche of negative stories in newspapers and magazines around the country, shone a spotlight on some of the worst excesses within our field, and became a source of sobering reflection for many therapists.

Therapists’ reactions to the documentary ranged from embarrassment to outrage to approval. “I was ashamed for my profession,’” says one Washington, D.C., psychologist. Harvard psychiatrist and trauma researcher Bessel van der Kolk, who was interviewed on the show, wrote to Bikel [the show’s producer] to say she had ignored scientific research validating traumatic amnesia and held trauma victims up to ridicule. Christine Courtois, psychologist and author of Healing the Incest Wound, says that the documentary used bizarre practices to discredit work done in the clinical mainstream. . . . But Atlanta family therapist and psychiatrist Frank Pittman, who contends that practically all delayed recall of childhood sexual abuse is iatrogenic, said the documentary was an enormous relief. “Finally, somebody is catching on,” he says. “I think repressed and recovered memory is a giant hoax that has had an absolutely disastrous effect on the mental health field and our credibility. It’s an expression of our terrible distrust of families and of how enamored we are with the concept of victimhood.”

–Katy Butler

The World Goes Digital—1996

Our first article on therapists and the Net appeared in March/April 1996, and seems soooo outdated today. Does anyone even remember how we tried to grapple with the Web’s unimaginable capacity by linking it to something familiar, resulting in the anachronistic-sounding “information superhighway”? And what about the “techno-creative people” using graphics on the Web?

To access the Internet, you need four things: a computer, a modem, a phone line and a service provider. And that’s it. You’re connected and ready to go. . . .

When we think “Internet,” most of us have in mind the World Wide Web. It’s the greatest adventure on the Internet, the pavilion at the state fair where amazing kitchen contraptions, encyclopedias, organic herbs, cotton candy, tarnish removers, social service organizations, gourmet food, snake oil salesmen and reclining chairs exist side by side. Because the Web can inexpensively create and transmit graphics as well as text, it has attracted the techno-creative people and entrepreneurs. It is virtually unregulated and full of opportunities and excellent resources, but there are also dangers. Whenever you hear people express reservations about the trash on the Internet, they are usually talking about the Web. . . .

Many therapists and social workers, for reasons ranging from altruistic to self-promoting, have begun their own home pages on the Web—like having a roadside stand on the information superhighway. You can put whatever you wish on your home page: you can list your resume, practice specialty, opinions and writings; you can try to sell things; you can set up discussion forums; or you can use your home page to point and link people to other resources on the Internet that you think are worthwhile.

–Garry Cooper

The Decade of the Brain—1999

Within the psychotherapy field, the Decade of the Brain led to an enhanced understanding of the role of neural processes—previously relegated to the Black Box—in both comprehending the difficulties that brought people to treatment and developing tools for bringing about therapeutic change. The Networker was typical of many therapy publications in having a dramatic upsurge of articles about brain research findings and their relevance for clinicians. The dispatch below, published in 1999, was a harbinger of many more articles that turned the long-neglected topic of brain science into one of the most influential areas of therapeutic inquiry today.

A surprising new study overturns the long-held assumption that the human brain stops growing after about the age of 6 and opens the door for the prospect that physicians may someday be able to replace brain cells lost to disease, strokes or injury. According to a study by a team of Swedish and American neurologists, the hippocampus region of the brain—the center of learning and memory—continues producing new cells for as long as we live.

Several years ago, scientists discovered that this lifelong cell creation goes on in the hippocampus of birds, mice and monkeys. But the marker used to track new brain-cell production in the animals is toxic and had not been tested on humans. Then the Swedish and American research team, led by neurobiologist Fred Gage of the Salk Institute in La Jolla, California, realized that this marker chemical, despite its toxicity, is used to track the spread of cancer in certain patients. They received permission from five terminally ill cancer patients who had been injected with this tracer to examine their brains immediately after their deaths. The patients, whose ages ranged from 55 to 70, received the tracer injections at periods ranging from two years to three weeks before they died. The results of the researchers’ examinations showed that every patient’s brain had continued to produce new cells until his or her death.

Now that we know that brain-cell production occurs throughout life, Gage speculates that with increased knowledge about biochemical processes, we may someday be able to control the process of brain-cell division. This would enable future patients to grow new, healthy brain cells to replace those damaged by disease, trauma or aging. “The door,” Gage says, “has been opened.”

–Garry Cooper

The Business of Psychotherapy—1999

As the millennium approached, economic shifts that had been long feared within the mental health field had finally begun to affect therapeutic practice. The impact of managed care and the increased emphasis on medications in treating psychological problems were taking a demonstrable toll on the therapists’ incomes.

During the 20 years that the monthly newsletter Psychotherapy Finances has kept track, therapists’ incomes have risen every year through 1996. In 1997, the trend reversed: counselors, psychiatrists, psychologists and social workers all reported making less than the year before, with only marriage and family therapists reporting an increase. The figures ranged from a high of $96,000 for psychiatrists to a low of $48,000 for professional counselors. Now, newsletter publisher Herb Klein is processing the numbers for 1998, and it looks as if all therapists’ incomes have dropped.

The numbers reflect the fact that therapists are getting smaller and smaller slices of the managed health care pie. Health Care Plan Design and Cost Trends, a report from the consulting firm Hay Group, found that in the decade from 1988 to 1998, behavioral health care benefits dropped from 6.1 percent of managed health care companies’ total health care costs to 3.2 percent.

–Garry Cooper

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