Reflections on the Evolution of Psychotherapy Conference

I am writing this month's newsletter as I fly home from The Evolution of Psychotherapy Conference in Anaheim. 8,000 therapists from 58 countries attended the meeting. It was rich with opportunities for learning, networking and especially for hearing many revered gurus present their work.

Albert Ellis at 92 was still going strong and as crusty as ever. The conference speakers demonstrated more consciousness of the world at large. Patch Adams, Mary Catherine Bateson and Jean Houston each in their own ways begged us as therapists to become more involved in the global community as social activists, in the areas of world hunger, global warming, the environment, and with projects in our local communities.

Mary Catherine Bateson, the daughter of Margaret Mead and Gregory Bateson, stressed the need for us as therapists to recognize a new life stage; the years between 55 and 70 or 75. This is a stage requiring a new kind of human maturity, a time to find meaning and give back to preserve the future for our children and those who come after us. It will also be a stage where our clients are increasingly asking us to help them find meaning in their lives.

There were so many demos, panels and presentations that there is no way I could completely report on the meeting. I thought I'd just share a few nuggets with you. I always enjoy Dr. Otto Kernberg. He has a remarkable capacity to synthesize years of psychoanalytic thinking into concise summaries. This year, during the panel on Sexuality he encapsulated all sexual problems as related to the following issues:

1. Problems of sexual inhibition
2. Splitting emotional and sexual attraction
3. Perversions, anxiety about these and the necessity to broaden our view and recognize that we underestimate the broad range of normal sexual behavior
4. Chronic conflicts in couples undermining their sexuality
5. Real differences between men and women and the need to continue sorting what is real, what is biological, what is cultural and learned
6. Private sexual morality vs. legal intervention into the bedroom
7. Sexual problems inherent to some personality disorders

Another thinker I find stimulating is Dr Thomas Szasz. I remember reading his famous book “The Myth of Mental Illness” when I was in graduate school. Now thirty years later, he is still prodding us to think clearly about what we do and urging us not to become too immersed in the medical model. He strongly pushed some elements that many of you have heard Pete and me stress in our teachings with couples. He believes that the goal must be set by the client and that often therapy is prolonged unnecessarily due to the therapist having goals for the client that are not what the client wants! He suggested that when a wife wants her husband to change, it is only ethical for us to say, “I can't take your money.” He reminded us that it is not possible to avoid judgment in therapy, and to avoid it we would have to be catatonic or dead.

James Hillman defined transference as that which arrives to replace a real relationship. He highlighted certain psychic factors lurking in the room which contribute to transference. He mentioned some of the common ones, but then added the figures of “duty”, “time”, “fear” and “high expectation”. Time is always an enormous factor in governing what does and does not happen in the therapy room and the inevitability of the client experiencing some fear with the situation itself. No matter what we do, the therapy situation is unnatural and will elicit elements of fear. He also stressed the inevitability of “high expectation” entering the room. This might be from the client, the therapist or both, but will certainly influence the nature of the transference or countertransference.

Although Dr. Hillman did not speak about this in couples therapy, I was reminded of how strong this element is when we begin with our couples. So many partners come to therapy with high expectations for changing the other person or with high expectations for returning to the intensity of their early romantic stage. We are often forced to address these high expectations sooner in couples work than in individual therapy. How we address these expectations can increase the client's motivation or can be very de-motivating. Indeed a strong reminder about how our work is much more of an art than a science!

All in all the conference was a wonderful collection of wisdom, gathered from years of experience and evidence of how much our field has evolved. It was also exciting to think about how much more we will know by the next Evolution conference in 2010, when so many additional findings from neuroscience will be integrated into our work.

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Dr. Ellyn Bader

Dr. Ellyn Bader is Co-Founder & Director of The Couples Institute and creator of The Developmental Model of Couples Therapy. Ellyn is widely recognized as an expert in couples therapy, and since 2006 she has led innovative online training programs for therapists. Professionals from around the world connect with her through internet, conference calls and blog discussions to study couples therapy. Ellyn’s first book, "In Quest of the Mythical Mate," won the Clark Vincent Award by the California Association of Marriage & Family Therapists for its outstanding contribution to the field of marital therapy and is now in its 18th printing. She has been featured on over 50 radio and television programs including "The Today Show" and "CBS Early Morning News," and she has been quoted in many publications including "The New York Times," "The Oprah Magazine" and "Cosmopolitan."

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