Not All Therapies Are Equal

Every now and then  I read an article and say "yes....yes" under my breath as I read. Such was the case with today's New York Times OpEd, "Psychotherapy's Image Problem." In the piece Dr. Brandon Gaudiano warned my industry that unless they make a commitment to proven treatment methods, over time our practices will be shut out by skeptical consumers and insurance companies who need to be shown therapy works.

And it does--at least some therapies do. 

I only work in empirically proven methods--primarily Cognitive Behavioral Therapy (CBT), Mindfulness and Family along with the Gottman method for couples. When I discuss my commitment to science my peers across the country--many of whom I respect and am friends with--pay lip service to proven methods and then do pretty much whatever they please. That concerns me because it effects me; if their patient's experience is not optimal that experience effects my practice and the reputation of the entire industry. Doing efficacious work is not only ethical but also smart business, if and when it is done. 

I agree whole heartedly with Dr. Gaudiano; if we do not move to evidence-based practices we will be shut out by consumers who don't trust us and insurance companies that rightly expect results from our work within reasonable time frames. As we approach a new era of health care in the coming months, I can only hope the American Counseling Association and the American Psychological Association are listening. 

Bradley Manning's Gender Identity Struggle

This morning Bradley Manning's attorney read a statement on the Today show saying that his client, recently sentenced to 35 years for leaking material to Wikileaks, wants to start living his life as a woman.

As I heard the news I was floored and, I have to admit, a tad skeptical.  I am honored to work with the trans community (not to mention all sorts of others, hetero and gay as well) and am defensive of those who would ridicule these brave folk, so that is my knee jerk impulse--to question this announcement. I don't know Mr. Manning and can't vouch for his integrity but I can only hope this is not a plea for publicity. The struggles of the trans community are so varied, deep and enduring that they cannot afford an opportunist seeking attention.

Chelsea Manning

That said, does this young man need any more publicity? He is known around the world for his actions, with some wanting to award him the Nobel Peace Prize and others demanding his execution.

I then did some reading and found Manning has struggled with the issue of his gender for some time and that it was discussed in his trial. I was not aware of this because of the lack of coverage of his trial in the mainstream. But once I found out he has previously been diagnosed with Gender Identity Disorder (GID)--literally having the brain of one sex in the body of another--I was relieved and felt tremendous sympathy for her. 

From here on I am going to refer to Mr. Manning as Ms. Manning, as I would with anyone else who told me they wanted to transition. Who am I to tell her, or anyone, who they really are?

As I tell my clients--from the heterosexual teenager with family issues to the housewife struggling with anxious thoughts to the woman in her eighties who wants a divorce after sixty years of marriage--you are an expert on yourself. I will never know who you are better than yourself.

The world is so hard for the most mainstream of people and it is even harder every step one takes away from the norm. So I wish Chelsea Manning well and hope she is afforded the medical and legal accommodations that allow her to be who she really is.

Thinking of Dr. Joyce Brothers

When I heard Dr. Joyce Brothers had passed away this morning I found myself to be profoundly sad. She has always been one of the constants in my life, someone who had been famous long before I was born and a constant face on the game shows and sitcoms that I grew up watching. She was friendly and pretty and funny, but also profoundly smart. She, along with Bob Newhart's fictional group therapist Bob Hartley, showed me that helping people could be a valid career choice. 

Now that I'm grown (and a psychotherapist), I appreciate her for a completely different reason. She made therapy more accessible to the masses by putting a friendly face on our craft. Dr. Brothers, a fellow alum of Columbia University I'm proud to say, was an early proponent of overturning the belief that that therapy and therapists had to be mysterious and puritanical in its practice. Instead of being a silent and judgmental, Dr. Brothers was accessible and real--even funny--something I thank her for every day. 

Rest in peace Dr. Joyce.