The Case Against Long-Term Therapy

I don't really know for sure either way but after reading the above therapists article it has put a lot of thoughts in my head. I think he makes some good points but also he is not very objective about the whole thing. To me his intention is to sway people away from long term therapy.

Ugh...he loses me at his first point:
"Long-term psychotherapy can encourage narcissism." And that entire paragraph is ridiculous. Boring I know I am NOT.
My T said we ALL have a certain degree of narcissism...the need to look after and take care of our own best interests. (He was not saying this as a negative, but applying the definition of narcissism, not Narcissistic Personality Disorder.)

From Wikipedia:
"Healthy narcissism
Main article: Healthy narcissism
Healthy narcissism is a structural truthfulness of the self, achievement of self and object constancy, synchronization between the self and the superego and a balance between libidinal and aggressive drives (the ability to receive gratification from others and the drive for impulse expression). Healthy narcissism forms a constant, realistic self-interest and mature goals and principles and an ability to form deep object relations.[9] A feature related to healthy narcissism is the feeling of greatness. This is the antithesis of insecurity or inadequacy."

And it's also normal to be upset when your T goes on vacation! Part of your support system, or your entire support system in some cases, is missing. I don't think being "dependent" on a T is a bad thing.
And I would tell tell the jerk from his example to go **** himself.
I apparently I just need a tough love lecture and a good self help book.
I agree with you...he appears to be biased, and I would say that a lot of Ts would disagree with his argument.

[wotchermuggle]

Heaven forbid that one hour a week or less, some part of my life gets to be about ME.

[stopdog]

I don't think it is quite so black and white as good or bad.
And narcissism in therapy is, in my opinion, just as likely, if not more, to come from the therapist as from the client.

Originally Posted by stopdog

I don't think it is quite so black and white as good or bad.
And narcissism in therapy is, in my opinion, just as likely, if not more, to come from the therapist as from the client.

THAT is an excellent insight. Thanks.

[velcro003]

UGH. there may be some valid points in there, but he IS a jerk. that is just one viewpoint. if i had someone tell me i am lazy and unwilling (which i am and know), it would just piss me off, or depress me. i don't need anyone colluding with my already dark fears. i don't want a T to just sit and let me be complacent (i am working on this right now in therapy, actually), but this "tough love" wouldn't work on me. i'd shut down.

Originally Posted by wotchermuggle

Heaven forbid that one hour a week or less, some part of my life gets to be about ME.

You only get 29 minutes...at 30 you turn into a raving narcissist.

[Perna]

It's a guy in another field's opinion, sounds like he's observed what works for people later entering coaching for jobs or whatever he does and long-term therapy clients have a harder time of it.

I can see that; if you spend time on yourself you are going to have a harder time doing things at a different speed, like getting a job. The major "point" of a job is to earn money to pay for food, shelter, clothing for yourself so you are not dependent on someone else; but I think many people hold out for "the" job or something, get too introspective, don't just "do" and go from there adapting and changing on the go. Long term therapy is slower in pace and one has to learn to adapt what one is doing to the speed of the new task, not easy. Short term therapy sets very specific, measurable goals, like coaching, and you work on those for 10 weeks or whatever and you end up where/or close to where you want to end up. Long term therapy typically doesn't have such goals so a coaching goal of getting a job will have a greater learning curve for those who are basing their experience on long-term therapy and how it worked for them.

Originally Posted by velcro003

UGH. there may be some valid points in there, but he IS a jerk. that is just one viewpoint. if i had someone tell me i am lazy and unwilling (which i am and know), it would just piss me off, or depress me. i don't need anyone colluding with my already dark fears. i don't want a T to just sit and let me be complacent (i am working on this right now in therapy, actually), but this "tough love" wouldn't work on me. i'd shut down.

I would too...I would either get into a huge argument or get up and leave. That whole idea of his is NOT therapeutic.

[PreacherHeckler]

He's a career coach who seems to know nothing about treating adults with relational and attachment problems. Any kind of therapy can be harmful if the therapist is unable to recognize when his or her own issues are interfering with treatment.

I think that he makes some valid points but also though, some very harsh points . Long term would work for some and not others. I bet it would be client dependant on who it works and doesn't work for. He is a jerk though, also I agree with stop dog that most of the narcissism is from the therapists

[BlessedRhiannon]

I think the author is seriously biased. Some people may do better with short term, solutions based therapy or coaching. Others may need longer term therapy. Heck, it took me a year just to trust my T enough to share the hard stuff with her.

Honestly, the author lost me after the first few sentances, his bias was so plain that it was a total turn off...

those that have undergone extensive therapy are among those least likely to land a good job or make a career change.

Ummm - been in therapy for 4 years now, I have a good job and don't need to make a career change.

Of course, psychotherapy, especially short-term therapy, has helped many people, and for severe mental illness, longer-term support may be needed.

He tries to make it seem like he's not being biased, but just comes off as insulting.

Long-term psychotherapy can encourage narcissism. It’s all about you. People who have had lots of therapy are often boring to be around. All they seem to care about is their own internal workings and too often whine in self-pity.

Again - just insulting to those that are dealing with difficult issues. Some narcissism is a good thing. And, yes, the point of therapy is that it's all about you! Learning how to improve yourself, deal with your issues, etc. The "whine in self-pity" comment just makes me angry. Sometimes, it's important to share your story so that you can move past difficult or traumatic events.

I'd comment on the rest of it, but honestly, it just made me even more angry the more I read. If someone were to say the things he recommends as tough love to me, I'd probably shut down, mentally retreat, panic, and be much worse off than I was before.

[PreacherHeckler]

He makes good points only if the long term therapist is unskilled or unhealthy. Or both.

[Elektra_]

1- hahahah does he even know what narcissism is??? lolol whine is definitely NOT narcissism. sooo funny.

2-yeah if the person has already a dependent personality OF COURSE they willl depend on psych to even breathe.

3- inaction thing... my therapist always pushed me to get a freaking job, never told me oh we have to work on that lolol

overall he has no idea what hes talking about and should keep it to himself. i actually had the opportunity to have short-term therapy recently. was the 1st time a therapist said it to me. in some cases is good caz is actually very practical (i am like that) but for people that have personality disorders is quite hard to make the difference. i even read an article about a try out with a borderline (i have some characteristics) and there was an improvement but it was only addressed one issue therefore it would be needed more therapy to address other issues.

the only thing i can say is most psychs like theoretical stuff when they should be practical. before i find the association im in i had this psych that would give allll the examples of people that managed to get better and whatnot (some with social phobia which i dont even have lol) and say "u have to challenge urself" over and over again. and im like thinking to myself "wtf, are u saying something fantastic?? how about u tell me HOW TO DO IT??" i left her, didnt have money anyway and sure dont like paying for balbalabla bla.

[ultramar]

a) On *Marty's* narcissism (from website): Marty's mother claims that he could read the New York Times at age 3 and that his reading comprehension in the 1st grade was at the 12th grade level. That's either the exaggerations of a Jewish mother or the first sign of what was to come.

b) On the utility of short-term treatment (from website):
The World's Shortest Leadership Course 1-page course he wrote
d) More on the utility of short-term therapy (his book recommendation): For a book on that subject, see San Francisco therapist Michael Edelstein’s book, “Three Minute Therapy.”
c) He is a "career coach" and holds a degree in Education, NOT psychology, therapy, etc.
d) Maybe he has a bone to pick with long-term therapy because no one in his wildest dreams would pay him to 'coach' them long-term.
e) He's an idiot.

I hate rules, in general. What works for one person may not work for others. Why must we be so black and white about this stuff! We all come from different backgrounds and have different needs. Someone who is narcissistic is going to be that way whether their therapy is short or long. I've been with my T a year and still purposely hide lots of things from her all the time. I've done short term stuff in the past and it never worked because I refused to trust anyone. That is me and how I am...others are not the same. I had no intention of being in therapy "long term" but that's where it's headed. And I'm glad I accidentally found a t who isn't so dogmatic as to say that it's wrong or dangerous in some way...

The guy clearly has no understanding of complex issues.

"If you need human support, before running to a therapist, schedule regular check-ins with ... “a loving taskmaster.” If that’s not enough, then perhaps sign up for a few sessions with a good career coach or with a therapist who specializes in brief cognitive-behavioral therapy."

Sorry, no. That may be fine for those with some motivation related issues, career-related indecisiveness, or a touch of situational depression - but it will work for **** all else. I think the last thing a person with a history of trauma or neglect needs is some arrogant ignoramus with no understanding of what they're going through telling them that they're lazy, that everything is their fault, and that they need to pull themselves up by their bootstraps.

Offensive.

Long term therapy doesn't mean encouraging a victim mentality - like this guy is saying. Conversely, seeing a therapist long term can mean building a meaningful relationship and finally getting that much needed support that has perhaps been lacking - somebody helping you to build your confidence, championing you, encouraging you to take your power back - and someone to help you tackle the kind of issues that could hold you back in a career (and life in general), like how you relate to others... the list goes on.

There are ways a long term therapist can be what could be termed a 'loving taskmaster' - but it's about addressing the core issues, healing, and getting you to a place where you can push yourself when you're ready, and supporting and encouraging you on that journey - not somebody telling you that you're a loser and you'll always be a loser unless you snap out of this **** right now!

Grr. Like anyone needs any help with the critical voice in their head.

[wotchermuggle]

Originally Posted by ultramar

c) He is a "career coach" and holds a degree in Education, NOT psychology, therapy, etc.

This is my problem with people posting this crap online. A PC post about bipolar disorder by an "associate editor" also has no relevant qualifications - only personal experience. This stuff shouldn't be passed off as fact and content by people familiar with the difficulties of MH issues shouldn't be downplaying the severity of issues people can face. It's all ********.

[~EnlightenMe~]

I don't think Marty was pretending or acting when he said he was a jerk. Great job calling people lazy! He is using shame as a motivator, and that rarely ends up with a, should I say it?, long-term positive outcome. He appears to be a motivational speaker wanna-be, and in my opinion, what he offers lacks any substantive value. I agree with ultramar, he's an idiot.

I give him zero stars.

[refika]

Originally Posted by monalisasmile

The Case Against Long-Term Therapy

I don't really know for sure either way but after reading the above therapists article it has put a lot of thoughts in my head. I think he makes some good points but also he is not very objective about the whole thing. To me his intention is to sway people away from long term therapy.

Wow, that article really got me angry! The author is entitled to his opinion, and does make some good points, but I think the way the article is written, it is severely taken out of context and degrading to therapists in general, and patients of therapist.

The author is a career coach, and I see his point in saying that long-term therapy kills careers. I think he was trying to say long-term therapy as a "solution" for career issues is a bad idea. However, he calls long-term therapy anything more than 5 or 10 sessions. What!? After 5 sessions, I was barely scratching the service with my T and 10 sessions I was just starting to get in the water up to my knees.

To me, long term therapy is anything more than 50-100 sessions. I use sessions, because it's not fair to say in terms of years, since some people may see their T once a week, while others 3x a week.

Regardless, the other thing that irked me is the author has a PhD in education, NOT psychology. So he is insulting psychology/psychiatry as a profession yet has no formal training in it. How would he feel if someone insulted his profession as a career coach?

Lastly, he gives tough love lectures - that may work well for someone who is mentally stable, emotionally stable, and just unsure about their career path. However, for someone who is not mentally/emotionally stable, I could easily see how that type of lecture could send someone into a crisis mode.

I guess the reason I'm really irked by his article is that it stereotypes psychologists as money grubbers, narcissistic, "evil" people who just prey on those who have emotional/mental problems.

I'm strongly against any form of stereotyping in any form, and definitely disgusted by that article.

Pfrog ain't buyin' what he's sellin' ... !!!

Are You?

[scorpiosis37]

Originally Posted by just_some_girl

The guy clearly has no understanding of complex issues.

"If you need human support, before running to a therapist, schedule regular check-ins with ... “a loving taskmaster.” If that’s not enough, then perhaps sign up for a few sessions with a good career coach or with a therapist who specializes in brief cognitive-behavioral therapy."

Sorry, no. That may be fine for those with some motivation related issues, career-related indecisiveness, or a touch of situational depression - but it will work for **** all else. I think the last thing a person with a history of trauma or neglect needs is some arrogant ignoramus with no understanding of what they're going through telling them that they're lazy, that everything is their fault, and that they need to pull themselves up by their bootstraps.

Offensive.

Grr. Like anyone needs any help with the critical voice in their head.

I couldn't agree with you more, Just_Some_Girl. This jerk-off knows NOTHING about the terminology he is using, how therapy works, or the fact that you cannot make generalizations about the effectiveness of long therapy from clopping together some anecdotal evidence about a few career counseling clients who happen to have also been in therapy. What an idiot! I wonder if it ever occurred to him to think about those who have been in long-term therapy and do not NEED career counseling!

I've been in therapy for 3 years, and do not see termination on the horizon. I also would never come into contact with someone like this guy since I don't need job counseling, as I have a PhD and a successful career. The 3 criteria he lists do not apply to successful, functioning people who are doing the "hard work" of therapy with a qualified therapist. He only interacts with those people who are struggling with their careers, perhaps because they are not far ENOUGH along in their therapy, their therapists were unqualified and enabling, or they have other disabilities/struggles that make it difficult for them to find or keep employment. To say long-term therapy does not work by only looking at those who are struggling is ridiculous. How many of us are successful, in part because we have had long-term therapy?

To say that those in long-term therapy are indulging their narcissism is one of the most offensive things I have ever heard. For those of us who had traumatic childhoods and did not receive any love, attention, or care growing up-- and are just beginning to feel as though we *deserve* to think about our own needs (since our needs have always been ignored and we have been the caretakers of others our whole lives)-- it really feels appauling. Therapy is the first time in my life that I've ever even thought of myself as having needs-- and that it's okay to have needs-- and that it's okay to ask for help and support from others To have this guy come and say that therapy makes us narcissistic is ignorant, damaging, and offensive.

And to say that therapy acts as an alibi for laziness? So he's calling those in long-term therapy lazy? I can't speak for his career counseling clients, but I can speak for myself and for others who are in long-term therapy. Let's see. I work 60 hours a week, volunteer 10 hours a week, help out friends and family several hours a week--- oh yes, and spend 1 hour a week on myself in therapy. Sounds pretty lazy and narcissistic, doesn't it? The ignorance in this guy's article really gets under my skin.

If he were going to treat his observations as hypotheses, he would actually have to conduct a study of those in long-term therapy-- not just those who he happens to meet in the career counseling office. I wonder what he would think when he encountered people in long-term therapy who are are employed, educated, successful, hard-working, motivated, giving, generous, and emotionally healthy? You mean people in long-term therapy can stop focusing on themselves and making excuses long enough to go to work? He doesn't even have a clue how scientific observation and the scientific method work (assuming he was trying to claim that his observations have some kind of credence). Not only does he fail to recognize that he is only meeting those clients who need career services, but with his objective attitude and scientific curiosity, I'm sure his observations of his clients who have been in therapy are totally unbiased, right? He certainly doesn't come into the room with a preconceived idea about which clients will be more successful, right? I wonder if he's ever heard of anything called a self-fulfilling prophesy. If his job is to help struggling clients find jobs, who do you think he works harder with: those clients who have been in therapy or those who haven't? Who do you think he shows compassion and encouragement towards, and who do you think he brushes off as a "lost cause?" You think his attitude might affect his performance as a career counselor and/or rub off on his clients? If he doesn't recognize that, HE'S the lost cause-- and he's in the wrong profession. He's calling his own clients narcissistic and lazy! And he's the one charged with encouraging them to be successful workers?! Anyone else see something wrong with this system?

*rant ends here*

[Miswimmy1]

I feel like the article was quite insensitive. He is a career coach who seems to have never been in therapy. I would love to know if he even has a background in psychology. I read the first line and went straight to the bottom to look for his credentials because I thought his logic was so ridiculous.

[ultramar]

Originally Posted by wotchermuggle

This is my problem with people posting this crap online. A PC post about bipolar disorder by an "associate editor" also has no relevant qualifications - only personal experience. This stuff shouldn't be passed off as fact and content by people familiar with the difficulties of MH issues shouldn't be downplaying the severity of issues people can face. It's all ********.

This drives me NUTS as well. I've read some stuff on PC (the homepage articles, whatever they're called), including stuff on bipolar I really take issue with... They don't pass themselves off as clinicians, but there is a sense/tone that they are some sort of experts. I always look at qualifications (though that is no guarantee either).

Anyone and their grandmother can set up a website and call themselves 'life coaches' (which is meaningless) and self-promote (which this particular guy seems to be good it, if you believe the publicity cited on his website). I think this guy comes off as an idiot from the get go, but the dangerous ones are those who do write well and can sound very authoritative but are anything but. Or maybe the stupid ones can be dangerous too, what do I know.

[beans_on_toast]

Oh gee....the dude even has a wiki page...

hmmm...and who is he calling narcissistic??