Almost 32 years ago, this magazine—then called The Family Therapy Networker—published a cover story called “The State of the Art,” in which a group of the field’s leading lights were invited to offer their two cents about whether the family therapy “movement” had lived up to its promise and what its future might contain. With this issue, we’re doing something similar for the broader field of psychotherapy. But it’s useful to take a moment to compare the hopes and worries of the contributors back then with those of our current commentators.
Back in 1983, James Framo—then president of the American Family Therapy Association— fretted about faddishness, particularly the “thousands” of young, inadequately trained family therapists rushing to perform the latest clinical trick, promising an instant cure for family problems, no matter how complex. Always eager to prick the bubble of pretense and pomposity, Frank Pittman, whose film review column was must-read feature in the Networker for almost three decades, zeroed in on the field’s tendency to glorify cults and super- stars, a temptation to which, he admitted, even he wasn’t immune: “An audience stimulates the ego and numbs the brain. . . . When people are deter- mined to follow you, it’s hard not to lead—even if you have nowhere new to take them.”
But overall, cockeyed optimism basically ruled the hour. At least two of the commentators seemed to suggest that family therapy was powerful enough to resolve age-old problems of human conflict and violence all over the world. And it’s clear that all the contributors felt they really did share a sense of common identity, an identifiable point of view, and a collective mission that gave them a solid platform from which to proclaim their heady confidence about the future. From that perspective, it wasn’t hard to believe that family therapy, guided by the beacon of systems thinking, really could transform the world.
The lead feature in this issue—“The State of Our Art: Do Our Old Ways Fit the New Times?”—strikes a different tone. There’s been a decline in the public’s utilization of psychotherapy as a consequence of the rise of what might be called the Gang of Three: DSM, Big Pharma, and Managed Care. Today, we appear to be an atomized and poorly organized field that’s lost economic ground to other approaches promising mental health consumers improved well-being. But while recognizing the missed opportunities and missteps we’ve made as a profession, the contributors to this issue also point to what we need to do to make a more concerted and effective stand to reclaim lost territory.
Clearly the world is different from what it was 32 years ago, and we can’t afford to coast along on what we learned in graduate school. We need to reexamine who we are and what we have to offer in light of the profound changes in our increasingly fast-paced, digitized culture. But we also need to recognize a fundamental principle of our professional identity—there’s something about confiding, direct, person-to-person conversation that’s irreducibly necessary to human beings, no matter how plugged-in they are. Even in a social and economic environment unfriendly to the mom-and-pop approach that provides the template for how most therapists offer their services, people still need and want something like what therapists do.
Will the exact form and method of delivery change? Most likely. Will we have to become smarter about explaining what we do and connecting it to the actual struggles people are facing in their lives? Absolutely. If you’re interested in a range of proposals about how psychotherapy can remain relevant in our tumultuous times, this is the issue for you.
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