Tuesday, August 4, 2015

Therapeutic Wussification

Just in case you thought I was caricaturing talk therapy, along comes someone named Eric Sherman to prove that I was, if anything, being too generous.

In a New York Times column, Sherman recounts the way he treated a man suffering from macho outbursts of anger. The man did not know how to express his anger at his “nagging” wife, so he acted like a tough guy. He went to see a therapist under duress, because he felt that he had to appease his wife.

Not to be too unkind, but Sherman’s therapy ends up wussifying this man; it helps him to get in touch with his feminine side. Better yet, Sherman considers it an enormously positive outcome.

At the least this account shows why more and more men refuse to go to therapy, even with male therapists: they are disrespected by professionals who will try to transform them into something that they are not.

When the man calls Sherman, he asks whether Sherman is one of those “touchy-feely” therapists… a kind that he does not want to see. The man wants some practical advice for how to handle his anger. He wants coaching.

Sherman does not seem to answer the question, but in point of fact, if we trust his account of the treatment, he was a “touchy-feely” therapist. Thus, he seems to have tricked this man into going into a kind of therapy that he was not looking for. Sherman had no intention of offering practical advice. He wanted to unman his patient and help him overcome his Daddy issues.

Sherman’s first assessment of his patient is an embarrassing reflection… on himself

After a moment’s reflection, I realized that Michael reminded me of my critical, self-involved father, whose recognition I had always craved. I knew from years of experience with patients that Michael’s bluster most likely was a defense against feeling weak and inadequate.

Surely, it’s enlightening to know that Sherman has Daddy issues, but that he is in touch with them. As for whether or not Michael’s bluster is a defense against feelings of weakness, the therapist’s rush to demean his patient completely ignores the circumstance that provoked the anger, fails to estimate whether it was just or unjust and does not examine other ways of expressing it.

Call it… three strikes.

As anyone who has read Aristotle knows, anger can be sometimes justified and sometimes unjustified. It can be expressed effectively or it can be expressed ineffectively. These are primary ethical considerations. Sherman does not seem to know that they exist and does not care.

In other words, Sherman wants to get his patient out of his life and into his mind. It’s a staple of therapy, and it’s perfectly useless… unless your sense of professional accomplishment rests on your ability to wussify men and to make them dysfunctional.

If Sherman did not tell his patient that he was a master of touchy-feely therapy he was being deceptive. His own words make clear his approach:

Psychotherapy requires them to get in touch with their most vulnerable feelings. This is antithetical to the emotionally detached, action-oriented persona that they adopt to protect themselves. In order to feel in control and avoid their pain, they tend to throw their weight around, intimidating the therapist and making sure he or she is kept at a distance.

And also:

I understood the fear and shame hidden under his anger, because, on occasion, I utilize a similar defense mechanism — one with roots in my childhood.

Of course, this is mental drool. Sherman slobbers over the inner life of banal emotions while ignoring the individual before him and showing no real interest in the man’s life. He tells us nothing of the situations that provoked the anger, so we know nothing of the man’s reality. Sherman is, however, proud to share the insights that he purchased on his own analyst’s couch. Here’s what therapy gave to Sherman:

I got approval from my father only if I excelled academically. Otherwise, I was forever a disappointment in his eyes. So I became the perfect student, afraid of losing his love. Any lapse caused me shame. Then I became a teenager, and something snapped within me. Without realizing it, I found a way to detach from my fear and shame: by provoking it in my father. I picked fights with him, hoping that it would make him feel like a bad parent. As expected, this made him furious. But at least I was standing up to him and feeling like a tough guy, even if I was just a frightened kid.

It becomes more pathetic. Sherman does not think. He does not analyze much of anything. This makes him a more modern version of the classical Freudian therapist. He emotes; he feels:

Surprisingly, I felt empathic toward Michael most of the time. I could sense the pain underneath his bravado. At other times I felt angry and wounded by his attacks. Since Michael wasn’t able to talk about his shame, unconsciously he tried to stir it in me. The only way I could truly understand his experience was to feel it within me.

If the word “feeling” suddenly disappeared from the language, therapists like Sherman would be struck dumb. Trust me, you do not need any professional training to feel your patient’s pain.

Of course, the treatment was about breaking Michael, making him more sensitive, more vulnerable, more in touch with his feelings:

Michael slowly began to share his vulnerabilities. With great hesitation, he finally addressed his childhood. He told me that his volatile father frequently beat him with a belt. His mother, who was verbally abused by her husband, was unable to protect Michael or herself. Michael was never sure what he did to provoke his father’s wrath or when it would happen again.

Sherman then has an epiphany: he sees Michael as a man who has become just like his father. Still, this tells us nothing about whether Michael has grounds for being angry with his nagging wife or how he can learn how to express anger effectively.

A therapeutic apotheosis occurs when Michael, recalling a time when his father beat him, cries in session. If the purpose of treatment is gratify the therapist emotionally, Michael has succeeded, in spades:

The swagger he used to keep me at bay had faded. A new, softer Michael was emerging, one who could allow himself to cry. There was still work to be done, but for now, Michael had begun to confront his crippling father and his own feelings of inadequacy. In helping him, I had once again come face to face with my own.

Unfortunately, Sherman has not really helped his patient, so he will surely have to face his own professional inadequacies at some point in the future.

For all we know-- Sherman seems to have no interest in it-- Michael lives in a professional or social world where macho bluster is his personal signature. When a man who has always played tough starts coming across as a kinder, gentler, more vulnerable figure… he will surely provoke gales of derision.

One of these days Michael will wake up from the stupor his therapy has put him in and realize that he still does not know how to distinguish anger that is appropriate to a situation and anger that is not. He will now know that he has a choice: between blustery outbursts and whimpering into the corner. Which way to you think he will go?

Considering how bad this therapy is, I am not entirely surprised that my own submission to the same New York Times column was rejected. If you would like to see how I handled a case, check out my post called: Up From Off Of the Couch.

17 comments:

Ares Olympus said...

I don't have a problem with the story, just concern over Sherman's confession of his own projections of his father onto the man. I mean how can you trust yourself when you're suppose to help someone who reminds you of someone else? And as usual, the idea of getting paid whether you help someone or not seems trouble to me.

Sherman: After a moment’s reflection, I realized that Michael reminded me of my critical, self-involved father, whose recognition I had always craved. I knew from years of experience with patients that Michael’s bluster most likely was a defense against feeling weak and inadequate.
...
Sherman: There was still work to be done, but for now, Michael had begun to confront his crippling father and his own feelings of inadequacy. In helping him, I had once again come face to face with my own.

I do agree the problem with this approach is prejudgement in seeing his father in the man, and assumption he knows everything important, and that the patient IS THE PROBLEM, and we don't know what his anger looks like. Perhaps his wife has "daddy issues" as they say, and if he slightly raises his voice, although "explosive anger" suggests more, but really we just don't know the dynamic.

Still I don't like the judgement of wussification. Whether or not that is "too unkind", and I don't understand why women are supposed to be the carrier of all soft emotions, and men apparently the carrier of all aggressive ones. What's up with that?

So if we're a life coach, then we can say the goal is to ignore the reasons he blows up in certain situations, and just teach skills of awareness (Oh, I'm angry), and reaction (finding other ways to defuse it, go for a walk, or make a joke?)

The trigger we're given is his "wife’s nagging", and so it does make sense to see if role playing could help, where the therapist plays the wife, repeating what she's saying, and then what he's feeling in response, and test out different reaction that might not sound as aggressive?

And we can also consider that feelings are not in response to facts, but in response to judgements about facts, so if someone is going from stimulus to reaction without thinking, that needs to be slowed down, replayed until he can see what judgements he's making in that split second.

So if that judgement is "she's disrespecting me", that is an interpretation, not a fact, and if he becomes aware that's what's behind his rage, then he can work on reserving judgement, and telling her that "I feel like you're disrespecting me when you ask me repeatedly to do the same thing I've already agreed to do." And if he could articulate that, then they'd be one step closer to perhaps?

But I have no idea what Sherman actually does, or how his work can help deprocess rage into self-awareness. Theory and practice are different things, and even if you have perfect theory, you may be a poor therapist and can't lead it into productive outcomes.

I do imagine therapists who call names like "wussy" probably are in the wrong ilne of business, and maybe coach works better for that skillset.

Pogo: I never said I was a diplomat said...

How do we know Michael *has* explosive anger, rather than being a victim of nagging?
A simple example would have been useful.

Maybe the two of them spiral out of control in this negative feedback loop because they are *both* bad at managing conflict.

The therapist also assumes that insight will yield cure. Your book suggests a lack of such findings. More simply, does making a grown man cry in the office make his anger better, or worse, or have no effect?

Patients cry in my office for all sorts of reasons, some involving insight (which direction I try to steer clear of), but it rarely has much effect other than motivating some subsequent directive behavioral change.

Like this one:
"A randomized controlled trial was conducted in which 70 patients with bulimia nervosa received either 2 years of weekly psychoanalytic psychotherapy or 20 sessions of CBT over 5 months. The main outcome measure was the Eating Disorder Examination interview, which was administered blind to treatment condition at baseline, after 5 months, and after 2 years.
Conclusions:
Despite the marked disparity in the number of treatment sessions and the duration of treatment, CBT was more effective in relieving binging and purging than psychoanalytic psychotherapy and was generally faster in alleviating eating disorder features and general psychopathology.
"

Pogo: I never said I was a diplomat said...

"I do imagine therapists who call names like "wussy" probably are in the wrong line of business"

I disagree.
If you cannot call a thing by its name, then you're just handing out self esteem ribbons.

Anonymous said...

Opinions are like assholes: everyone has one.

When it comes to judging and naming the behavior of others there are only personal opinions.

One juror says "guilty" the other says "innocent."

One therapist says "Wussy" the other says "Courageous patient."

Pogo: I never said I was a diplomat said...

Not so. Some opinions have greater value than others.
The unlearned or those refusing to learn have opinions that are simply worthless.
I won't take my car to a social worker for a repair opinion.
How foolish!

And research supports CBT over psychoanalysis. So having the tough guy cry likely means nothing in the long run as to changing his behavior.
Aside from providing a cognitive anchor, I don't see its value in reducing unwanted aggression, at least I see no proof that that is so.

Anonymous said...

Calling a person a name, such as wussy, based on a pattern of behavior is just an opinion deriving from a moral judgment. Even children call each other such names.

Having the tough guy cry is meaningless to me unless I invent a personal meaning. I can invent or entertain many such meanings which means none of them are a "thing" that needs to be named for what it "is."

Pogo: I never said I was a diplomat said...

An opinion, but accurate.

Ignatius Acton Chesterton OCD said...

Anonymous @August 4, 2015 at 3:49 PM:

"When it comes to judging and naming the behavior of others there are only personal opinions."

Understood. But what about human universals? What happens when a strong majority of people hold opinions about another's behavior, and those opinions match generally accepted human universals? Are those just opinions?

We are social beings. We have to live together. In order to do that, we need accepted standards of behavior: protocols so we can communicate, established customs so we don't have to overthink during interactions, et cetera. Are those just opinions?

In the age of Caitlyn Jenner, should we be teaching children that what they think is a man might also be a woman, and that's just okey-dokey? Might that create confusion for the children and, well, most everyone else? Are we to play social bumper cars so we don't offend anyone? Are we supposed to navigate in the purely subjective world of others, where long-held social expectations are now merely opinions?

I just want to make sure we're clear on this. Yes, everyone has opinions. Everyone has judgments about others. It's part of being human... hardware and software. My contention is that there is a mounting chaos of moral subjectivism that is leading people to assume judgment is bad. We cannot survive without judgment. We make hundreds, even thousands of judgments every waking hour.

I submit judgment is fine if people are willing to be responsible for it. Most people are not willing to do so. They either (a) demand that people conform to their subjective views; or (b) declare that it is immoral that others make judgments about people's behavior... which is itself a subjective judgment demanding that others change their behavior, beliefs, judgments or opinions. It's the Empire of Nice, where we pretend it is virtuous not to be "judgmental," even though we all are... often in the next breath.

If I wake up tomorrow and identify as British, should I be able to drive my automobile down the wrong side of the road and demand that people adjust to my subjective needs and desires borne out of my own expression of ethnic self-identification? How much should people be required to heed my desires? Is this a human right? Do I miraculously become British? Can I demand people call me Sir Iggy? Should they be obligated? After all, ethnicity or social custom is a very "fluid" thing, some experts may say. What if I identify as Italian? Should I demand my employer provide me with facilities for my mid-day siesta?

There's no end to this converging postmodern madness. Yes, "One juror says 'guilty' and the other says 'innocent'". But what is true? Surely it's not just a matter of opinions. We live in a social system. Our system won't last if we cannot come to recognize some universals and create structures beyond this increasingly hollow concept of "tolerance." We can tolerate our way into despotic anarchy. Right now, it seems everything is up for grabs, particularly if you're a man who identifies as a woman and has a show on the Glowing Box. We can't live sanely in a society where subjective pluralism has no boundaries whatsoever. Eventually, we must say "Enough!" But that's "mean-spirited and judgmental" the self-proclaimed nice-spirited and open-minded will say as they pass judgment on others' intolerance, saying we must be intolerant of those who don't practice tolerance and pass judgment about people who make judgments of others' judgments.

Ugh. This is quite a pickle.

Ignatius Acton Chesterton OCD said...
This comment has been removed by the author.
Ignatius Acton Chesterton OCD said...

Anonymous @August 4, 2015 at 3:49 PM:

"Opinions are like assholes: everyone has one."

Or maybe there are multiple assholes sharing a singular opinion.

Ignatius Acton Chesterton OCD said...

Anonymous @August 4, 2015 at 7:21 PM:

"Calling a person a name, such as wussy, based on a pattern of behavior is just an opinion deriving from a moral judgment. Even children call each other such names."

So the name-caller is an asshole, and the children are assholes, too?

I'm not sure where assholedom ends.

Sounds like we're all assholes making moral judgments. Perhaps our species would've best re-designated Homo assholus, but that will probably be interpreted as a homophobic slur by the crusaders for tolerance. So let's see, maybe we're just Homo sapiens and all assholes with opinions. That sounds about right. Just don't call the children assholes, because they won't get it... their assumption is that they each only have one, which is also correct. Let's not create confusion.

Ignatius Acton Chesterton OCD said...

I was reading the Bookshelf column in the WSJ today, and came across a review of "Applied Minds" by Guru Madhavan. Interesting piece about engineers and their worldview. Let's keep in mind that engineers are creators... the make things. They create wealth, substance, stuff. Material objects that have value.

From the review: “Structure, constraints and trade-offs are the one-two-three punch of the engineering mind-set,” Mr. Madhavan tells us. “They are to an engineer as time, tempo and rhythm are to a musician.”

It got me thinking about the postmodern sickness that we live in, manifested most presciently in modern Leftism, which is an assault on value in all forms. It is a destructive force. Hillary Clinton is a ventriloquist doll of postmodern thinking, her gyrating vocalizations About her private email server notwithstanding.

Compare what was said in the book review about the engineering mindset, in full consideration of the postmodern mindset, and it's clear what the problem is, and how postmodernism has infected thought. Engineering relies on the objective, not the subjective. It is a social endeavor that requires agreement and shared effort to reach an outcome. That's how we build a Hoover Dam and Golden Gate Bridge.

The postmodern vision does not rely on this objectivity. The objective is denied. Everything is relative. Objectivity is anathema.

Structure? Postmodern thought opposes structure in favor of the subjective. Constraints? Postmodernist a believe that constraints are illusory social constructs man must be freed from. Trade-offs? There should be no trade-offs... only the individual's vision and interpretation has integrity in its own eyes.

So what do we get? We get the craziness of modern human interaction, where structure is viewed as an unjust power-grab, constraints are imposed by the powerful, and trade-offs are seen as flagrant capitulation. So we eschew structure, we refuse constraints, and trade-offs are anathema to the dignity of an imagined ideal: thecreative spirit... whatever that is. Our elites live in decadence. And we wonder why our economy, politics, arts, social sciences, et cetera are so sclerotic and base? We've given up on truth, and we've given up on what's real. We live in a fantasy world, at the most elite levels. We make less and less stuff, create less and less real wealth. We're becoming wusses.

Stuart's book shows how Freud just imagined it all as an abstract personal narrative writ large on the world, and people bought into it. Therapeutic wussification is but an extension of all that relativism. Alas. More engineers, please...

Dennis said...

The more I read about how we treat men as defective women and read and see the UTube presentations on Plan Parenthood and the justifications given for such inhuman behavior, among other actions, the more I wonder if maybe ISIS is not right about us being an evil country. It begins to appear that there is nothing we cannot degrade and push to its lowest common denominator. We have in many ways become a death cult of epic proportions. There seems nothing or no one a significant portion of the population won't destroy or kill if they can get away with it. I have seen more compassion from troops who were in combat under high stress. Think "Lone Survivor" where the desire not to kill innocents lead, I believe, to the ultimate outcome.
Though I do wonder if most psychiatrists are filled with self hatred of being male, suffer from the desire to be the "White Knight," or from misandry if female. Never has something with so little scientific foundation and oblectivity tried to convince itself of its applicability to everyone.

Anonymous said...

IAC,

According to legend Jesus said, "Judge not lest you be judged." In my experience this advice is not so much about judging the social behavior of others as it is about understanding how the judgments ascribed to others have an impact on oneself. For some of us the only real relief does not come from making rules for others to follow or from obedience to rules made by others, but rather, from a transcendent experience as capture in this Sufi poem:
http://www.worldprayers.org/archive/prayers/meditations/out_beyond_ideas_of_wrong.html

Even though humans make a lot of unnecessary judgments I don't think it is possible to live without judgments. Engineers, doctors, and many others certainly could not engage in reasoning without the refinement of emotions into expressions of judgment. The most destructive forms of judgments are the one's which are not open to question.

Ignatius Acton Chesterton OCD said...

Anonymous @August 5, 2015 at 1:42 PM:

Jesus said lots of things. So did the Sufis.

All societies have rules and accepted protocols that provide some service to human social interaction. Of course judgments ascribed to others have an impact on oneself. That's their intention. We can't all function in a subjective fantasyland. We have to connect. We all need each other.

Sufism is the mystical inner dimension of Islam. But Sufism is corrupted without Sharia. Rumi required the discipline of religious practice, just as the mullah requires the Sufi. It's a both-and. Sufism makes no sense without the context of Islam, and Islamic experience is enriched by Sufi contribution.

Christian mysticism has a pronounced strain throughout history, but it always required a check to keep it in line. Consider that St. Teresa of Avila had a confessor and spiritual director who supported her growth and deepening within Catholic understanding of God and man's world. Mystics and institutional tradition are often at odds, but both need each other.

. We need both structure and freedom. What is tricky is discerning where the spirit is moving within a person.

With regards to Western Christian tradition, you offer one of the most often-quoted passages from the New Testament: "Judge not, lest you be judged." (Matthew 7:1-2) So are we to interpret from this that we are not to judge? Of course not. Judgment is part of being human. You have taken this out of context. The full NRSV passage is: "Do not judge, so that you may not be judged. For with the judgement you make you will be judged, and the measure you give will be the measure you get." Here, Jesus is talking about hypocrisy, and the judgment that will be visited on those who judge. So the message is caution, humility and discernment, not prohibition. How do you run a sane society without judgment? You simply cannot. And Christianity is not a suicide pact. As I said before, the opportunity is for us to be responsible for our judgments, to own them. We will be judged by the same measure that we judge others. Therefore, it is sensible that later in Matthew 7 we get to verse 12: "In everything do to others as you would have them do to you; for this is the law and the prophets."

One of the great indignities of our politically correct culture is that people are not given the proper training in how to act within their communities, lest we hurt their feelings. In America, this is often known as "assimilation." We have largely abandoned this standard as paternalistic, condescending and ethnocentric. This new stance is not a blessing, it's a curse, because it creates so much misunderstanding and separation. You are claiming that there are "a lot of unnecessary judgments," but that is itself a judgment. We must make choices. It takes all types, and we eventually find a way to work together as a society. You are correct: it is impossible to live without judgments. You simply cannot. You must make what you think is the best choice at any given moment, and you learn from those choices.

Continued below...

Ignatius Acton Chesterton OCD said...

Continued from above...

You state "The most destructive forms of judgments are the one's [sic] which are not open to question." What judgments are not open to question? Again, the opportunity is to recognize and be responsible for one's judgments. Caitlyn Jenner is a train wreck. That's a judgment. But it is also a judgment that I am supposed to not only silence myself, but to suspend my truth of Jenner's material form and call him a "she." I will not do that, because he is not a "she." Just because one imagines so does not mean it is. I do not think it is loving to celebrate something that is clearly not recreational (like Benny Hill) but is instead indicative of emotional disturbance and an irrational demand that people accept Caitlyn's subjectively-constructed identity. If it is all an act, then someone should say so. It doesn't appear like an act. Indeed, ESPN is giving out serious awards for courage to Mr. Jenner. We cannot pretend this is not disordered. Caitlyn Jenner is not a woman, and no level of surgical self-mutilation is going to change that. I want him to be a happy, contributing member of society. Instead, he is confusing himself and confusing others. I am willing to be responsible for that judgment. If Caitlyn Jenner were my son, I would of course love him, but I would also be very, very sad about his choices. I would also be angry with media enablers and opportunists seeking to make money off of his situation like it's a sideshow. No one would wish this for their child. They might come to accept it, but they would not wish for it. There's a reason for that. I have opened my judgment to question many times, and wondered if I am being hateful or hurtful in my view of Jenner. I do not think I am. In fact, if I were Jenner, I would hope people would love me enough to say "Dude, what are you doing?" and help me make sense of my humanity, in all its wonders and foibles. Just because I identify as something doesn't mean that's who I actually am. Society accepts certain standards. Bruce Jenner won the 1976 Olympic decathlon as a male. He is a man.

And we're human. That's why everything Jesus says is surprising, and challenging.

Anonymous said...

IAC,

I live in an area where there are high concentrations of embedded ethnic minorities. These ethnic groups include first generation immigrants from a variety of regions as well as large and growing populations of Orthodox and/or Hasidic Jews. I think in the past it was widely feared that Catholic immigrants would have many children (like my Italian grandparents) and fail to assimilate. That did not happen.

In my judgment the more fundamentally religious Jews may resist assimilation in the future by taking over increasing areas in the region. The assimilated local taxpayers are not welcome in largely religious regions and do not generally want to live in close proximity to these ethnic minorities as they become a majority in a region. The tax base for public schools is being destroyed and Jews who send their children to private religious schools now dominate the school board which causes the taxpayers to get concerned over the diversion of and misuse of resources. The thing is our American traditions empower the resistance to assimilation of such ethnic minorities because they are entitled to voting rights and to choose where to live, and there is no law that says they must send their children to public schools. If there were a voucher system, as many Republicans prefer, I am not sure it would help solve the assimilation problem that many local residents, including moderate Jews, see as a problem. Obviously those who use America to live without assimilating do not see their customs as a problem, but rather, as a cherished tradition of their ancestors. I see nothing harmful about their traditions except, in my judgment, it is a little superstitious (e.g., kosher laws could give way to health codes). However I do not want to live surrounded by a culture that diverts too far from the culture of my parents/ancestors, much like the Native Americans did not want to have their culture destroyed by the cultural invaders.