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Originally Posted by atisketatasket
But if, as you say, therapy “could be done right, usually it’s not,” then why wouldn’t the problem be the structure?
These people receive similar training, have similar codes of conduct and ethical standards...so either the profession attracts a lot of incompetents (the problem is with individual therapists), or it doesn’t prepare its practitioners with proper training and doesn’t maintain standards (the problem is structural). Close to what you say in your last paragraph.
Generally the simpler solution is better to me—that means questioning the single factor, the structure, in its various aspects, rather than the multiple factors (incompetent therapists).
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I guess what I'm saying is, therapy fails primarily when the wrong person is sitting in the therapist's chair, and it is failing often because the licensing organizations are frequently putting the wrong people in that chair, people who simply do not possess the skills that are required of them.
But then I could definitely see the argument that the framework being so dependent on the performance of the individual therapist is actually an issue with the framework itself. There aren't really any failsafes, that's what I see as being the major problem. If the therapist is 100% bad, then they are doing harm to 100% of their clients, 100% of the time. And these situations are actually being enabled to persist. So I guess I essentially agree with you. The therapy structure in my mind can work, but also it needs more measures of accountability, maybe as a framework right now it is simply too idealistic and not realistic enough. It kind of has a "wild west" type of thing going on to this very day, you cannot reliably anticipate what kind of service you'll receive from any given therapist, and that's a big problem...
So I'll concede to your point here, I think you are totally right, that is a systemic problem and the system itself needs a change in order to address it. What I was trying to get at is that the basic therapy framework has value WHEN it is used correctly, though not necessarily as a rule.
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Originally Posted by BudFox
Agree that individual therapists are accountable. Disagree that so called "good" therapists can reliably transcend a dysfunctional framework. Purchased caring is a problematic construct, even if the therapist is super special and has magical powers.
Also seems most therapists are perpetuating therapy orthodoxy unthinkingly, according to their indoctrination. One of the best descriptions of therapists I've come across is... "naive followers of a faith".
I do think therapists ought to get a real job and stop humiliating people, and for that they are absolutely responsible.
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Purchased caring hasn't ever been the point of the therapy framework, the whole structure is designed to identify and bring awareness to inappropriate psychological defense mechanisms. Caring is not even supposed to be what is healing about therapy: awareness and insight are. However so many therapists have arrived at the notion that they are supposed to demonstrate caring, due to a one-dimensional understanding of this structure and their own training.
The problem here is that the structure also equally brings out the psychological defense mechanisms of the therapist, and its effectiveness is thus entirely reliant on the mental health level of the therapist.
Anyway, it is completely natural for one human being to care about another. This is the "just like any relationship" part. For someone to perceive that as UNnatural is the whole problem. Any physically healthy human being will experience involuntary empathy for others. Usually when this empathy is not functioning appropriately it's purely because that person is distracted by a perceived threat to their own survival. A therapist shouldn't be saying to their clients, "here, I will prove your PTSD wrong by demonstrating that I care about you," they should be trying to answer the question of, "what would lead you to assume that I
don't care about you in the first place?"
Their training is meant to help them answer this question, however too frequently they themselves are distracted by their own defense mechanisms to even see what the client is actually experiencing, and in that case their training is rendered useless.