What are parts of therapy that can’t be written down on a checklist or hoisted off to AI? Today, I’ll discuss how depth therapy goes beyond the medical model.
Short term therapy and the Medical Model
Short term, solution focused therapy has become the ideal method of therapy in the United States. However, this trend has been driven by the insurance companies which are motivated by making profit. Unfortunately, research follows funding, which means the most strongly research backed, evidence-based practices are the ones that are the most profitable, for the medical and insurance industry. This does not mean that they are necessarily also the best options for the individual’s complete recovery or optimal well-being. Furthermore, this discounts clinical experience for lab driven study environments. Certain experiences cannot be replicated in a lab. I’ll get to more on that in a bit.
The Effects of Therapy Studies on Participants
I also want to say here that using people for the sake of a study innately affects their treatment. I’ll say that again; using people affects them. This means a study will not encompass what actual treatment can do.
Does online therapy work?
Yes, the research has proven that online therapy works. It is a bit more effort as far as the participants talking about what’s going on a little bit more because some of the body language and intuitive sense of the other person in a shared physical space is lost. However, especially for those who manage tight schedules or live in rural areas, online therapy can be a convenient option.
My first 5 years of Jungian analysis were conducted solely online. I was grateful for this for the following reasons:
- I had been having a lot of difficulty for finding a therapist who was a good match for me locally and
- I moved across state lines several times in those 5 years. Online therapy meant I did not waste any time reconnecting to a new therapist. This would have involved restating my biographical history again as well as building trust with a new person, which also takes a good deal of time.
This is especially true for those with anxiety, lack of trust in their parents growing up, or for people recovering from trauma.
Big Box Therapy
What about the big online companies? How do they do as far as be effective? They might be a good way for you to try therapy at a discount cost. They certainly have a lot of resources for cornering the market and making sure they can find a therapist with your scheduling needs. And again, online therapy is proven to work.
The Limitations of Big Corporate Online Therapy
This is where it gets tricky though. They don’t pay their clinicians very well. Often this means that their therapists must work long hours with huge caseloads to make enough money to support themselves.
Burnt Out Therapists
The research is saying that 20 to 25 client hours a week is what a therapist can do without experiencing burnout. To make good money at an agency or online company, they are often managing caseloads of twice that amount or more.
Why is the recommended caseload so low? Therapy requires the therapist to have an engaged, active attention, utilize their intuition, and do some heavy lifting emotional labor. From a depth perspective the therapist can be seen as tending psyches.
I know for myself, if I am too busy or am tired, my quality of my attention goes down. I think about my cases outside of the therapeutic hour doing notes, treatment plans, reading research and processing ideas for treatment. That’s the measurable work that is done outside of session. I also find there is psychic labor that relates to the therapeutic field. This is where therapeutic regard and concern for the client is no longer theoretical and gets real. Yes, therapists care about their clients.
If someone is doing 40+ hours of client time a week, they are slogging through notes on the weekend and just trying to eat, sleep, and care for their families. I will bet money they are not spending considerable working out clinical ideas outside of their client hours. It’s just not humanly possible. So much so that memes of overworked, burnt-out therapists are ubiquitous.
At that level therapists can be empathetic and teach you coping skills. They are not able to do the intense emotional labor needed for depth work or attachment work.
Transformation in Therapy
Carl Jung said that for a. therapy to be successful, the therapist much also change. The consideration of two people working together means that in that setting, both are affected. This concept isn’t generally talked about. Jung said, “The meeting of two personalities is like the contact of two chemical substances: if there is any reaction, both are transformed.” True, deep transformation can’t happen if the therapist is showing up, fully conscious and engaged with their thoughts, feelings, intuition—their total psyche.
There’s been a lot of talk amongst therapists lately about AI. Some are concerned that algorithms will put us out of a job. However, I’m not concerned about that particular issue at all. In fact, I find that there is a lack of understanding about what therapy is in the greater culture and with my own inquiry and interaction with AI.
I was on vacation in Wisconsin a year or two ago and saw cutesy little signs with adages such as “who needs therapy when you have friends (or a dog),” “wine because it’s cheaper than therapy,” (OMG!!!), “and fill-in-the-blank-hobby is my therapy.”
Do I have a Good Therapist?
Really good therapy isn’t having someone to talk to. It also isn’t a way to numb out or zone out. A good therapist looks at your life experiences, your early childhood, and your current behavioral emotional and interpersonal patterns and helps you look at how those patterns formed and then helps you change those responses so that you can build different patterns for your present and the future. A lot of this work isn’t about analyzing the content of your life. It’s about how the interpersonal dynamic forms between the therapist and the client.
Therapy Beyond the Workbook
Some of what psychodynamics is cultivating is about skill sets that are outside of your logical thinking ego. Thus, these are things that can’t be reduced to a checklist or mass produced that’s an easily replicable workbook.
Trauma and Attachment Therapy
Trauma psychologist Bessel Vander Kolk sets forth in the book the body keeps score that trauma is processed through the body. He recommends somatic processing such as dance massage exercise yoga and breathing exercises.
When somebody is well aligned with their therapist in therapy, there is a harmony, a synergistic energy that forms in the room between therapist and client. In art therapy, this experience can be called a state of flow, as defined by creativity researcher Mihaly Csikszentmihalyi. Another word for this experience is the aesthetic experience, where time seems to slow down and there is a sense of being rather than thinking. It is as if the individual has a sense of merging with the art or process rather than a separate experience between individual, their thoughts, and their experience.
Therapy is Human
Another piece is that therapy is intrinsically human. One of the main things across the board no matter what kind of mental health therapy you’re talking about that has been proven to work is the therapeutic relationship. What I mean by this is over time two humans understanding each other, seeing each other fully, in a secure environment creates trust. That trust allows for healing and for permanent change.
Long-Term Trauma Therapy
This is one of the reasons why trauma therapy can’t be done with lasting effects infrequently or any very quick period. There may be some initial benefit to short term therapies especially when it’s crisis intervention. But crisis intervention is triage. Long term healing happens after stabilization.
The Limitation of Short-Term Therapy
On this note, it is not profitable for insurance companies for the long-term, intensive relationship, attachment work that is needed to fully treat personality disorders. Again, most of the research is aimed at more profitable and replicatable, short-term programs and coping skills.
Long Term Trauma Recovery
However, the research also shows that long-term psychodynamic treatment can have better long-term, lasting outcomes with better prognosis for personality disorders. I am making a point about this because there is stigma about personality disorders because they do not respond as well to medication therapy.
Are Personality Disorders Treatable?
There is also a stigma about personality disorders as unchangeable or “just a behavioral” issue that people suffering from personality disorders choose rather than something that is originating from unconscious impulses and survival instincts.
The intricacies of what it is to be human and the emotional quality of trust, compassion, empathy, it can only be created from an ongoing, actual human to human interaction.
Finally, it can be terrifying to face your shadow, or instinctual parts of yourself that you are not consciously aware of. Instincts are automatic reactions, not thought out behavioral responses. In order to face those survival instincts and change them, a degree of trust is needed in order to face them and feel like you are safe enough to do so and get through to the other side of the ordeal.
Considering the Human Individual in Therapy
Humans are also individual and complex. Psychologist Carl Jung said, “A shoe that fits one person pinches another.” He also said that the therapist should create a unique therapy that considers the needs of each individual. This certainly can’t be done from the perspective of a summation or of an averaging of generalities. (Which is what AI does).
Meaning of Dreams are Individual
This is also why dreams are analyzed on an individual basis considering the person’s current life situation and history. Without considering the details, you miss the specificity of the metaphors being utilized in the dream.
Beyond Short Term Medical Model in Therapy
In the realm of therapy, certain aspects cannot be quantified by checklists or handed off to artificial intelligence. Short-term, solution-focused therapy, often favored due to profit-driven insurance models, might fall short in addressing profound human complexities. Research tends to align with financial incentives, often undermining the holistic recovery and well-being of individuals.
Unveiling the Depths: Beyond Checklists and AI in Therapy
While corporate online therapy providers offer accessibility, they often compromise therapists’ well-being due to overwhelming caseloads, reducing the potential for depth work and transformation. Depth therapy can be effectively done online, however, and while may be more of an investment, also provides more abundant rewards. Furthermore, depth therapy promotes a deep, transformative relationship between therapist and client, necessitating personal growth in the therapist as well in a co-created journey.
AI’s role in therapy raises concerns, as genuine therapeutic experiences can’t be replaced by algorithmic solutions. Good therapy goes beyond mere conversation, offering profound insight into life experiences, emotional patterns, and interpersonal dynamics. Psychodynamics engage skills beyond logical thinking which cannot be codified into standardization.
As mentioned above, traumatic experiences are deeply connected to the body. Somatic therapies like art therapy, massage, and yoga are often vital ways to process trauma. Harmony between therapist and client is essential; the therapeutic relationship fosters trust, facilitating healing and lasting change. As proven by meta studies such as Shedler (2010), long-term therapies, especially for personality disorders, yield better permanent outcomes than short-term alternatives.
Human intricacies and emotions defy AI replication. Shadow work, facing one’s unconscious and instinctual responses, requires trust and human interaction. Individuals are unique; each therapeutic journey demands tailored attention. This concept is in stark contrast to AI’s intrinsic generalization. Dream analysis, too, considers personal experiences, making them highly individual metaphors for healing.
In conclusion, certain therapeutic dimensions remain elusive to checklists, mass-production, and AI algorithms. Human complexities, emotional nuances, and personalized approaches characterize depth therapy’s effectiveness. Trust, human interaction, and individualized attention create a therapeutic environment that empowers individuals to confront their struggles, facilitating profound transformations that cannot be mechanized.
Next Steps for Going Deeper in Therapy
If you’ve gone through the worksheets, the coping skills, the Pinterest boards, and the 6-week program and want more. Depth therapy and art therapy might be exactly what you need to invest in yourself to go the next level.
If you’d like to chat more with me about any of these ideas to see if exploring depth art psychotherapy is your next step on your path of self-discovery, book a 20 minute consultation with me to chat.