Psychotherapy Bulletin

Psychotherapy Bulletin

A Psychotherapy Researcher

Dinosaur or Chameleon?

The Golden Crown Sifaka is the smallest member of the lemur family from Northeastern Madagascar. He has a creamy white coat that is topped with a bright orange crown and a triangular face with small black eyes. These creatures live in groups of 5 or 6, care for their young, and form social groups dominated by females. Their habitat was first threatened by logging and bush fires, but the recent discovery of gold in the region has led to further destruction of forest to make room for the miners who eat lemurs, all leading to the Sifaka being labeled as an endangered species. The little lemur faces endangerment largely becomes of habitat loss, brought about by human greed and environmental carelessness.

While I am obviously not a Golden Crown Sifaka, I feel a certain connection to his kind. Similar to this small beady-eyed lemur, as a psychotherapy researcher, I too feel like an endangered species with little fertile ground on which to thrive. The combination of diminished funding for psychotherapy research and minimal academic jobs for psychotherapy researchers is akin to logging and bush fires, as such conditions lead to a climate in which psychotherapy researchers struggle to survive. As an Early Career Psychologist, I find myself in this paradoxical state of beginning my career in an area of research that has come to a startling halt. As Darwin might say, the survival of psychotherapy research rests on how “fit” the next generation of psychotherapy researchers is to survive and compete. Thus, Early Career Psychologists play an important role in whether psychotherapy research is to continue and thrive. This article explores threats to a psychotherapy researcher’s survival and proposes some suggestions for counteracting extinction.

Why Does a Species Become Extinct?

There are three major reasons (among others) that species become extinct: habitat loss, climate change, and disease.

Habitat loss

Practically speaking, in order to survive as a psychotherapy researcher, you need a place from which to conduct your research, i.e., a home or habitat. As any Early Career Psychologist (ECP) who conducts psychotherapy research knows, there are few job announcements specifically seeking a psychotherapy researcher. As one prominent and respected colleague once told me, “Unless you have an fMRI machine, you will not get a job here.” The lack of positions for psychotherapy researchers forces ECPs with an interest in this kind of work to venture into other areas of research to ensure their survival. As another mid-career psychotherapy researcher told me, “there is a feeling that no matter how much you publish, no one will hire you.” In essence, the sure fire way of threatening a species survival is to eliminate its habitat.

The presence or absence of a thriving habitat for any species is closely tied to money. The lemurs are losing their habitat largely because humans found gold right under their noses. Psychotherapy researchers are losing their habitat largely because there is little funding currently available for their research. In a recent article in Psychology Today, Jeremy Safran writes eloquently about the NIMH’s shift in grant funding away from psychological explanations and treatments to studies on the biological basis and treatment of emotional disorders. He writes,

This is a perpetuation and expansion  of a trend which has been taking place at NIMH for many years now, that privileges the biological over all other levels of analysis (e.g., psychological, emotional, social). It is one thing to hypothesize that psychological and emotional problems are associated with changes at the biological level (e.g., specific patterns of brain activity or levels of neurotransmitters) or that symptom remission is associated with biological changes. It’s another to assume that the underlying causes of mental health problems are always biological in nature and that meaningful improvements in treatment will only take place when we can directly target the relevant brain circuitry. (Safran, 2013)

Particularly in this economic climate, universities look to hire candidates with a potential for major external funding. One does not usually find large grants for psychotherapy research, especially process and outcome research. The lack of a hospitable climate for psychotherapy researchers is mirrored in the practice community. In 2008, NBC News ran a story entitled, In the Era of Pills, Fewer Shrinks Doing Talk Therapy” (Associated Press, 2008). This article cites a study that found a significant decline in psychotherapy among psychiatrists in the U.S., although the study did not look at rates among psychologists. The article attributes the expanded use of psychopharmacological drugs and the insurance company’s preference for short-term visits as causes for this decline. Interestingly, this article goes on to state that the current preference for medication is in contrast to research suggesting that psychotherapy is superior to medication for some patients. In essence, despite research on the effectiveness of psychotherapy, there seems to be an “aura of invincibility around meds” (Associated Press, 2008). Psychotherapy researchers and clinicians both struggle to be seen as valuable (and fundable) at a time when biological explanations and treatments are in vogue. 

Climate change and disease

All living creatures are deeply affected by their surrounding climate. Although the exact reason is still debated, leading theories suggest that climate change was a central reason behind the extinction of dinosaurs. More recently, polar bears, sea turtles, the giant panda, and elephants are among the species whose survival is in trouble due to climate change, according to the World Wildlife Fund (2014). The dearth of funding and job prospects for psychotherapy researchers have transpired within a change in our culture’s climate.

Psychotherapy of all “brands” is essentially about introspection, whether one is reflecting on one’s emotions, thoughts, and/or behaviors. The process of introspection is often a long and nonlinear one, requiring one to have patience. Psychotherapy calls for clients to forestall immediate gains and waddle in a sort of ambiguous and undefined place. In other words, while there may be quicker fixes, there is no quick fix, and change is most often internally driven rather than externally received. No magical pill exists to instantly cure all of our ills. For instance, as a novice counselor, co-leading a substance abuse group, I vividly remember one group member who was given more medications than diagnoses, once proclaiming, “too bad there isn’t a pill to stop me from drinking myself to death.” In that moment, as an overwhelmed novice, I too wished there was some pill that could save this patient from himself. The wish to be saved and to be saved quickly has, arguably, never before created so much atmospheric pressure. The hard work, patience, and introspection required in psychotherapy are all antithetical to the fast paced, appearance based, externally reinforced, achievement-oriented climate in which we live. In other words, a culture that values external reinforcement and appearances more than internal self-definition, integrity, and introspection gives rise to a sort of cultural narcissism that does not readily lend itself to psychotherapy. Consistent with this, Nancy McWilliams (2011) writes “social theorists have argued that the vicissitudes of contemporary life reinforce narcissistic concerns. The world changes rapidly; we move frequently; mass communications exploit our insecurities and pander to our vanity and greed” (p. 177). It is within this cultural climate that the psychological basis and treatment of our emotional life struggles to compete with the promise of a fast acting and externally derived “pill.”

Despite all the empirical evidence to the contrary, this cultural climate has given rise to a widespread disease in our society that causes many to believe that psychotherapy is useless, outdated, and a waste of time, especially when there is perceived to be a chemical solution to a psychological problem. Therapists themselves are not immune to this error. I once worked with a 31-year-old patient, with severe depression, who, after much convincing, finally agreed to see a psychiatrist and start antidepressant medication. When she reported positive gains from the psychopharmacological treatment, I expected her to stop the therapy. As a result, I preemptively started to discuss termination with her, when, with a confused expression on her face, my patient stopped me and said, “I do feel less depressed but this leaves me with another problem. If I’m not depressed, then who am I?” Apparently, there is no pill for self-identity.

How to Save an Endangered Species

How does a species save itself from extinction? As an ECP, am I fighting a losing battle sticking to psychotherapy research, rendering myself irrelevant? In thinking of how ECPs can survive the current cultural trend, I find some comfort in the famous misquotation, paraphrasing Charles Darwin, “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change” (see Matze, 2009). Three strategies for ECPs interested in psychotherapy research to manage change are: sticking together, conducting interdisciplinary research, and waiting the course.

Sticking together

Perhaps it is my background as a group clinician and researcher, but I tend to see strength in numbers. It is important that psychotherapy researchers, whether early-, middle-, or late- in their career, regardless of theoretical orientation, stick together. Unfortunately, scare resources tend to engender competition, as seen by the (in my opinion) counterproductive competitiveness that is seen today between “brands” of psychotherapy. In the fight for competitive and scarce funding, these are often pitted against each other in a contest of survival of the fittest, when, in fact, such a focus on psychotherapy brands probably underestimates the common ingredients to all psychotherapy approaches that predict client change (Norcross, 2002, 2010; Wachtel, in press). Until I became involved with Division 29, as a dynamic therapist, I never actually sat down and had a conversation about psychotherapy with a “CBT person.” Becoming involved in this Division has helped me to redefine myself not only as a psychodynamic researcher, but as a psychotherapy researcher. Division 29 represents a forum wherein psychotherapists of all theoretical orientations can come together under one roof to work together toward a common goal, i.e., preserving psychotherapy and psychotherapy research. In essence, to ensure our survival as psychotherapists (not just psychodynamic psychotherapists or cognitive behavioral psychotherapists, etc.) we must all stick together. You know the old expression—first divide, then conquer.

Perhaps for self-serving reasons, I believe an important function of the Division is to care for its “young” early career psychotherapy researchers. Accordingly, the Division offers ECPs a comprehensive mentoring program, opportunities in leadership, small grant funding, and conference programming and workshops. Moreover, Division 29 offers ECPs interested in psychotherapy research a group in which to belong, a community of likeminded individuals who understand and value each other’s work.

Interdisciplinary research

This is no time to be a purist. We must adapt to our current environment and the changes around us to survive. This means that psychotherapy researchers like myself must step out of our corner and collaborate with researchers of related disciplines in developmental and social psychology, neuroscience, psychiatry, and other medical professions. However, for this strategy to be effective, I believe it must be genuine and not forced. For me, for example, my interest in attachment theory and pregnancy naturally lends itself to collaborating with developmental psychologists and researchers in the medical profession. The key is to not isolate ourselves but to collaborate with other like-minded colleagues in related disciplines.

Waiting the course

All things come full circle. Right now, the pendulum has swung in one direction; history (and gravity) suggests that, eventually, it has no choice but to swing back. In an article for Psychology Today, Robert Howes (2008), a practicing clinician, describes psychotherapy as “natural and organic,” effective, relational, and having been around for a long time; thus, he argues, it is not likely to die out. Currently, as a society, we are flirting with the notion that we can somehow numb our emotional pain with drugs and circumvent our emotional life by focusing on our biological bases. Yet, at the end of the day, there is no drug for loneliness, trauma, self-other definition, or self-esteem. There is no drug that will allow you to look at yourself in the mirror or connect with others. Thus, there will always be a need for psychotherapy and psychotherapy research.

Conclusion

The lemurs have little “say” in their future survival and are largely at the mercy of forces beyond their control, such as the actions of humans. On the other hand, human beings obviously had no role in the extinction of dinosaurs. Rather, many scientists believe that these creatures simply ran their evolutionary course and could not adapt to a changing climate and other competing mammals. Unlike either of these species, the chameleon has survived for about 80 million years and changes color to adapt to its climate (i.e., temperature). Like the chameleon, for psychotherapy research to move forward and thrive, early career psychotherapy researchers must adapt to new environments and climates. We must come together as psychotherapy researchers under one large umbrella, while simultaneously reaching out to neighboring disciplines. I believe early career psychologists will largely define what it means to be a psychotherapy researcher in the future. Are we going to be dinosaurs or chameleons?[2]

[1] All patient information has been de-identified and disguised (any identifying information has been changed or left out and the context of treatment altered) and any client quotations are paraphrased and not direct quotes.

[2] For more information on dinosaurs and chameleons please see http://paleobiology.si.edu/dinosaurs/info/everything/why.html and http://www.nwf.org/Kids/Ranger-Rick/Animals/Amphibians-and-Reptiles/Chameleons.aspx.

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Cite This Article

Markin, R. D. (2014). A psychotherapy researcher: Dinosaur or chameleon? Psychotherapy Bulletin49(1), 45-49.

References

Associated Press (August, 2008). In the Era of Pills, Fewer Shrinks Doing Talk Therapy. Retrieved from: http://www.nbcnews.com/id/26011514/#.Ut_p3LROnIU.

Bishop, G. (n.d.). Chameleons. http://www.nwf.org/Kids/RangerRick/Animals/Amphibians-and-Reptiles/Chameleons.aspx

Howes, R. (2008). Is Psychotherapy Dying. Psychology Today. Retrieved from: http://www.psychologytoday.com/blog/in-therapy/200808/is-psychotherapy-dying

Matzke, N. (2009, September 3). Survival of the pithiest. Panda’s Thumb (blog). http://pandasthumb.org/archives/2009/09/survival-of-the-1.html

McWilliams, N. (2011). Psychoanalytic Diagnosis (2nd ed.). New York, NY: Guildford Press.

Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patient needs. New York: Oxford University Press.

Norcross, J. C. (2010). The therapeutic relationship. In B. L. Duncan, S. D. Miller, B. E. Wampold & M. A. Hubble (Eds.), The heart and soul of change: delivering what Works in therapy (2nd ed.) (pp. 113-141). Washington, DC: APA Books.

Safran, J. (June, 2013). The medicalization of emotional life. Psychology Today. Retrieved from http://www.psychologytoday.com/blog/straighttalk/201306/psychiatry-in-the-news.

Smithsonian Institution National Museum of Natural History. (n.d.) Dinosaurs: Why did they go extinct?  (http://paleobiology.si.edu/dinosaurs/info/everything/why.html)

Wachtel, P. (in press). An Integrative Relational Point of View. Psychotherapy.

World Wildlife Fund. (2014). Species directory. https://worldwildlife.org/species/directory?direction=desc&sort=extinction_status

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