Why the Traditional Model of Psychotherapy is Ineffective

traditional psychotherapy

One of the problems with almost all psychotherapists is that they try to help you based on the theories of their respective school of therapy. Constrained by their invisible framework, such psychotherapists explain and interpret your fear and anxiety from their theories of reference.

This means that your problem (and all its accompanying symptoms) have to match their model of a disorder; leading to two subtle but important realities with dramatic consequences. First, if you, with the help of the therapist search for the ‘why’ of the problem, the finding would always be ‘presumed causes’. This means that the so called causes were in actuality constructed by their adopted theories and their respective school of therapy. Another problem appears when they interpret your fears and anxiety in the light of their theories; the building blocks of your problem are distorted. Again you and your fears and anxiety must match their theories.

People who always keep asking ‘why’ are like tourists who read the guide book while they are standing in front of a monument; they are so busy reading about the building’s history, origins and so on that they don’t look at it.
Ludwig Wittgenstein

When discussing fears, phobias and anxiety, it seems logical to ask what is at their root. But at the heart of such inquiry lies the assumption of a linear relationship between cause and effect. From this lineal way of thinking, in order to solve a problem it seems necessary to go back in time in search of the cause. And since the cause must come before the effect, one must investigate the past.

However, this traditional model has become obsolete. More than a century ago the fields of physics and natural sciences have undergone a major change replacing lineal cause and effect with a circular one. Scientists like Einstein, Heisenberg, Bateson, Maturana, Prigogine and Watzlawick (among many others) have contributed to dismissing the old and obsolete linear causality and adopted the circular one which is more in harmony with contemporary understanding of reality. However, most schools of psychotherapy have attached themselves stubbornly to traditional models of mind and behavior.

Another problem with most psychotherapy approaches (including psychiatric procedures) is that they are based on rigid theories about human behavior. When you go to a psychotherapist, you as the patient, are expected to adapt to them, the therapist. If you don’t or can’t they just dismiss you as a resistant person. But I believe that the fundamental criterion for the validity of a therapeutic model should not be the its theoretical framework, but rather its actual intervention capacity, measured in terms of effectiveness and efficiency in solving problems.

The job of a therapist is not to search for the deep rooted causes and analyse to uncover hidden meanings. The search for the ‘why’ of a phobia or anxiety originates as a philosophical endeavor, and rarely helps to solve it. In contrast, an effective therapist asks ‘how’ questions in order to discover how a phobia is limiting your life and to being to work on how to change that. This latter approach is more scientific.

There is a belief that a phobia or anxiety that has lasted and resisted change over a long span of time must necessarily need a very long therapeutic treatment. Most experts are convinced that the rare and complex phobias that are characterized by great suffering require equally complicated and painful solutions.

Yet another problem with the usual treatment methods comes from the fact that most of the psychotherapies are based on the assumption that thinking comes first. Therefore, to change a phobic or anxiety response, we must first change the way of the patient’s thinking. And only then can we change the way he or she behaves and reacts.

However, as the science of neurology reveals, this process must be reversed. In order to change a fear reaction, first you have to change the way you act and then to change your thoughts. Jean Piaget, the great psychologist, demonstrated that people learn by doing. Cognition comes last. In other words, if you want to learn to relate to a situation or object free from fear and anxiety you cannot achieve that exclusively by your thoughts. First, you must act and then understand its why. Therefore, cognition and insight must come at the end – not the beginning. This is why a set of actions or an emotional experience can change the fear and anxiety into tranquility.

Franz Alexander, a psychoanalyst, coined the term “corrective emotional experience” as the key factor for change to occur in therapy. The person has an emotional experience that corrects his perspective. He also pointed out that “intellectual insight alone is not sufficient”.

As Milton H. Erickson emphasized: “Therapy should always be designed to fit the patient and not the patient to fit the therapy.” (Erickson & Rossi, 1979, p.415)

All contemporary schools of psychology (behavioral, cognitive or psychoanalytical) share the same epistemological basis: all originate from the rationalist paradigm. Rationalist epistemology states that there is only one objective reality that is equal for all.

So although they may appear different at face value because of their different techniques and approaches, their core foundation is the same. Therefore, they share the same efficacy rate in treating people. A study conducted by Dr. Martin Seligman from the University of Pennsylvania confirmed this fact:

… no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse.

Thus, all schools of psychotherapy follow a linear and rationalist view of human behavior. However, a number of disciplines in the new sciences have challenged this rationalist paradigm. Among them we can mention the theory of complex systems, cybernetics and the biology of learning which highlights the importance relationship between the observer and the observed. Because the observer, by the mere act of observation alters the observed reality, it cannot be assumed that we can know reality objectively.

This interesting fact becomes crucial in helping an anxious or phobic person. The rationalist mindset can be likened to wearing a set of eye glasses and head phones that distorts a therapist’s perception based on a certain bias. Would they be able to understand the problem and help people with precision or would they be seeing and hearing according to their theories(biases)?