What is the purpose of therapy? (Gestalt)

This may be obvious, but it always surprises me that there is no general, agreed-upon "purpose" for therapy. Why do people go into therapy? Why should they (or shouldn't they) go into therapy? Of course, there is no single purpose. But one way to divide broad perspectives is into "treatment" or "growth." A treatment-approach focuses on symptoms - anxiety, relationship problems, depression - that interfere with life. This is analogous to the treatment of physiological symptoms like rash, headaches, etc.. The goal is to decrease the symptoms so that life can go on.

From a growth perspective, the goal of therapy is not just to "get back to normal" but to learn something about ourselves that allows us to grow as individuals. The assumption is that growth occurs naturally over the lifetime, and it is an inherently positive process. Many people seek therapy with a goal of "growing", often because they feel that other parts of their life (e.g., peers, family, or their environment) are not supportive of their growth.

These two categories overlap, of course. Investigating and shifting out of age-old patterns that developed early in life and that still produce problems in our lives can be looked at either as a way to address problems (or "symptoms") or as promoting our growth. If the therapeutic work leads to positive subjective change or improved objective functioning, it doesn't matter what motivated it.

All that said, each therapeutic perspective - Ego psychology, Lacan, Gestalt, Self psychology, for example - have different views of the "goal" and this can radically influence the nature of the therapy. Meanwhile, each therapist comes with his or her own idea of what the goal is, even within the same clinical perspective.

All this is to say that, as I investigate different approaches, I've been keeping my eye out for what each writer considers the "goal" or "purpose" of therapy, to get a hint about each one's overall attitude towards life, individual autonomy, and human relations.

As one example, Gestalt therapy views many problems that people come to therapy with as growing out of the inability of the individual to adapt to his or her ever-changing environment. Here is quote from Perls' The Gestalt Approach that summarizes his vision of the "goal of psychotherapy" (apologies in advance for the dated pronoun usage):

The man who can live in concernful contact with his society, neither being swallowed up by it nor withdrawing from it completely, is the well-integrated man. He is self-supportive because he understands the relationship between himself and his society, as the parts of the body instinctively seem to understand their relationship to the body-as-a-whole. He is the man who recognizes the contact boundary between himself and his society, who renders unto Caesar the things that are Caesar's and retains for himself those things that are his own. The goal of psychotherapy is to create just such men. (p. 26)

As I come across other statements by different theorists, I will post them, and perhaps contrast them.

Lacan and Gestalt

Before I started studying social work in New York, I spent a lot of my free time reading books on psychology. In grad school I had to read assigned reading (some of which was good / relevant to me, and some of which was not); between school work and my internships, I didn't have a lot of time to pursue my own interests. Then I graduated, got a job as a family therapist in Brooklyn, and became a parent. I didn't have the time or energy to focus on areas of therapy that didn't apply to my work, and besides, I wanted to do other reading in the free time that I had.

I learned a lot in my two years of work in family therapy and child protective services, but I think it made me lazy, too. We had a lot of mixed roles and there was not a huge incentive to grow, clinically, in my areas of interest. Meanwhile, the demands of working at an agency - getting enough contacts, doing case management, record keeping, etc. - distracted me from doing my best therapeutic work. There wasn't a lot of curiosity and energy.

Now that I'm unemployed and considering starting a private practice, I've been going back to the literature to figure out just what perspectives interest me, and what kind of a therapist I want to be.

Somewhat arbitrarily (or is it?) I've dipped into two very different areas that I have little background in: Gestalt and Lacanian Analysis.  Lacan and his followers use a complex jargon that can seem absurdly arcane. As I understand it, Lacan was writing for professionals, not for the layperson. I still have not decided whether it is worth making the investment in learning the language. Are there not others who say the same thing in a much simpler way? I don't know. 

On the other end of the spectrum is Fritz Perls, who wrote that "Any reasonable approach to psychology not hiding itself behind a professional jargon must be comprehensible to the intelligent layman, and must be grounded in the facts of human behavior." (The Gestalt Approach, 1).

I think both approaches - jargon and simplicity - have their benefits and drawback, and both perspectives probably attract different "types." In the end it is a question of how they are implemented and what the outcomes are.

All that said, and apropos of nothing except what I'm currently reading, here is an interesting excerpt on love, from an interview with Jacques-Alain Miller (a French Lacanian academic). It is interesting to think that love can and often does exist without regard to a response from the other. It is reciprocal not because it needs to be mutual, but because it intrinsically involves or 'implicates' the other:

H. W. – ‘Love is always reciprocal’ said Lacan. Is this still true in the current context? What does that mean?  

J.-A. M. – This sentence gets repeated over and over without being understood, or it gets understood the wrong way round. It doesn’t mean that it’s enough to love someone for him to love you back. That would be absurd. It means: ‘If I love you, it’s because you’re loveable. I’m the one that loves, but you’re also mixed up in this, because there’s something in you that makes me love you. It’s reciprocal because there’s a to and fro: the love I have for you is the return effect of the cause of love that you are for me. So, you’re implicated. My love for you isn’t just my affair, it’s yours too. My love says something about you that maybe you yourself don’t know.’ This doesn’t guarantee in the least that the love of one will be responded to by the love of the other: when that happens it’s always of the order of a miracle, it’s not calculable in advance.

But what makes an individual fall in love with that particular person? According to Miller it's all about the unconscious minutiae, that derive from our specific personal histories.

J.-A. M. – There’s what Freud called Liebesbedingung, the condition for love, the cause of desire. It’s a particular trait – or a set of traits – that have a decisive function in a person for the choice of the loved one. This totally escapes the neurosciences, because it’s unique to each person, it’s down to their singular, intimate history. Traits which are sometimes minute are at play. For instance, Freud singled out in one of his patients a cause of desire that was a shine on a woman’s nose! 

H. W. – It’s hard to believe in a love founded on these trifles! 

J.-A. M. – The reality of the unconscious outstrips fiction. You can’t imagine how much in human life is founded, especially where love is concerned, on little things, on pinheads, on ‘divine details’. It’s true that’s it’s above all in men that you find causes of desire like that, which are like fetishes whose presence is indispensable to spark off the love process...

Finally, on the impossibility of communication, i.e. the limitations on love in the real world:

J.-A. M. – Yes. What objects to the Aristotelian solution is the fact that dialogue from one sex to the other is impossible, as Lacan said with a sigh. People in love are in fact condemned to go on learning the other’s language indefinitely, groping around, seeking out the keys – keys that are always revocable. Love is a labyrinth of misunderstandings whose way out doesn’t exist. 

FDR, "Class Warrior"

What this speech (which I spotted on Slog) shows very well that some things change and some things stay the same. We are in a similar economic situation to the one we were in during the 1930s, and the causes were the same as well. FDR even predicts that at some point the U.S. will be faced with a repeat of history, and says:

Any clear-thinking business men share that concern. Indeed, if such reaction should develop -- if history were to repeat itself and we were to return to the so-called "normalcy" of the 1920's -- then it is certain that even though we shall have conquered our enemies on the battlefields abroad, we shall have yielded to the spirit of fascism here at home.

(depending on how you define 'clear-thinking', you could argue that the part about "any clear-thinking business men" is pretty naive after what's happened)


So we've been through much of what is going on now - or at least our grandparents have. What is different is that these days, there are very few politicians, and no presidents, willing to take a stand (Sen. Bernie Sanders, not coincidentally the only liberal independent in the Senate, is an exception). What FDR says in the speech seems like common sense but it is not even close to being discussed.


Why is this so? I don't know enough about the political culture in the 1920s and 30s, but it seems to me that the right is much better organized now than they were than to oppose any kind of regulation and progressive change. The 1960s happened and they regrouped and decided to organize to ensure that the world would continue to work to protect their interests. Now the right managed to frame the entire national debate, with talking points like "class warfare".


Before anything can really change in our government and in our country, there has to be a shift so that this kind of discussion is "allowed". Hopefully the OWS movement will move us in that direction...





(transcript is at American Rhetoric)

What is a credit union?

I've already explained why I think that now is a good time to switch from your bank to a local credit union. Here are some qualities of credit unions that make them different from commercial banks (e.g., Bank of America, Citibank, Chase, and Wells Fargo), and, in my view, far superior.

A credit union:

• Is a not-for-profit institution (commercial banks are for-profit companies, which is fine, but you should know that their priority is to increase shareholder value, not to serve customers and protect their money)  
• Is governed by a volunteer board of directors, elected by members - and if you have an account, you are a member, and can vote
• Is generally locally-based, and customer friendly
• Offers credit cards, loans and business account-services, in addition to checking and savings accounts
• is usually federally insured, just like banks, up to $250,000 (through the NCUA) - check the bottom of their webpage to confirm (BECU and WSECU are insured)
• often has agreements with other credit unions, so you can use ATMs of other institutions
• In almost all ways, it feels just like a regular, community bank

(For more info, check out the Move Your Money Project.)

So if you are reading this, consider reading up on credit unions and transferring your money to them. No matter what you politics are, you will probably be happy with your decision. (Here is how to find one in the U.S.)

If you can think of any other positives, or negatives for that matter, please let me know in the comments!

Why I'm in favor of Bank Transfer Day

Abstract (since this it so long):

• For Occupy Wall Street to survive/expand, a broader population of Americans needs to get involved
• At this moment in the country, there is a general frustration with our government, but also a lack of options for how to change it
• "Bank Transfer Day" is a good next step for getting people involved in financial reform, because:
• A lot of people are not satisfied by how the bail-outs of banks were handled; 
• Americans are not generally satisfied as customers of the big four being Bank of America; Citibank; Chase; and Wells Fargo)
• A lot of customers are upset that Bank of America and others will now be charging for debit card use
• Transferring to a credit union
• Will may you happier because the customer service is good at it feels good to bank with a local, not-for-profit institution
• Empowers people to "vote" with their money
• Sends a message that we don't want to support "too-big-to-fail" corporations
• It won't change the world, in itself, but it is a good way to vote with your money.

Here is a question: Why, three years after the economic collapse and bail-out, do we still have banks that are "too-big-to-fail"? Look at what our financial ecosystem looks like these days:

(Image source: unknown, but it's all over Facebook)

A lot has already been written about divesting from the big banks and putting our money in local, member-owned credit unions. I thought I'd just add my own perspective.


As I noted in an earlier post, I support the Occupy Wall Street movement, but I have been thinking a lot about how a protest can expand into a movement that can influence our legislators. I think one thing is certain about OWS: We don't really know where it is going or how it will grow. Many people dismissed it as a radical extremist cause; it could have been snuffed out, but it wasn't, and it continues to survive and morph (friends who are down there tell me that despite the media slant, the crowds are diverse and by no means extremist).


I believe that there has been a populist-vibe in the country for some time now, but no one, I think, knew what to do in the face of a government as dysfunctional as ours. The scope of the institutional problem is humongous, and the absence leaders is disappointing that it just feels daunting (here I am definitely including myself). I'm talking about average Amercans who don't have the time, energy, or social support to get involved in direct action or advocacy, but who don't like the way this country is headed and want more representation. I'm not talking about the anti-Tax Tea Party here. Most people support higher taxes and social services. For instance, a Washington Post poll recently found that 68% of adults supported raising taxes on households making over $250,000, and 53% of Republicans supported this! If more than half of the Republican support this, that tells us that this is not as controversial an idea as pundits and politicians make it out to be, and that we are a lot less divided than we think.


If people feel generally unhappy with the situation but don't feel like their representatives are on their side, this is a recipe for disengagement and apathy. I don't blame them either; I feel apathetic, and just making a living and raising a family takes a lot of time and energy. I believe that what will get the average American involved is a personal stake in the situation, and a simple, specific step they can take which is personally beneficial and will make them feel empowered.


I think Bank Transfer Day, and other manifestations of this cause, are a perfect next step to get Americans involved, for a few reasons: 1) A large number of people in this country are not satisfied by how the bail-outs of banks were handled; you don't have to be an economist in a suit to smell something fishy; 2) Americans are not generally satisfied as customers of these giant institutions (the big four being Bank of America; Citibank; Chase; and Wells Fargo) - that is, they don't have a lot of brand-loyalty; many customers just don't know that they have other options; 3) At this current moment, a lot of customers are pissed off that Bank of America and others will now be charging for debit card use, claiming that this is necessary due to the very mild restrictions imposed by the Dodd–Frank Wall Street Reform and Consumer Protection Act - specifically the Durbin Amendment (for an overview of why this is B.S. on the banks' part, see this NYT Op-Ed).


The combination of these three factors means that a lot of Americans who would not otherwise join a protest may be willing to go to some trouble to shift to local credit unions. A big factor in this: People who use credit unions like them. I know I do. I switched over from Washington Mutual to Washington State Employees Credit Union in about 2004, and I've never looked back. If you look at the comments on the Bank Transfer Day site, you will find that a lot of participants are people who have been in credit unions for years or decades, but just want to express their enthusiasm. There may be psychological reasons for this (we tend to value things we chose, just because we chose them, but that's another post) but in my experience, people get better customer service and have stronger sense of belonging and community when we bank with a community organization - especially a credit union (see my next post for what a credit union is). They are owned by members (i.e., customers), not by shareholders.


But the benefits to the customer are not the main point. So what is the point? As I said above, we don't know what OWS will turn into, and we also don't know what BTD will turn into either. We don't know if it will impact the banks financially. Regardless, I think the main point is about empowerment. People (many of "the 99%", that is) feel disempowered and trapped in a system that does not care about them. The act of "voting" with their money is a way to take some power back. By switching to a credit union, people are saying that they want to keep their money in a smaller, local institution whose primary concern is towards its customers, not towards its shareholders.  I think this is good in itself.

What about impacts? First, we are not talking about a bank run, which involves a mass withdrawal of cash from financial institutions in response to fears about the bank's solvency. Since banks loan out more than they hold as investments, they can easily run out of money in such an event. There are several differences, in this case: 1) People will be withdrawing their money from banks at different times, not all on one day. This allows banks to plan ahead; 2) They aren't hiding their money under a mattress, keeping the money out of circulation, but are investing them in credit unions so that the cash can be loaned out and invested locally; 3) It is not an action responding to fear about the immediate stability of the bank.


Even so, some have argued that there is a risk of bringing about another bank bailout, or even another recession, if too many people do this. Considering that individual customers' funds make up a small percentage of a banks total assets, I don't think that this is likely. Banks do stand to loose profit (from debit use and fees), but they are not going to go broke. Meanwhile, credit unions across the country are being strengthened, and will begin loaning out money, without skimming profit off the top for shareholders.


I think that if there is enough momentum on this, it will get the attention of our politicians. It will show that there is a groundswell of support for financial reform, and that we as a nation are not happy with the "too-big-to-fail" model. This won't, in itself, change the system, but it is a start, by voting with our dollars.


What we need, in the end, is legislative reforms that regulate banks so that they start doing what they used to do: Save people's money, and loan money out to people. This is not a controversial goal, and many have made this argument already. That system worked quite well for many decades. In 1933, the Glass-Steagall Act was passed to regulate banks to make sure that they did not get involved in the type of speculation that brings about depressions. Banks were divided into two categories: Commercial and Investment banks, which were kept separate so that your savings account could not be used for risky investments. Then, in 1999, the act was repealed (this was in response to intense lobbying by the financial industry, of course; Clinton signed off on it, demonstrating that this isn't just about corrupt Republicans). Over the last decade, banks and investment firms got involved in risky investments (in order to maximize shareholder profit, which is what they do). This led to their failure and bail-out when those investments turned out to be bad. The Frank-Dodd Act was passed later to set up some reforms, but it is generally considered insufficient, and there is little movement in congress to enact stronger reforms, or to re-enact Glass-Steagall (probably because of the level of lobbying and campaign contributions by banks).

Besides regulating the risks they take with our money, we need to break up banks so that there are no companies that are "too-big-to-fail". That is a recipe for disaster, because those companies are by nature devoted to shareholder profit, not to supporting a healthy economy, and they will act in the interest of shareholders, which may, as we've seen, be in direct contradiction to the interest of the nation as a whole. This is why it makes sense to refer to these companies as "Systemically Dangerous Institutions".


(I didn't come up with this on my own. Others who know a lot more about the economy seem to agree - at least the ones who want a better future for the country and not just for the top 0.5%. There is of course disagreement, but it seems clear to me that anyone arguing against financial reform is probably worried that they will make less money as a result. Matt Taibi at the Rolling Stone provides a good overview of what other financial reforms the OWS movement should call for.)


How can we communicate this to our politicians when they are really working for big business? Vote with our votes, but also with our money. Bank Transfer Day will send an important message to our leaders, and could help bring about greater financial restrictions. It will also feel good to walk into a local credit union and know they are working for you!

Meditations on an Occupation

I have been excited and, strangely, sad to see the Occupy Wall Street movement build support and get mainstream attention over the last few weeks. One reason I am sad is simply that I lived in New York City up until May of this year, and I wish I could witness and take part in what is happening. But I also feel sad because it has brought up memories of the November, 1999 WTO protests in Seattle (I cannot believe it was 12 years ago, but there it is).

For several months I was involved in organizing for the WTO protests on the University of Washington campus. This was an exciting experience as a sophomore in college, and the protest and events that followed were exciting and inspiring - we felt like we were part of something big. But in the months following, I was left with the awareness of the limitations of such protests. It was an event that many co-participants remember as a great moment of standing up to the status quo, but it also felt insular and its long term impact is unclear. In the long run I think that was left  less idealistic about the possibility of substantive change though such movements. This was in part due to the limitations I saw in my co-organizers - gross blindspots, ignorance, egotism, narcissism, and general flakiness (not that I was free of those traits either). "Were these people," I asked myself, "supposed to lead us to a new future?"

Many of these feelings have been revived in the last month, as I've watched the developments in Manhattan: a desire to participate, to "be there" but a melancholy pessimism about it all. One question I've been asking myself and others is how the movement can keep up its momentum and spread its message to a broader American public. Friends who are "on the ground" in New York tell me that the protests are much less radical than the media suggests - they are diverse in terms of age, ethnicity, race, and socio-economic status ("99%" still includes a wide range of incomes, and it sounds like a wide range is indeed represented there). This is hopeful, but I look at friends, family and neighbors around me who are not "political" and they barely know that the protests are happening - even the ones right in our own downtown Seattle. I feel very strongly that for systemic change we need to get "those people" (including the sizable population of Americans who are "Republicans" but don't like what is going on in Washington) concerned enough to do something; not occupy, maybe not even protest. At least vote, and hopefully do something more to demand change.

I've come to conclusion that one cause that could be adopted by a wide spectrum of Americans is divestment form the "too-big-to-fail" banks whose practices precipitated our economic crisis. This movement, represented by the Move Your Money Project and Bank Transfer Day, advocates divesting from Chase, Citibank, Wells Fargo and Bank of America, and putting money in local credit unions (I hope to make another post summarizing the reasoning behind that, soon).

Another idea I am bouncing around is a Children's Party. The Right had a Tea Party, and the Republicans essentially have their own party within the Democratic Party (the Blue Dog Democrats). What about a party/movement representing children - with the basic message:


What's best for our children is best for our country.


I will hopefully post a more detailed description of what a Children's Party would be, but until then, let me know if you have any thoughts!