The Four-Hour Cure

The good news is that a four-hour treatment will shield you from depression and burnout.

The bad news is that it’s four hours a week, not just four hours.

If you were thinking that it would only take four hours you really need this treatment.

Ironically, four hours a week used to be the standard for real psychoanalysis. In the old days you needed to lie on the couch for at least four hours a week. Otherwise you weren’t doing a real psychoanalysis.

At least, the analysts got the four-hour part right. They were wrong in prescribing four hours of mind-numbing and slothful inactivity.

Substitute four hours on the treadmill for four hours on the couch, a good habit for a bad one, and you will do yourself a world of good.

The research coming out of the University of Tel Aviv, thoroughly consistent with other studies, says that four hours of strenuous physical exercise will effectively keep depression and burnout at bay.

Strenuous means breaking a sweat.

The American Friends of Tel Aviv University  website reports on the findings:

Depression and burnout rates were clearly the highest among the group that did not participate in physical activity. The more physical activity that participants engaged in, the less likely they were to experience elevated depression and burnout levels during the next three years. The optimal amount of physical activity was a minimum of 150 minutes per week, where its benefits really started to take effect.

In those who engaged in 240 minutes of physical activity or more, the impact of burnout and depression was almost nonexistent. But even 150 minutes a week will have a highly positive impact, says Dr. Toker, helping people to deal with their workday, improving self-efficacy and self-esteem, and staving off the spiral of loss.

But, what happens when it feels like everything is coming apart, like our world is unraveling, that we are overwhelmed.  

Sometimes it takes more than exercise to deal with a major life crisis.

Happily, today’s Wall Street Journal shows how a Florida woman, Hannah Shapiro, facing a major life crisis, got her life back under control.

After ending an unhappy marriage and getting laid off twice, Hannah Shapiro last year found herself alone with two small children to support in Miami, far from her family in England. "I was so scared, I was paralyzed," she says. "My heart was racing. I would take the kids to school and get back into bed."

After a week like that, Ms. Shapiro, age 33, says she had a "light bulb" moment. "I thought, 'What the heck am I doing in bed? I can turn this around.' And I did." She put her writing skills to work and set up a communications consulting business. She still gets anxious at times but no longer feels she's on the edge of breaking down. "I just made myself snap out of it," she says.

Hannah Shapiro had a suck-it-up moment. She did what she had to do. It’s fair to say that she did not have another option. She was the sole support for two small children. Spending all day in bed was not an option.

Flirting with a major depressive episode, Shapiro roused herself from her bed because she had no other choice.

Obviously, she was not cured by a flash of insight, a therapeutic epiphany. Her problems were real, not psychogenetic.

Now, think about how much depression could be controlled, if you cured, by four hours of exercise a week and by resilience. If so, why do we have a major industry devoting itself to treating and curing depression? Why does it happen that when someone gets depressed or burned out, the first thing everyone says is: get a prescription or get some counseling?

Doesn’t it feel like we’re shifting responsibility? And doesn’t it feel like we, as a culture, are feeding depression by telling people that there is nothing that they themselves, as moral agents, can do to ameliorate their condition?

Why do we have armies of therapists insisting that an injection of empathy is the cure?

If you don’t do your four hours of exercise empathy might console you, but it will not compensate for your sloth.

Empathy did not cure Hannah Siegel. Her moral sense did. She acted as a responsible adult should act. Not to put too fine a point on it, she could not afford to be depressed.

Granted, not all depressions are the same. Some do require medication. Still, you have to wonder which side the therapy profession is really on.

An End to Individual Therapy?

Time Magazine is reporting that Yale psychologist Alan Kazdin has called for the end of individual therapy.

While he does not quite go that far, he does suggest, in Time’s words that individual therapy is “overrated and outdated.”

If you take a closer look at the Kazdin’s research paper, you will see that he sees individual therapy as an inefficient way to deliver mental health services to those who need them.

In truth, he sees a vast quantity of untreated mental illness, and wants to help find ways for the profession to tap this new marketing opportunity.

Among other things Kazdin recommends telephone sessions, Skype sessions, diet and nutrition, and self-help books.

Strangely enough, Kazdin does not mention the therapeutic value of aerobic exercise or of yoga. He also ignores the most effective and efficient delivery system for mental health treatment—Alcoholics Anonymous and its offshoots.

While Kazdin does write that “one–to-one therapy will always have a place” he largely prefers what he calls “evidence-based therapies,” which means therapies that are based on cognitive principles.

In his words: “If you want to get over an anxiety disorder, do graduated exposure. But sit down and relate to me or love me like your mom and dad? There's no evidence for that.”

Here he is dismissing the importance of the human connection between patient and therapist. 

Yet, when he talks about how the therapist/patient relationship replicates something that happened with mother or father, he is referring to what psychoanalysis has called transference.

Not to be too technical about it, but therapy conducted in terms of transference specifically precludes anything like a human connection between patient and therapist. If the attachment must always repeat something that happened in the past, no real connection is possible in the present.

Kazdin does not grant sufficient importance to the fact that most patients come to therapy because they are suffering some form of social anomie, dislocation or dissociation, feelings of loneliness or rejection.

For anyone who is feeling detached and adrift connecting with another human being confers therapeutic benefits beyond those that are gained by doing cognitively-prescribed homework exercises.

I agree that a good relationship will not cure an anxiety disorder, but there is a great deal more to most therapeutic practices than anxiety disorders.

Kazdin seems to recognize this. He defines psychotherapy as follows: “Psychotherapy is defined broadly in this article to include systematic efforts to apply psychosocial intervention to reduce distress or maladaptive behavior or enhance adaptive functioning. Psychosocial intervention, in contrast to medical or biological intervention (e.g., medication, surgery), focuses on such means of change as interpersonal interaction and systematic experiences (e.g., new ways of behaving through practice, role-playing, homework assignments, advice) designed to produce change.”

To me this resembles coaching and some forms of cognitive therapy more than insight-oriented therapy. In fact, it leaves no place for the kinds of insights that have long been a staple of individual therapy.

Still, if a therapist is going to function as a coach he had best tailor his approach to the person he is working with. Otherwise, his pearls of wisdom will fall on deaf ears.

If patients do not develop a relationship of trust with their therapists they will not willingly accept advice and counsel. Therapists delude themselves if they think that making their practice more like science will inspire their patients to grant their words the credence that they would give to scientifically-proven hypotheses.

In his Time interview Kazdin makes another remark that I find especially intriguing: “When I was starting out, I thought that the public would be an ally, but research shows that satisfaction with therapy is not very much related to getting better. [So, they don't necessarily realize they are not getting good treatment.]”

The bracketed sentence is published as such in the magazine. I do not know whether it should be attributed to Kazdin or is an editorial comment.

Assume that Kazdin is right, how does it happen that people can be perfectly happy with therapy that does not help them to get better.

Why have people continued to work in therapy when the treatments have not been producing good results? Perhaps, they have felt that there were no other viable treatment options. Or else, as I suspect, therapists have created a culture that has made it seem normal to have bad outcomes.

Therapy has often suggested that emotional outbursts are a sign of therapeutic progress. Sometimes it has implied that a depressed mood is a sign of a clear vision of reality. It has also suggested that making your life into a permanent psychodrama is a sign of therapeutic success.

In truth, if treatment and/or coaching is aimed at helping people learn how to negotiate differences and to achieve harmonious relationships, these outcomes, sanctioned by the therapy culture are really signs of failure.

"Men Help. Women Don't."

So says Susannah Breslin, and if you had had her experience you would be hard put not to draw the same conclusion. Link here.

Even if you are totally committed to a world where gender has passed into desuetude.

Here’s the story: Writer and blogger Susannah Breslin lost her editorial job at a website called: The Frisky. If you don’t know The Frisky, it is dedicated to women’s issues. It’s subtitle is: Love. Life. Stars. Style.

Meaning that Breslin has an audience that contains a large number of women. Breslin also blogs at Forbes, and there she undoubtedly has a goodly number of male readers.

Upon being fired Breslin wrote a post called “Hire Me” for her blog. In it she presented a brief synopsis of her experience and qualifications.

Here’s what happened, in her words: “After my post went live, I linked to it on Facebook and Twitter. I emailed the link to men and women. Men responded by introducing me to someone who was in a position to hire me, by sending me links to job listings that could be a fit, or by directing me to opportunities that resulted in paying work.

“Women responded emotionally — with support or sympathy. Men responded proactively. Women responded passively — or not at all. Every response that led to paying work was from a man.”

We should all be struck by the disparity. In truth, we should all be gobsmacked.

But how could it happen that the responses should be so stereotypically male and female. Were all of those years of gender bending for naught?

And how did happen that men are the more eager to help a woman find gainful employment? Weren’t we all told that men are threatened by working women? What happened to sisterhood solidarity?

Men read of Breslin’s plight and offered to help; they sent her concrete proposals, including one from a man who helped her find her new job as a copywriter.

Women, however, did not even think to address the real issue. They believed that they were being called on to offer sympathy and empathy. Neither of which are of very much help in finding a new job.

As it happens there is nothing wrong with sympathy, or, even empathy, because there are times when sympathy is the only thing you can offer.

We express our sympathies when a friend has lost a loved one. The expression of sympathy implies that there is nothing we can do to change reality, so, we share our feelings and stand among the mourners.

When a person has a real problem, one that might be solved by better management, it is better to offer more than sympathy.

When you limit yourself to an expression of sympathy, you are telling the person that the problem is insoluble, that it is like a death, and that there is nothing that anyone can do.

Unfortunately, expressing sympathy for a problem that might be solved is demoralizing. It feeds depression.

You see where I am going with this, so I will not leave you in suspense. Nowadays sympathy and empathy are the stock-in-trade of the therapy business.

More and more women have been entering the field, and as therapy becomes a woman’s profession, the emphasis has shifted on to more maternal, more empathic, more sympathetic skills. Or, at least, to skills that women are supposed to have in abundance.

At times it helps to have someone who is going to feel you pain. At times you suffer a grievous loss and there really is nothing you can do to bring back your loved one.

But if a therapist applies the same balm to any problem, she is also telling you that your problems cannot be addressed and that reality cannot be changed.

By now most people have gotten the message and they are turning away from therapists and toward coaches. Coaching is more practical in its approach and more positive in its outlook. A coach sees you as a competent person who can manage your problems constructively.

A good coach will help you to expand, to reach out into the world. A therapist will be telling you to pull back and to pull in.

In her job search Susannah Breslin happened to discover someone who was willing to provide some brief coaching. The man recommended that she apply for a job as a copywriter.

Breslin had never thought of herself as a copywriter. She did not even know what the job entailed. Yet, she applied and got the job.

Here is her description of her new job: “Now, I write Facebook and Twitter posts for an inanimate object. You are probably familiar with this inanimate object because it is an iconic American brand. I pretend to be the inanimate object while crafting the Facebook and Twitter posts that are supposed to be from the mind of the inanimate object.

“As it turns out, I am very good at channeling the inner-thoughts of an inanimate object. Or at least this particular one. This part-time, paid-by-the hour job pays more per hour than any job I have ever had.”

Has she found her true calling? Is she now following her passion? Not exactly.

Does she seem to be happy with her new job? I would say Yes. If I may speculate, she is happy because she has found a job doing something that she is good at.

If you are not good at what you are doing you are not going to be happy doing it… regardless of how much passion you have for it or how often you have dreamed of it.

As you read Breslin and quietly rejoice in her good fortune, you are left with a nagging question: what happened to the sisterhood? Why are women so passive, even inert, so unwilling or unable to help another woman?

Haven’t we been on a gender bender for all these many years? Hasn’t the purpose of this gender bender been to disembarrass women of the feminine mystique, the better to help them to work more effectively in the marketplace?

How does it happen that women reacted to Breslin with such utter passivity, with behavior that is almost a caricature of femininity?

It almost seems that women have been induced to deny their femininity, to the point where it can only show itself in a caricatured form, as weakness and disengagement from the real world of work. And even then, only when they are taken by surprise.

If women had known that their reactions would be published as an informal survey, I am sure that they would have offered much more practical advice.

It seems somewhat absurd, to me at least, to think that women cannot offer practical advice when need be. You will not convince me that a woman cannot function effectively in a world where plans need to be made or where guidance needs to be offered.

The problem is, women seem to have absorbed the lesson that such work is masculine and that they cannot do it and remain truly women. When it comes to their femininity, they have been thrown into a state of denial.

They seem to believe that they have to choose between acting like a woman and being an executive, as though there is an inherent contradiction between the two.

They also seem to believe that in order to gain access to the boardroom they must deny something essential about themselves, their femininity. Like the crazy aunt in the attic, this femininity can only show itself when it thinks that no one else is around.

Other parts of the culture have been trying to offer as role models women executives who are both womanly and decisive. Think Meg Whitman, Carly Fiorina, Sarah Palin, and Nicki Haley.

So, if I were to offer an explanation for why only men were willing to help Susannah Breslin, I would say that the fault lies in our culture’s denial of the value of femininity and its failure to allow women to become women in full.

Leaders Need a Good Coach, Not a Shrink

Actually, Steven Tobak seems to believe that leaders need a good shrink, not a coach. Links here and here. I am happy to correct his rather strange idea.

As you may know, therapists have been having difficulty competing against coaches, whether they be life coaches, relationship coaches, or executive coaches.

For reasons that escape me, Tobak seems to find this to be a bad thing. So, he is trying to market psychotherapy to people who know exactly what it is and what it does and who do not want to have anything to do with it.

After examining the bad behavior of executives who are either psychopaths or philanderers-- without noting that the two are not really the same-- Tobak seems to suggest that criminal executives would have done better to go into therapy than to seek out an executive coach.

I have no idea how he knows that these criminal executives availed themselves of the services of coaches. Or that they did not see a therapist.

And I cannot imagine where he got the idea that executives call on coaches to help them control their criminal impulses.

Tobak does not really define what kind of therapy he is talking about. I assume that he favors introspective insight-oriented psychotherapy. If he were talking about one of the variants of cognitive therapy or solution-focused therapy, then he would be referring to something that is akin to coaching.

Therapy has been around for quite some time now. It has been tried and tested by many people for many different conditions. It is fully accepted by our culture; there is no great stigma to consulting with a therapist.

By now, most Americans have had an experience with therapy or know someone who has. They have concluded, based on experience, that therapy is largely ineffective.

Even if therapy worked with some happy few patients, no one believes that it can have any salutary effect on narcissistic sociopaths and psychopaths.

No one who is even minimally informed about therapy would suggest that a criminal will be cured if he discovers the childhood traumas that set him on the road to crime.

Besides, people who are fundamentally dishonest are going to lie to their therapists, anyway.

None of which prevents Tobak from diagnosing these criminal executives-- people like Jeff Skilling, Bernie Ebbers, Dennis Kozlowski, Richard Scrushy, et al-- as suffering from personality disorders.

In the same article he says that they are suffering from arrogance and greed, which are not personality flaws, but are character flaws.

I appreciate that therapists are trying to drum up more business, but still, having character flaws does not make you sick and does not point to a personality disorder.

People make mistakes. Sometimes they make grievous mistakes. That does not make them sick. It means that they are suffering from moral failings.

Let’s understand the difference between character and personality. Character involves how you behave toward others. You may or may not be responsible, reliable, trustworthy, honest, honorable, disciplined, loyal, and generous: these are character traits.

It is certainly fair to say that a narcissistic psychopath is lacking in good character.

Yet, he may still have a pleasant, even an engaging personality. He may be gregarious, charming, sweet, and cheerful, but that does not mean that you can trust him. His personality says little if anything about his character.

Be that as it may, all of the executive-level criminals Tobak cites are of the masculine persuasion. The same applies to a second group of men that Tobak seems to want to lump with the first: philanderers like Eliot Spitzer, John Edwards, and Tiger Woods. He might have added Bill Clinton and Mark Sanford.

Of course, there is a difference between embezzling corporate funds and cheating on your wife. Running a Ponzi scheme is not the same as getting involved in an orgy. Falling in love with a woman who is not your wife is not the same as having sex with a bevy of beauteous groupies.

Of the men Tobak identifies as philanderers, the only man who we know underwent therapy was Tiger Woods. The result of his therapy: he got divorced, lost his family, and forgot how to play golf.

One doubts that his example will lead too many executives to run straight to the couch.

Besides, why does Tobak select out a group of corporate criminals, add on a group of philanderers, and then generalize to all corporate executives? This feels like an exercise in sloppy thinking.

Though Tobak does not mention this point, it is more likely that a therapist will be a woman and more likely that a coach will be a man.

One cannot read Tobak without suspecting that he believes that these men will be cured of their testosterone-driven behaviors if only they get in closer touch with their feminine side. In certain segments of the culture, this passes as an article of faith. It is plausible that Tobak has absorbed it, even unwittingly.

Yet, no man in America today has not heard that he needs to become more sensitive, to get over his aggressive and competitive behavior. The culture scolds men for being men. It does so through sensitivity training, many forms of therapy, talk shows and the movies of the week.

Some men have reacted by becoming more sensitive and caring… more metrosexual, if you will. Others, however, have reacted by becoming more defiantly manly, more aggressive and more competitive… even to the point of testing the limits of legality.

When you advise people to go into therapy, you have to consider that these same people have been saturated with what the therapy culture counts as correct thinking. This means that therapy might be the problem more than the solution.

As for the men who have cheated on their spouses, we should notice that these men are not the kinds of corporate criminals who are currently occupying various penitentiaries across the nation. Tiger Woods excepted, they are all politicians.

A trendy psychiatric classification might lure you into thinking that an embezzler should be linked with an athlete who has a few too many groupies, but no one gets fired or arrested for acting like an alpha male.

Corporate executives who have been done in by their amorous dalliances usually fall afoul of insider trading or conflict of interest rules. It’s one thing to have a mistress; quite another to share inside information with her.

Before consigning corporate executives to the world of psychiatric dysfunction, one must recognize that most of them, the vast majority, are high-functioning individuals.

They did not rise to the summit of the corporate hierarchy by consuming themselves with mental anguish or by getting in touch with their feminine side.

Most of them know that for the most part, therapy will not provide them with the kind of guidance they need when faced with difficult leadership or management issues.

Most therapists do not know very much about the business world. Reality is not taught in psychology or psychiatry graduate programs. Their bailiwick is the world of feelings and fantasies, cognitive function and dreams.

When executives seek out coaches, they are looking for people who have had business experience, who can grasp the essentials of their problem, and who can offer helpful and directed counsel.

It is fair to say that some therapists are, by virtue of experience, savvy about certain types of business. As I see it, these professionals work more as coaches than as therapists.

A Treatment for Anorexia

Nearly two decades ago I ran into an old friend at a party. We had not seen each for quite some time, but instead of catching up, he wanted to tell me about an experience his family had had. Given the profession I was practicing at the time, he thought that it would be useful for me to hear about how he and his wife had helped their college-aged daughter to overcome anorexia.

When my friend's daughter developed anorexia in college, her worried and affluent parents sent her to a first rate clinic specializing in eating disorders.

During the course of her stay they had the opportunity to visit with her, to see how she was doing. After a few weeks, however, they noticed that she was getting worse. Her condition was deteriorating.

As you know, anorexia is a dangerous and potentially fatal disorder. My friend and his wife did not know what to do, but they knew that they could not leave their daughter in the hands of physicians who were not helping her.

They decided that they could do better. So they took her out of the clinic and brought her home.

They invented their own treatment. As my friend described it to me, he and his wife sat her down at the kitchen table, presented her with some food, and told her to eat. If necessary, they would force her to eat. They told her in no uncertain terms that she was not going anywhere until she had eaten what was in front of her.

It is fair to say that this process did not run smoothly. Parents who are going to try it should seek out the advice of a professional who can provide guidance.

Evidently, there is more to their approach. For now I want to follow my friend's description and isolate the concept that was defining their treatment.

Was this treatment successful? Yes, it was.

I have occasionally written about how impressed I am by everyday people who manage to discover psychological treatments for emotional and behavioral problems that escape the theoretical dragnet that most therapists use.

The most obvious example is the 12-step programs that were developed, not by the luminaries of the therapy world, but by a couple of drunks in Ohio.

I count my friend and his wife's work with their anorexic daughter in the same category.

At roughly the same time, psychiatrists at Maudsley Hospital in Great Britain were working on the same approach. Nowadays it is called the Maudsley approach, or else, family-based treatment (FBT).

I would emphasize the fact that FBT can be practiced within a hospital, and that for some anorexics the health risk is sufficient grave to require strict medical supervision.

If psychotherapy involves working on the mental processes that are supposed to be causing the eating disorder, I think it fair to say that FBT is a lot closer to coaching than to psychotherapy.

I recalled this conversation yesterday while reading a report on the Jezebel site about Harriet Brown's experience using FBT to treat her own daughter's anorexia. Link here.

Brown has written a book on her experience: Brave Girl Eating: A Family's Struggle with Anorexia. It is going to be published in a couple of weeks.

In the Jezebel article I linked above, Brown tells Anna North that follow up studies have shown that 90% of the girls (anorexia is very largely a female disorder) who have had FBT are doing well five years after treatment, while the same can only be said of 36% of those who were treated by individual psychotherapy.

The extent of this disparity tells me that one form of treatment works while the other does not. Consistency is the hallmark of an effective treatment. When you compare relapse rates of around 10% with rates of64% you can only conclude that individual therapy may provide something of a respite, but that it does not resolve the problem.

And this is ironic, indeed. Anyone who practices psychoanalysis or any of the therapies that derive from it will tell you that long term in-depth therapy takes so long because it is not just working on the surface; it is treating the underlying causes of the problem.

It tells you that once you have resolved the underlying infantile issues, you will be less apt to suffer its recurrence.

The evidence, however, suggests that this is a convenient fiction, a rationalization for clinical failure.

Individual psychotherapy sees eating disorders as symptoms of developmental difficulties-- oral stage fixations or the like-- or as symptoms of a toxic family environment.

In lieu of cure they offer what Brown calls a "parentectomy." The anorexic is either placed in a clinic setting that controls parental access or is induced in individual psychotherapy to believe that her parents are the problem. Once she understands why her mother wants her to starve to death, she will start eating again.

FBT coaching is based on an entirely different principle. It sees the eating disorder as a bad habit, one that need not mean anything at all, but that needs to be replaced by a good habit, by any means necessary.

A girl can develop an eating disorder if she starts too radical a diet, if she gets caught up in the experience of dieting, if all of her friends are competing to see who can eat the least. And she can do so to the point where fasting feels normal.

It does not necessarily mean that she has a problem with her mother or that she was molested as a child or that she is being manipulated by Anna Wintour.

In comparison to most individual therapies, FBT coaching takes the child's parents to be part of the solution, not the problem. It makes them the primary instruments of treatment. It rejects the notion that parents want to starve their children, or that they are unconsciously motivated to do so.

FBT coaching relies on parental good will, along with parental willpower. It sets up a battle of wills between a defiant young woman and her even more defiant parents.

Obviously, this form of treatment does not involve respecting the child's wishes, her independent judgment or her autonomy. It is much closer to force-feeding than to: Please eat your vegetables.

It also does not assume that the bad habit is trying to say something, that the child has a hidden or repressed grievance, or that the disorder will be cured as soon as she expresses her pain or guilt or anger.

But if FBT works so well, why is it not practiced more widely. Anna North asks Harriet Brown that question in her Jezebel interview.

Surely, one reason is that anorexia has the potential to produce severe medical complications, and thus, that physicians are not enthusiastic about giving these patients over to unlicensed parents.

The other reason, Brown explains, is that the people who are treating eating disorders most often have suffered from eating disorders and have undergone standard, but not very effective, psychotherapy for them.

They have learned to think if their illness in terms of psychodynamics. In Brown's words: "You know, 'I had a wretched mother, and an absent father, and this happened to me when I was a child.' You know, that's your personal narrative, and I think that it's human nature to impose yourself on the world."

I am convinced, as Brown is, that people who have learned to think one way will continue to think that way, regardless of whether it works or not. And I agree with her when she says that many therapists have been trained to construct narratives, to fill symptoms and other disorders full of meaning.

But I do not agree with her that it is human nature to want to impose this narrative on others. It is not human nature that leads people to that extremity, but psychotherapy and its attendant culture.

Anger Management via the Treadmill

How are those anger management classes working out for you? And how are they working out for New York Congressman, Mad Anthony Weiner?

By now everyone has witnessed Mad Anthony's intemperate rant on the floor of the House of Representatives. When you were watching it, weren't you thinking that this man needs some anger management?

You don't have to answer that one, but it's a good way to introduce the latest scientific research on mood management. It turns out that physical exercise helps people to control their moods, up to and including anger. Link here.

Of course, this assumes that you feel that controlling your moods is a good thing. A lot of people don't. When Mad Anthony was offered the chance to apologize for his behavior, he refused, saying that he felt very strongly about... whatever.

If you want to have more temperate moods, then the treadmill will do you a lot more good than the couch. Strangely enough, if sweating on the treadmill tempers your moods, then spending too much time supine on the couch would, necessarily, make your emotions more volatile and your moods harder to control.

As the New York Times article reports, aerobic exercise combats clinical depression, makes you more confident and more focused, and helps you to manage your anger with more "aplomb."

Of course, if you have a problem with out of control emotion, adding a little coaching to the mix would probably be a good idea. But why deprive yourself of the benefits that the treadmill will provide to your mental and physical health... unless you have bought into the idea that the spontaneous overflow of powerful feeling signals authenticity.

If you have bought into that notion of authenticity, I recommend that you sell it it immediately. Otherwise you risk morphing into Mad Anthony Weiner. Check out his performance again, and ask yourself whether you would be proud if that were you. Link here.

When Good Parents Have Bad Children

Dr. Richard Friedman was not completely surprised when a patient tried to blame herself for the fact that her seventeen year old son was simply not a very good person. Link here.

Her two other children were thriving, but this one, who possessed no diagnosable psychiatric disorder, was rude, unfriendly, and not very nice. Truth be told, she did not really like him very much.

Dr. Friedman's response is refreshing, sensible, and surely correct.

In his words: "My answer may sound heretical, coming from a psychiatrist. After all, our bent is to see misbehavior as psychopathology that needs treatment; there is no such thing as a bad person, just a sick one.

"But maybe this young man was just not a nice person.

"For years mental health professionals were trained to see children as mere products of their environment who were intrinsically good until influenced otherwise; where there is chronic bad behavior, there must be a bad parent behind it.

"But while I do not mean to let bad parents off the hook-- sadly, there are all too many of them, from malignant to merely apathetic-- the fact remains that perfectly decent parents can produce toxic children."

As I say, it is good to hear this from a distinguished mental health professional. For many years therapists made it their business to guilt-trip parents into thinking that they were at fault for everything that happened to their children.. These same therapists then defined their own treatment as a way to compensate or supplement the inferior parenting.

Thus, the culture lost confidence in real parents and ushered in an age where experts ruled.

Thus, our our therapy culture embraced the notion, as Dr. Friedman said, that any child can be made into anything at all with the proper expert advice.

As Dr. Friedman writes, there is: "a prevailing social belief that people have a nearly limitless potential for change and self-improvement. After all, we are the culture of Baby Einstein, the video product that promised-- and spectacularly failed-- to make geniuses of all our infants."

He adds that what I would call therapeutic idealism, the notion that human beings were blank slates on which we could inscribe anything at all, has been succeeded by a more realistic concept, namely, that: "everyday character traits, like all human behavior, have hard-wired and genetic components that cannot be molded entirely by the best environment, let alone the best psychotherapists."

Children have different potentials; parents help them to actualize those potentials, or not. Good parents understand that a child who has an aptitude for music should not be forbidden from taking piano lessons and forced to play basketball.

Good parents know that they should help their children develop their strengths, not suppress them in order to fulfill the parents' vision of the perfect child.

And yet, aptitude for mathematics does not feel like the same thing as good character. Or, not entirely. Surely, some children are born sociable; they are born gregarious; they are naturally outgoing, cheerful, and kind.

Other children are born mean; they are born fighters and dramatizers; they do not like other children and are constantly provoking arguments.

These children might be more than unusually individualistic. They may need to find activities and a career path that does not require intense interpersonal contact. They would do better at trading than at sales. They might be better at golf than at football.

While we cannot make a born mathematician into a star baseball player, we do believe that we can and should help children improve their character.

But you would not be able to do it with psychotherapy. According to Dr. Friedman, the most promising results have come from coaching.

Surely, there are limits, but we should take Dr. Friedman's words seriously: "There are some interesting studies that such antisocial behavior can be modified with parental coaching."

Link to the studies here.

Psychiatry and Psychotherapy Today

I hope you do not take my views of the state of psychotherapy today as gospel truth. I don't, so why should you.

However well informed my analysis, it needs to be tested against reality. There it will either rise or fall, be affirmed or be revised.

For this reason I was very interested to read the essay that psychiatrist Daniel Carlat contributed to the New York Times Sunday Magazine today. Link here.

Carlat practices psychiatry. Of late he has grown dissatisfied with the rote nature of his professional activity. As he describes it, psychiatry consists of physicians conducting impersonal interviews, running through a checklist of questions, marking down the answers until they arrive at a diagnosis. Then they write a prescription.

As Carlat explains, he was not trained to establish a dialogue or have a conversation with his patients. They were clusters of symptoms, not people with lives.

In his words: "Psychiatry, for me and many of my colleagues, has become a process of corralling patients' symptoms into labels and finding a drug to match."

He continues: "...psychiatry has been transformed from a profession in which we talk to people and help them understand their problems into one in which we diagnose disorders and medicate them."

In the old days when psychoanalysis ruled the profession, mind was more important than brain. According to Carlat the profession seems to have overcompensated for his love affair with psychoanalysis: now it is brain over mind, often to the exclusion of mind. And also to the exclusion of the person.

And yet, we must note that psychoanalysis is not about establishing dialogues. It is about refusing dialogue. Nor is it about getting to know the person. Psychoanalysis is about treating disembodied minds.

Psychoanalysis insisted that you could solve your problems by understanding them. When I speak of therapy in this blog, especially in its title, I am referring to a form of psychoanalytically influenced treatment that believes the symptoms and other emotional problems are meaningful experiences, expressing unresolved childhood traumas or deficient upbringing.

Given this presupposition, treatment consisted in recovering these past traumas and finding better and more constructive ways to process them mentally and to express them verbally.

It was an interesting theory; it had a compelling narrative structure. Unfortunately, it did not work in practice.

In consequence, I would say, psychiatrists gave up doing therapy and began writing more and more prescriptions. Carlat is acutely aware of the factors influencing this transformation. He counts the perverse incentives that insurance companies create to favor medication. A 20 minute session with a psychiatrist pays about as well as a 50 minute session with a therapist.

If you had the choice, what would you do?

But Carlat also notes that patients have been voting "with their feet" for medication over therapy. It is cheaper, less time consuming, and has become more effective.

The point is worth underscoring, and not merely as a corrective to the kind of paranoid thinking that sees insurance companies conspiring with pharmaceutical firms to push drugs on unsuspecting patients. It may simply be the case that the American public has had enough therapy, and has shifted its trust to medication.

Could this be the reason why psychopharmacologists enjoy a higher status within the mental health profession than therapists?

Carlat makes this point, and it is important to underscore it. Within the mental health profession there is a status hierarchy, with psychiatrists at the top. Psychologists and social workers, the ones who do most of the talk therapy, are of lower status.

In Carlat's words: "The unspoken implication is that therapy is menial work-- tedious and poorly paid." If therapy were effective, would it have been consigned to this demeaned status?

Carlat does not say it, but psychiatry also remains a more male profession, while psychology and social work have more female practitioners.

Nevertheless, Carlat does distinguish one form of therapy for its effectiveness: that being cognitive behavioral treatment. I agree him here, and would emphasize that when I speak about having enough therapy, I am NOT referring to the cognitive behavioral variety, which is, I would say, currently ascendant in the field.

This form of therapy does not see symptoms as meaningful experiences, but sees them as bad habits. Thus, they can be controlled or removed without your needing to find out what they really, really mean or what they really, really say about you. Aristotle would have said that bad habits should be replaced by good ones, and this concept, which is at the basis of cognitive therapy, does not involve dealing with your deeper issues.

To me this means that cognitive therapy is closer to coaching than it is to psychoanalytically inspired talk therapy. And would say the same of what Carlat calls "supportive therapy."

Carlat's article chronicles his movement away from the impersonal check-list way of dealing with patients toward "supportive therapy." He describes it as: "... a technique favored by many therapists and involving basic problem solving and emotional support. It's a bit like what a friend would do for another friend offering advice in time of trouble, but more elaborate and with an accompanying raft of studies showing its effectiveness in psychiatry."

To me this is another term for coaching.

Supportive therapy is distinguished from insight oriented therapy for its emphasis on problem solving. And it is distinct from any therapy inspired by psychoanalysis because it emphasizes giving advice to someone who is being treated as a friend.

So, when Carlat is now working with a woman who was given an impossible assignment by her boss and who was then criticized for failing to get it done, he explains to her that her distress is not a function of an unresolved infantile trauma, but is a normal reaction to her boss's bad behavior.

He does not assign her any fault or blame. He does not attempt to help her get in touch with the guilt that presumably makes her vulnerable. Instead, he offers a series of mental training exercises to perform whenever she is tempted to blame herself for her boss's failings.

When we get into the realm of training exercises we are closer to coaching than to psychoanalysis.

This approach is both constructive and therapeutic. It should not be the end of the story. But it is an excellent way to start. This patient might still need counseling about how to deal with a hostile and incompetent boss... further steps that coaching might provide... but her psychiatrist has set her on the right road.

Friendly Cognitive Fluency

Here is some great advice, the kind that is so obvious that it is easy to skip over. It is also far easier to talk about than to do it.

It comes from a blog called "Little Things Matter," by Todd Smith. Link here. Smith explains that one of the most important keys to success, in business and in the world, is the ability to communicate effectively. Of course, we all know that. We are less confident that we know what it means to communicate effectively.

According to Smith, it involves two, not entirely synchronous, qualities. First, you need to be clear and precise, simple and direct. This means that you need to perfect the art of what the psychologists call "cognitive fluency," that Hollywood calls "high concept," and that philosophers call "Occam's razor." My previous posts on cognitive fluency are linked here and here.

All of that is well and good, though, certainly easier said than done. If you fall in love with a thought that comes to you in a moment of inspiration, i.e. an epiphany, if it is totally obvious to you, then you will not be putting in the time and effort to make it readily intelligible to your interlocutor. You probably just blurt it out and feel offended if you friend does not immediately acknowledge its brilliance.

That is why Smith adds a second point, namely, that you need to couple your clarity and concision with another quality: friendliness.

Friendly means respectful; unfriendly involves histrionic outbursts of powerful emotion. Unfriendly means rude, discourteous, and insulting. It is one thing to have a good idea; another thing to express it clearly; yet another to avoid the tendency to insist that your listener accept it.

Unfriendly means trying to impose your idea, talking down to other people, and dismissing their ideas.

Smith is quite right to qualify cognitive fluency with the requirement to be friendly. After all, clear and concise does not need to be friendly. In fact, as Smith notes, it takes considerable work to balance cognitive fluency with friendliness. Not because they are intrinsically contradictory. They are both good things, but they are not the same good thing. Thus, they need to be balanced, and it takes a lot of practice to do it.

Friendly means tactful and considerate. It means respecting other points of view. It means engaging a discussion, not trying to shut one down.

When you have a great idea, when things come together in your mind, you want to blurt it out, to tell people, to let them in on the good news. But you are also likely to think that you are right and that they, if they do not accept your idea, are wrong.

Thus, friendly involves a large dose of humility.

According to Smith, people who succeed in business and in life practice friendly cognitive fluency. They get to the point; they do not beat around the bush; they do not invite you to read their minds; and they do not waste your time.

As I was reading Smith I myself had a strange thought.

What if some wicked imp invented a practice whereby you would be trained to speak in incoherent fragments, avoid getting to the point, invite mind reading, disrespect your listener, and disregard his feelings? What would you call it?

How about psychoanalysis! Or any form of psychotherapy that derives from it.

Haven't I just allowed this wicked imp to invent something that is wildly consonant with Freud's technique of free association. Let's recall what it is. Freud insisted that his patients say whatever came to mind, regardless of how painful and unpleasant it was, either to say or to hear, and regardless of how trivial, uninteresting, and boring it was.

If you learn how to free associate you will learn to speak incoherently, to allow your speech to invite interpretation,to indulge a frankly unfriendly attitude, and to renounce any effort to connect with your listener. Any consideration of the listener's feelings, shown by offering a clear and precise statement of your idea, is considered a violation of the rule, evidence of yielding to censorship.

You might argue that free association offers a clear picture of the mind, unencumbered by any requirement to craft speech to the sensibilities of another person. Free association teaches you how to disconnect.

Naturally, it pretends that after you have resolved your infantile issues, you will connect more meaningfully than you did before. It never really explains where and how you are going to acquire the social skills that will solidify those connections. It assumes that divine intervention is going to make you socially adept, cognitively fluent, and naturally friendly.

Of course, research has shown that we normally craft our speech to the sensibilities of our interlocutors. And this means that speech is fundamentally conversation; it is not a means for externalizing whatever it is that passes through your mind. The purpose of speech is to forge connections with other people; it does not exist to allow you to expel toxic ideas.

If social behavior is normal, then free association is training people in dysfunctional social behavior.

There is no redeeming social value to a technique that will cause you to sabotage your relationships with other people and to compromise your ability to manage and lead. If you go around your life saying whatever comes to mind, you will invariably be rude and offensive, reveal too much information,and be tactless and inconsiderate.

If you are oblivious to the facial expressions of your interlocutors you are going to be unfriendly. If you talk around questions, jump around to different topics as the spirit moves you, and dispense with the requirements of clear and concise presentation of your idea... then you will be showing disrespect. In that case your friends will probably return the favor.

Someone might object here that free associations are cleverly designed to lead you to cognitive fluency. Maybe not the patient's fluency, but that of the analyst. Doesn't the psychoanalyst have the role of providing the cognitively fluent expression that sums up what you have been trying to say.

If you are talking about snowflakes, soccer, toffee, and catalepsy, the clever psychoanalyst will interject his notion that you are really trying to say that your heart's desire is to copulate with your mother.

Now, that certainly sounds high concept. After all, it's the high concept that animates Sophocles' play: Oedipus the King. Well, not exactly. Actually the fictional Oedipus is cursed to marry his mother. The play does not really say that this is the only thing he has ever wanted in love. That variation we owe to Freud.

Aside from the fact that, as Todd Smith understood, you can only become clear, concise, and friendly by practice it yourself, the truth is that Freudian interpretations tend to be insulting. And they tend to be presented as something like an indictment.

A good psychoanalyst will not just tell you that you want to copulate with your mother, but he will run through your associations and show that they all point toward this one interpretation.

As you know, psychoanalysts are so unfriendly that if you should happen to disagree with their oracular pronouncements you are going to be charged with resisting ... arrest.

To be fair, while most contemporary psychoanalysts, and any therapists who have suffered their influence, still swear by free association, they no longer traffic in the Oedipus complex. First, because it has become a banality. And second, because they had to stop insulting everyone's character.

Psychoanalysts today have toned it down. They are more likely to tell their patients that the meaning of their rambling verbal perambulations is that their mothers loved them too much, their fathers did not love them enough, and their siblings were wildly jealous of their success. So you are not cursed by a criminal desire that you can never fulfill. You are cursed for having had loser parents.

Don't say that psychotherapy has not made any progress.

The interpretations have been denatured. Surely, this is a step in the right direction. But the structure of the therapeutic miscommunication remains, and as long as therapists continue to insist on free association, they will be training their patients in dysfunctional behavior.

Dare I say that the basis of life coaching is to engage the client in conversation, to take him at his word, to be friendly about recognizing the value of his articulation of his problems, to offer clear and concise responses and advice, and not to insist that he take it.

Treating a Chronic Tendency to Self-Sabotage

In Monday's New York Times Dr. Richard Friedman wrote a column about patients who suffer chronically self-defeating behavior. Link here.

For the record, Dr. Friedman is a distinguished psychiatrist at a distinguished psychiatric facility. He represents the best that the profession has to offer. If you, as did many of the Times commenters, find his approach lacking, you can draw a conclusion from that fact. You might even want to muse over the fact that many of the masters of the Wall Street universe are treated by psychiatrists who think like Dr. Friedman.

I am not alone in finding his article disappointing. Many commenters expressed frustration and annoyance at his condescending attitude toward his patients. I haven't read all the comments, but I would recommend #24, #35, and #55. Link here.

If you read through the comments you will get a very good sense of the debate surrounding psychotherapy today.

One commenter noted that Dr. Friedman's article centers around an epiphany he had. Dr. Friedman saw the light when he discovered that patients who are invested in failure will usually be compelled to fail at therapy too.

In the not-too-distant past case studies used to contain patient epiphanies where the suffering individual discovered a truth about his childhood, recovered the memory of a trauma, and felt liberated to march off into the sunset. Now, we have a psychiatrist having an epiphany telling him that it's not his fault that his patients do not get better.

Having labelled these patients as masochists-- with some commenters taking vigorous exception-- Dr. Friedman despairs of not having a pill to erase their now-eroticized impulse toward self-defeatism. Beyond that, as the commenters note, he is unsympathetic, condescending, and defeatist himself.

Dr. Friedman's approach seems to involve telling the patients that they are themselves responsible for their failures-- in itself, unobjectionable-- and that they are doing it for a reason-- in itself, objectionable. Telling people that they are failing because they want to and because they are deriving a perverse sexual enjoyment from it is not likely to help them to improve their condition.

Since patients who fail at love or work are failing in public, Dr. Friedman is telling them that a certain group of the enlightened sees through their mask and knows that they are repressed masochists who have sublimated their deviant sexual impulses into self-sabotage. How would you feel if your psychiatrist told you that the world knows something about you that is deeply humiliating, only you do not know it yourself?

If that is the interpretation, then treatment would consist in persuading the patient that that his repressed masochistic impulses are directing his behavior. Do you think that once he accepts the interpretation and embraces his inner masochist, he will feel motivated to succeed.

I have no intention of leaving things in such a morass. Surely, there are better ways of treating people who engage in repeated self-sabotaging behavior.

Cognitive therapy is one step in the right direction because it will challenge the patient's basic assumption, namely that he always fails. At best, it will help him to marshal evidence of his basic competence and successes. It is easier to build on success than to imagine that you are destined to fail.

Dr. Friedman seems to accept his patients' all-or-nothing thinking, even though I am sure he knows that it expresses depressive thought patterns.

Another approach, more in line with good coaching practice, would also ignore all reference to past history or to the behavior's hidden meaning. It would would see him as having become mired in bad habits, not knowing how to succeed. Coaching would then help him to develop good habits to replace the bad ones, roughly as Aristotle would have recommended.

Teaching him how to succeed would seem to be preferable than telling him that he is destined to fail at everything.

"Happiness Coaching"

Let's hope it's a trend. In some corners of the American business world executives have decided to help their employees overcome the pernicious influence of the therapy culture by offering them happiness coaching.

Having imbibed the nostrums that the therapy culture has been prescribing American workers have become mired in bad habits. They have learned to find fault everywhere, to complain about everything, and to criticize mercilessly.

These habits may make you feel part of an intellectual elite, but they do not contribute to your well-being, your happiness, or your job performance.

To break these habits retraining is needed. And some workers are starting to receive it from the happiness coaches that are being hired to run seminars for them. So writes Sue Schellenbarger in today's Wall Street Journal. Link here.

Schellenbarger throws a little inadvertent irony into the mix when she talks about "thinking happy thoughts," but her article is serious and to the point. Even with the advent of positive psychology we have been taught to disparage a good attitude, and to believe that negative thinking is more sophisticated, more serious, and closer to the truth.

And if you think that capitalism is bad, you will be alarmed at the advent of happiness coaching. You want people to be miserable at their jobs because that will make them less productive and will cause their capitalist enterprises to fail more rapidly.

For my part, I am all for happiness coaching. All coaches work to help people to be happier, more positive, more productive, and more confident.

Surely, we will be living in a better world and a better workplace environment if happiness coaching takes over and supplants sensitivity training.

Have you noticed that no one seems to be talking about sensitivity training these days? Or am I being overly optimistic?

Conflict Resolution

Here's an excellent post by Shannon Wills, via Scott McArthur's blog, on how a manager should go about solving a conflict between two staff members. Link here.

In reading it I was struck by the simple fact that the same strategy can be used effectively to resolve conflicts between feuding spouses or feuding children.

It might feel strange for marriage and couples counselors to take their cues from management theory, but, we should all get the best advice from wherever we can find it. The fact that this strategy represents practical advice, roughly in the same way that 12 step programs do, and does not pretend to be science, should lead us to take it more seriously.

Coaching is more about leadership and management than it is about medical treatment. Thus, its natural allies are found less in the hospital or laboratory than in the workplace and the boardroom.

Coaching Arrives at Harvard

For those of us who believe in the value of coaching, and who are frankly excited to be part of a burgeoning field, the moment is well worth noting.

An Institute of Coaching, the first within an academic setting, has been founded at the McLean Hospital in Boston. Affiliated with the Harvard Medical School the Institute will conduct research into the effectiveness of coaching. Link here.

The Institute is being supported by philanthropist and coach Ruth Ann Harnisch of the Harnisch Family Foundation.

While executive and business coaching does not really need academic credentials, life coaching does. A profession's credibility and prestige determine who will and will not seek it out. If coaching can demonstrate, to the satisfaction of the academic community, that it is effective, people will be more likely to trust the advice that coaches offer.

In the past psychotherapists never gave advice. Their focus was relentlessly inward... toward the mind, its fantasies, thoughts, and feelings.

In fact, if your therapist offered advice, the conventional wisdom declared that this was suggestion and manipulation and that you should run, not walk, to the nearest blank screen.

As long as the practice of psychotherapy limited itself to exploring the past and pretending to accumulate insights into why things were going wrong, it did not really work. And yet, its practitioners often had advanced degrees, either in medicine or psychology, and used those credentials to pretend that what they were doing was science and medicine.

When it came to psychoanalysis, they used their credentials to convince patients that if they did not get well then they were simply bad patients.

More than that, until recently psychotherapy was the only game in town. Life coaching is a relatively recent phenomenon; it has had difficulty establishing itself because most people have thought it was simply a rehash of New Age nostrums.

Now that is changing. This blog has tried to keep you all apprised of the movement in the direction of coaching.

I am happy to link Boston Globe article by Elizabeth Cooney about the new Institute of Coaching and the way that coaching is beginning to be taken seriously as an alternative to therapy. Link here.

As you will see in Cooney's article, coaching is beginning to receive a better and more precise conceptual focus.

As I have often mentioned, and as Cooney's interlocutors affirm, coaching directs people to the future, not the past. It concerns changes in behavior and conduct, not insight into psychic conflict. It is about getting you into your life, not getting you into your mind.

As Coney reports, when you undergo a drastic life-change, whether it is a psychic trauma or a bad medical diagnosis, you will need a coach to help you navigate your way through your new life.

The practice works well as an adjunct to medical treatment because physicians recognize that it is one thing to tell a person to get fit and to eat well; quite another to help them to effect the kinds of lifestyle changes that will make this a reality.

When a patient receives a soul-shattering and life-changing diagnosis, physicians are more than happy to refer to a coach who can help the patient reconstruct her life and navigate her new reality.

What Next, Tiger? Rebranding...

For well over a century now therapists have agonized about curing trauma. As men and women of science they have hypothesized, experimented, and tried out different approaches.

But what if the answer does not lie in a scientific treatise or a medical experiment? What if the answer lies outside of the field of therapy, in fields like marketing and public relations?

After all, the pain of trauma involves a loss of dignity and reputation. As we often forget, how you look to others is a major factor determining how you feel about yourself.

Losing your reputation, falling into disrepute... these are certainly traumatic experiences. Even when a child is abused or molested, his or her anguish derives in the loss of modesty, the feeling of having been exposed unwillingly to another person, someone who now knows things that he should not know.

The work of reputation-recovery is difficult and arduous. If we are looking for new techniques to help people on this journey we would do well, in my view, to look outside of therapy into the worlds of marketing and public relations.

Don't think curing trauma; think rebranding.

Don't think insight; think self-management.

As any good life coach knows, the key to rebuilding reputation does not lie in insight into what went wrong, but in knowing how to start getting things right.

And yet, in order for the rebranding to work, you need to deal with the trauma.

Now, The Economist has published an article about how Tiger Woods should rebrand himself, recover his reputation, and return to what he does best. Link here.

The article begins by saying that Tiger has not done a very good job protecting his brand. He and his advisers have failed at crisis management and damage control. This, of course, is the first task for anyone who has undergone a trauma.

I have suggested in a previous post that I did not think it would have been a good idea for Tiger Woods to go public immediately after his automobile accident. Assuming that his wife injured him-- before, that is, she trashed his car with a golf club-- he did not need to show the world his wounds.

As an athlete, as a man among men, Tiger would have solved nothing by displaying his wounds, that is, his stigmata.

I still believe that this was correct, though I now see that it was only partially correct. As more and more women started coming forth to expose their trysts with Tiger, his absence from the public eye made it appear that he was in hiding.

And this is not a good thing.

The branding experts consulted by The Economist found an excellent way to split the difference. They would have advised Tiger to designate a spokesman to address the media, to answer questions, to change the context, and to shift the focus.

As of now, the only person who has spoken up for Tiger Woods is John Daly, a golfer whose bad behavior has been so consistent that it has become part of his brand.

What should the spokesman have said? One rebranding expert said that the message should have been that Tiger Woods was a golfer, and that he was not hired for how he conducted his personal life.

Clearly, this is an approximation of the truth. But if it allows some people to think their way out of the prurient details surrounding Tiger's reputation, it will have served a purpose.

This presentation would not have been ideal, but it would not have been nothing.

Say what you will, no one ever suggested that Tiger Woods cheated at golf.

If the press was unable to accept the "spin," the spokesman should add that Tiger Woods had not committed any crime, did not have problems with drinking and gambling, and was a good father.

Rebranding involves placing a fault or flaw within a larger context. The fact that Tiger cheated on his wife diminishes his reputation, but it does not mean that he has no character.

If Tiger erred in not having a spokesman speak for him, he has done the right thing, the experts say, by withdrawing his product from the market, thus, by taking a break from golf.

Clearly this demonstrates shame and shows a willingness to accept that he is taking responsibility for his mistakes.

The next step must involve relaunching the brand, returning to public view.

The rebranding experts say that this will involve two things: returning to tournament golf and constructing a new narrative that contains Tiger's flaws but shows him overcoming them.

Since most golfers and lovers of the game are still sympathetic to Tiger Woods, the chances are good that his return to golf will be greeted with cheers from his fans.

After all, this morning the Associated Press named Tiger Woods the athlete of the decade!

But Woods also needs to present a new narrative, not because life is a narrative, but because disruptions and traumas need to be covered by a narrative. A new story would explain what happened and show the path to recovery. The narrative is a bridge back to normality.

Yet, rebuilding a brand, like recovering your reputation, requires long work and consistent good behavior.

A redemption narrative must be accompanied by a rebuilt marriage or scenes of Tiger as a great father, or even a new beginning with a new marriage.

People are like companies. As one rebranding expert explained, companies that apologize when they make mistakes, and that do everything in their power to correct the error, often end up with: "better customer relations than before."

He adds that Tiger Woods: "...hasn't committed a crime against humanity. He has just been caught with his pants down-- which actually adds drama to his story, and could improve his long term value."

The Economist adds: "Accenture could even start running adverts featuring a triumphant Tiger with a new slogan: 'However bad it looks, it can be turned around.'"

Tiger Woods could become a role model for those who despair of overcoming adversity or recovering from trauma.