Note: This post is different than previous ones and not for clients, but written for my colleagues, my psychotherapy co-students in Antwerp, and friends who couldn't join the 2017 Evolution of Psychotherapy Conference. Many people were asking me how the conference was, so I decided to write this blogpost. This post may be too technical and long for clients, so feel free to check out my future posts or look at previous ones on depression, anxiety, stress and expats which may be more relevant to you. This post is based on my subjective experience of the conference. It was impossible to attend all workshops, and I'm not knowledgeable in all the presented therapeutic approaches. So please take my biased summary with a grain of salt.
After a very eventful 2017, at the end of the year, I had the opportunity to go to the Evolution of Psychotherapy Conference where the most well known American psychotherapists and researchers meet every 4 to 5 years (however, the next one will already be in 3 years!). With 300 volunteers and more than 8000 participants from 50 countries it was a huge conference. With all the great names and constant input of knowledge, it was an over-saturating experience. After every evening my brain was aching, being filled with new information and stimuli. Next to that, I got to meet a lot of amazing people, not just the psychotherapy gurus, but many people in the field from all over the globe. This gave me the impression as if I was meeting my tribe: all kinds of therapists from different cultures who share a passion to work with people.
dr. Jeffrey Zeig, founder of the Evolution of Psychotherapy Conference and Milton H. Erickson Foundation
In this blogpost I'll touch on the following three topics:
What I believe the well-known therapy 'gurus' have in common, and what makes them great.
Meeting Beck, Siegel and Yalom.
When you meet your gurus, get rid of them.
1. What do well-known therapists have in common? What makes them great?
There are many outstanding therapists and healers on this world - and of course also sufficient bad therapists and charlatans. But then there are these Great therapists. Great with a big G. They can transform our whole field or come up with a new therapeutic paradigm. After reflecting about the idols I met, I believe they have the following traits in common (just my opinion):
They have strong interpersonal skills and are uniquely charismatic. When listening to people like Irvin Yalom, Sue Johnson, Aaron Beck or Philip Zimbardo I was struck by the warmth in their voice and interaction with others. You can sense them oozing with kindness and charisma. Next to all their accumulated research, books and titles they seem very genuine in their relationships with others. I believe that they've developed an acuteness in their way of listening and empathizing with people. From that basis, and by being authentic, they are able to connect with their clients or students more profoundly.
They don't have half-knowledge, but continuous curiosity. Many thought leaders have an innate sense of curiosity which can foster their desire to learn. They don't sort of know things. You could see a near child-like curiosity in dr. Peter A. Levine's eyes when doing an intervention during a clinical demonstration. And most likely they read a lot. In dr. Yalom's memoir Becoming Myself(Amazon affiliate link), he mentions how he went to the library as a child and would read 6 books a week, going through the library from A to Z. Next to the perseverance to deeply study subjects, they are also original and creative thinkers. Otherwise they could not have come up with new hypotheses or practices that push therapy beyond its established limits.
They conduct research. Though there are plenty of therapists with good interpersonal skills, few also possess the analytical capacity to conduct a lot of research. The combination of being a practitioner and researcher can give them an interdisciplinary perspective. I wouldn't be surprised if scientist-practitioners have a denser corpus callosum in relation to non-scientific minded therapists. Moreover, by having the scientific background to empirically validate one's hypotheses, can help them contribute to the field of therapy. The Greats extend our knowledge of how the mind or therapy works.
They follow healthy routines. Dr. Jeff Zeig mentioned in one of his lectures how he goes exercising whilst listening to an audiobook - at age 70 mind you. Also dr. Jack Kornfield and dr. Dan Siegel were very open about their daily awareness practices.
Do your own work. Many therapists also go in therapy themselves, and for a good reason. How are we to help others if we don't face our own personal challenges? In 2011, Marscha Linehan, founder of Dialectical Behavior Therapy, disclosed her own mental health struggles. Yalom in his memoirs shares how he had useful therapy with Rollo May(!), and in his lecture he said that he was still attending a local group therapy with fellow colleagues up to this day.
dr. Antonio Damasio trying to get something into my thick skull.
2. Meeting Beck, Siegel and Yalom. I met a lot of Greats at the conference, but I only picked three to not make this text even longer. However, many other speakers also really left an impact, and I will elaborate on them another time.
Aaron Beck, MD - The Founder of Cognitive Therapy Dr. Beck touched upon research regarding cognitive behavioral therapy (CBT) with very difficult psychiatric patients including psychotic complaints, and how CBT can be utilized effectively. He also discussed the overlap between cognitive therapy and Buddhism.
I was very surprised to hear dr. Beck mention that CBT protocols are not as relevant (!) as people make them out to be. Here is what dr. Beck said: "Now the problem with the manuals, [...] they are very technique oriented, and they go from one step to another step, with each week you are supposed to do something else. Whereas a true cognitive therapy is a holistic approach, that deals first of all with the relation with a patient, and then it deals with the problems as they come up. And so it doesn't try and fit the patient into a particular chapter of a manual, but tries to fit the therapy to the patient. So it is very personal, and each person is different. So I don't think that the [individual] can be manualized." (I am not permitted to share video material of the conference without the consent of the presenter, but maybe this lecture will be available online in the future).
When asked what one piece of advice he would give to young therapists he suggested to study Carl Rogers! Can you believe it? The father of modern-day CBT advises all listeners to read more about client centered/humanistic psychology, as the therapeutic relationship is more important than following a protocolized manual? Amen to that. But maybe I shouldn't be so surprised. It wasn't Beck who preached that everyone ought to use CBT protocols, as is happening in many Anglosaxon countries like the UK, US and The Netherlands. It is not the charismatic leaders that create the dogma, but the fervent followers of the Church of CBT. Or in a more extreme analogy, Jesus did not intend for the inquisition to happen under his name.
Daniel Siegel, MD - Interpersonal Neurobiology and Adolescents
Harvard & UCLA trained psychiatrist dr. Dan Siegel is one of the founders of Interpersonal Neurobiology, one of the most fascinating areas of research for psychology. I simply had to go to all of his lectures, as I believe it is a very promising framework for the field. Interpersonal Neurobiology can be defined as the neuroscience of relationships, based on the understanding that our brain is a social organ. For those interested, I also highly recommend the work of professor Louis Cozolino who coined the term neuropsychotherapy, and wrote The Neuroscience of Psychotherapy: Healing the Social Brain and Why Therapy Works: Using Our Minds to Change Our Brains (Norton Series on Interpersonal Neurobiology). What makes Interpersonal Neurobiology so interesting, is that it takes into account attachment theory, biology, psychotherapy, but also physics and complex dynamic systems. Complex dynamic systems helps explain the emergence of the inter-relational and embodied mind (see video below; a more sophisticated thread will follow a different time).
Similar to Damasio's research, Siegel understands the brain as being embodied, considering it is not a separate machine, but deeply rooted within the rest of the nervous system and body with continuous interactions with the environment. Thus the flow of information/energy is being regulated physically by the body and brain with the mind being an emergent property whilst we intersubjectively connect with our environment.
In Siegel's latest book (and somewhat misleading title), The Yes Brain: How to Cultivate Courage, Curiosity, and Resilience in Your Child he describes how to foster self-awareness in children, strengthen one's empathic capacity, and how to become more resilient. There are no quick fixes, but rather changes in one's lifestyle that help. More neuronal relational intergration allows us to find resilience within ourselves and not collapse or give up hope. At the end of adolescence a teenager should have learnt "not to be afraid of storms, 'cause I'm learning to sail my ship". For that to happen, the supportive interaction with a parent/therapist/mentor can be crucial for the adolescent, to tune into a zone of proximal development (as Vygotsky described it). In that way parents, mentors and therapists play an important developmental role in our communities, to move the planet back to sanity. Another concept that struck me during his vibrant lecture on the adolescent brain was his question on why teenagers rebel. If teenagers grow up in a stable nurturing home where they get fed, have shelter, and emotional support, why would they ever rebel against that to go into an unsafe world? Well, from an evolutionary perspective one cannot mate with one's closest family as that increases the chances of a mutated offspring. Hence a teenager may be biologically primed to rebel against his/her closest relatives in order to have a reason to leave the stable childhood home. Keeping that in mind, when being with one's child, may create more understanding for the essence of adolescence as a whole.
Finally, based on contemplative neuroscience, there are simple mindfulness practices that can foster a more integrated, healthy state within ourselves. A simple way is breathing whilst resting one hand on your chest and the other on one's belly, and being aware of one's (physical) sensations. A more sophisticated exercise is Siegel's wheel of awareness practice.
Irvin Yalom, MD
Meeting dr. Yalom was a dream come true. I remember reading When Nietzsche Wept as a teenager and what an impact it left on me. Just like the many characters in his novels, this man is equipped with a genuineness and kindness that are very disarming. Whilst he shared two new short stories with us, his kind voice made him seem so human, yet at the same time so much more dignified than others. This may seem far fetched, but he reminded me of the impression I had when seeing the Dalai Lama at a conference a few years back. By just being himself, very natural and open, he appears so much more special.
In Yalom's short stories he shared his angst of how many memories will die with him, and how some of them already vanished or have been distorted over time. He opened up about his vulnerabilities as he is getting older, or how he was moved by the story of a patient and that he nearly began to cry in front her. He shared the pleasure of his work and joys with his wife, historian Marilyn Yalom. And, being the educator he is, he used this moment to teach us how narratives and self-disclosure of the therapist can be a good tool to elicit change in one's client. Moreover, he emphasized the strong evidence of "the intimate accurate empathic relationship with the client" as most conducive to creating change in therapy. Echoing Carl Rogers, he numerated the 3 variables to ensure the quality of the therapeutic alliance: genuineness, unconditional positive regards, and accurate empathy. Wow. I feel very lucky to have listened to him speak, and I realize that I have not even shared half of my notes from the lecture without going way over my regular word count.
dr. Yalom, my conference buddy Archana Chatkara, MA, MFTI, and myself.
3. When you meet your gurus, get rid of them.
As Linji's old zen koan goes: "If you meet the Buddha, kill him." The idealization or deification of masters can stop one in one's own process of growth. Sometimes it is best to kill one's conceptualization, to be able to focus on what is actually going on. In Yalom's Becoming Myself there is a whole chapter titled "On Idealization" where he specifically states (pg. 333):
"And the impact of all this attention and applause upon my own sense of self? At times I feel heady and at other times disquieted, but generally I keep my balance. Every time I meet with colleagues in my support group or in my case discussion group, I am aware that they, excellent clinicians in practice for decades, are every bit as effective in their work as I am in mine. So I don't take the adulation to heart. All I can do is take my work seriously and be the best therapist I can be. I remind myself that I am being idealized and that we humans, all of us, crave a wise, all-knowing, white-haired elder. If I've been chosen to fit that slot, well I happily accept the position. Someone has to do it."
Putting someone above you, also means putting yourself below them or making yourself feel less worth. Whilst these days there is not enough humility in this world, we are all equally worthy as human beings. It might still take many years of learning before I properly understand the thoughts and research of the Greats, if at all. But that should not hold me back from learning or idealizing them too much. At the end of the day, we are all human, going through the same joys (laughter, friends, sex, etc) and struggles (loss, disease, anxiety, death, etc). All in all it was an amazing conference, and I can only recommend people to attend. Hopefully this post was useful to you. In an upcoming blogpost I will go more into detail of specific therapeutic techniques some of the Greats used at the conference whilst doing live demonstrations with clients. Let me know if this is of interest to you. This post was an experiment, so feel free to give me some feedback or comment below.
Full Disclosure: The book links are Amazon Affiliate links. If you click on them and decide to buy a book, Amazon gives me a small percentage, helping me to run this blog.
About Patric Esters Patric Esters, MSc is an expat psychologist who provides psychological counseling and diagnostics to expat teenagers and young adults living in The Hague. Patric speaks and treats clients in English, German, and Spanish, Portuguese, Catalan and Dutch. Patric Esters has been working for several years as a child and adult psychologist in a renowned international clinic for expatriates. He has a vast background in psychology and psychotherapy and first- hand expat experience, being born in Germany and raised in Spain at an international school.