Book: Voicelessness and Emotional Survival: Notes from the therapy underground

[Dr. Richard Grossman]

Hi Kathy,

Welcome back!  Thank you for reading my book.  I’m looking forward to hearing your thoughts and feelings.  As you might guess, my beliefs about therapy--based upon what my patients have both taught me and confirmed in my 40 years of “practice”—are very different from traditional therapist’s views.  But no spoilers here—let me know what you think!

JustRichard (you’ll understand this after you read the book!)

[Dr. Richard Grossman]

Hi everybody,

One of my favorite authors, Yuval Noah Harari writes about a theme of my book in his latest book, 21 Lessons for the 21st Century.    https://www.amazon.com/Lessons-21st-Century-Yuval-Harari/dp/0525512179/ref=sr_1_1?crid=1N4WOODQ8NYRL&keywords=21+lessons+for+21st+century&qid=1563054756&s=gateway&sprefix=21+Less%2Caps%2C138&sr=8-1

“Truth and power can travel together only so far.  Sooner or later they go their separate paths.  If you want power, at some point you will have to spread fictions.  If you want to know the truth about the world, at some point you will have to renounce power. “

Fortunately, I learned this early in my career, hence my decision to leave the Harvard Medical School/Massachusetts General Hospital system and work/practice from the “therapy underground.”

While I don't agree with everything he writes, all three Harari’s books are well worth a read!

Richard

[Dr. Richard Grossman]

Hi everybody,

Not surprisingly the graduate school experience that I wrote about in my book was far from unique.  Here’s an editorial from Nature about what many Ph.D. candidates face:

The mental health of PhD researchers demands urgent attention
Anxiety and depression in graduate students is worsening. The health of the next generation of researchers needs systemic change to research cultures.

https://www.nature.com/articles/d41586-019-03489-1

The following paragraph, in particular, stood out for me:

“How can graduate students be both broadly satisfied, but also — and increasingly — unwell? One clue can be found elsewhere in our survey. One-fifth of respondents reported being bullied; and one-fifth also reported experiencing harassment or discrimination.”

In my book I write about asking my Ph.D. mentor what I believed to be an important and logical question:

“So, I understand that there are unconscious processes that occur in the brain, but what I don’t understand is why psychoanalysts group these processes together and call them ‘the unconscious.’”

His response was to label me a “ f…ing American psychologist”-- and then he never spoke (or listened) to me again.  Such an important lesson in "voicelessness" he taught me!  As "Dr. Friend" says in the preface to my book:  "Learn from everything.  Especially the bad things!"
 
But most graduate students will not experience such faculty behavior in this way.  And sadly, as we see in the Nature editorial, this behavior happens all too frequently in the world of academia.

Richard

[lighter]

This behavior happens everywhere, Doc.

Lighter

[Dr. Richard Grossman]

So, true, Lighter.  I wish the adult world was not like this.  One of my dear ex-long-term patient/friends e-mailed me this from a recent NY Times Magazine article on Mr. Rogers because it reminded them of me and what I wrote about in my book:

“L’essentiel est invisible pour les yeux.” That was Fred’s favorite quote. He had it framed and hanging on a wall in his office. “What is essential is invisible to the eyes,” from Saint-Exupéry’s “The Little Prince.” “It’s not the honors and the prizes and the fancy outsides of life which ultimately nourish our souls,” he once said, expounding on the idea in a speech. “It’s the knowing that we can be trusted, that we never have to fear the truth, that the bedrock of our very being is good stuff. … What is essential about you that is invisible to the eyes?”

He put it this way in a speech:

“There are those of us who have been deprived of human confidence. Those who have not been able to develop the conviction that they have anything of value within. Their gap is rather a chasm. And they most often despair of creating any bridges to the land of what might be. They were not accepted as little children. … They were never truly loved by any important human other. … And so it seems to me that the most essential element in the development of any creation, any art or science, must be love. A love that begins with the simple expressions of care for a little child.
“When people help us to feel good about who we are, they are really helping us to love the meaning of what we create.”


Richard

[Hopalong]

I loooooooved that article too, Doc G.
And I look forward to the movie with its perfect lead actor for the part.

Those kinds of people soothe the soul, and we all need to remind ourselves
there are many of them. Somebody on every block who lives according
to kindness.

As YOU do!

Hugs
Hops

[Dr. Richard Grossman]

Hi Hops,

Mr. Rogers would have made a wonderful therapist!  I so appreciate what he said in the speech above.  I have tried to do as much as I can as a therapist by combining art and science and finding out, in a loving way, who each individual person I’ve seen is.  The question for me has always been how much of a difference a therapist can make in a person’s life.  And learning as much as possible about the psychoanalytic approach, the cognitive behavioral approach, the mindfulness approach, etc., I discovered that the relationship between the therapist and patient had by far the most powerful and lasting influence on a patient’s life.

I’ll write about some of the “issues” of this approach in posts to come.  Sadly, my father died in September, and I have been very busy taking care of all the legal and personal matters surrounding his death.  So, I’ve had very little time to do anything else.

Thank you, also, for the compliment!  You have been such an important and supportive member of this message board for 2 decades!  And I know you have been very much appreciated not only by myself but other members.

Richard 

[Hopalong]

I am so very sorry you have lost your father, Richard.
What a hard and poignant time to be a son.

I hope many memories sustain you during this time.
Plus...pie.

with love,
Hops

[Dr. Richard Grossman]

Hi everybody,

The human struggle between truth and status, which has come to the fore in our country in the past few years, has (as I write in my book) always been an issue in the “field” of psychotherapy.   I very much appreciated the Vox article below as another example of this struggle:

“Is positive psychology all it’s cracked up to be?
Just over 20 years old, this field has captivated the world with its hopeful promises — and drawn critics for its moralizing, mysticism, and serious commercialization."
By Joseph Smith 

https://www.vox.com/the-highlight/2019/11/13/20955328/positive-psychology-martin-seligman-happiness-religion-secularism

Richard

[lighter]

Doc G:

I watched a TedTalk, bc I've never heard of Seligman, or read anything of his, and here's what I got from it.

It seems Seligman is an iconoclast, and a very rich one.  Very successful. 

He's created scales and measurement for everything to do with positive and negative emotions/experience/social interaction, and flow..... and he does it with confidence, which I'm sure is annoying to some. 

He has categories, and he wants everyone to take tests so they can be labeled, and work on tricks and techniques to get more out of the 3 categories.  If they're lacking in one, or more, he figures out if it's meaningful,  I think he has 3 major things... work, social, and positive affect... can't quite remember, but he does go on with his interpretations, and what he's interpreting is.....
everything. 

Everything old, new, I mean he's looking at Buddhism (2500 years old), exploring what makes sense to him from all walks of mind/body/spirit studies, doing more studies on what he finds interesting, but without boring anyone with details of why something works or advances in neuroscience, or exact studies proving what the Buddha knew back in the day.  He just bounces along, hitting the high notes, and doesn't slow down to connect any dots, which is what I require,  so I'm not a fan. 


Honestly, he reminds me of my martial arts instructor (MAI)  picking and choosing what he liked from all walks of battlefield arts, then honing them for himself, and teaching them to others.  MAI created his own "art", but everything was found, not created BY MAI.     

Seligman might not be coming  up with anything "new", but his frank assessment of the standards of practice in mental health treatments,  not effective enough in his opinion, along with his quick bouncy style from one idea to another... meaning he doesn't stop to bore anyone with the specifics of leaps in the study of neuroscience over the last 20 years..... certainly not mentioning energy work, or chakras for that matter either.  I'm not sure he cares WHY something works or doesn't.   He just grabs it, identifies value, and seizes on it... which does remind me a bit of Van der kolk, Levine, and Porges in that he claims he does long term studies and experiments, but it's impossible to know what kinds, or how accurate they are from a TedTalk, and how can he really study anything well, if he's studying everything?

Seligman seems to be standing on the shoulders of giants, and packaging that information for the masses.  He's also getting rich and famous.  I guess he might be considered a marketing wizard, but does that make him a cult leader?  (There were a couple icky moments around victims making bad choices, and then something about moral choices, but.... he bounced right past, and didn't dwell on them.  It was a red flag, waved once, then thrown down, and stomped past in his very eager pursuit of the next thing he felt worked, IMO.

Seligman packages other people's ideas using colloquial everyday language, and tremendous self-confidence, IMO. 

He's unsatisfied with the current standard of practice in the mental health field.  He's unapologetically curious about his exploration of everything and anything he feels might be effective.... it's a little like watching Willy Wonka show you around his idea factory. 

How do you feel about him, Doc?

 
Lighter

[Hopalong]

LOL.

I interviewed Seligman many years ago, just after he came out with Learned Optimism. I read the book and it did make sense to me.

I don't trust that blindly believing in pibble-pabble affirmations or The Secrets changes lives much (and holds dangers of delusion), but I remember coming away from it thinking, well, I do at least have SOME control over the direction of my thoughts. Later on, on learning that one of the features of clinical depression is rumination, I thought his approach could be useful in trying to short-circuit that. (But I was always too lazy or squirmy to follow anybody's "program" of self improvement. No gurus!)

Then again, I read enough self-help books in my 20s and 30s to build a house with them. So maybe part of me WANTED a magic affirmation-pill. Would've been nice.

I dunno if he's another Norman Vincent Peale huckster or not, but I viewed him generally positively. Haven't really thought about him much since.

Oh, and I remember he was very cheerful!


Hops

[Dr. Richard Grossman]

Hi lighter,

While I know about Seligman’s work—his book, Learned Optimism, is on one of my office bookshelves—I have never met him in person, and so I can’t comment on who he is as a “person.”  I found it striking that he describes himself in the Vox article referenced above as “brusque, dismissive, and a grouch.”  He certainly doesn’t sound like a “learned optimist!”  And obviously (if one has read my book), our approaches to making a significant difference in a person’s life are very different.  Because everyone’s brain is different, some approaches will help some people but not others.  His approach would not have helped me.  But the other point that is important to me, and that I wrote about:  it is the patient side of the room, and his or her report on the significant long-term difference a particular therapy has made, that is crucial to evaluating therapies.  It does not matter how many books you write, how many TED talks you give, how well known your name is, how rich you become, who you know, etc., etc..  What matters, at least to me, is how much your patients’ lives have changed for the better in the long run as a result of the therapy.  Fortunately, and as I have been told many times by my long-term patients, this is the one result I can take pride in, and it gives me comfort as I grow older and think about the meaning of my life.

Richard

[lighter]

Doc G:

From what little I've read, and seen from Seligman..... you're not one of the Ts Seligman would take issue with.  I think he's most impressed by how well a client does in treatment.
If they're making progress... if healing takes place... that's success.

I see this with my T.  If we're making progress in a session, we keep going.  If we stop making progress, she shifts focus, and we try it another way. She doesn't rely on ONE way, and she certainly doesn't rely on a patient retelling their trauma story over and over without any progress.  That's a big no no with her.

I know some Ts do that, and it's how they practice.

My T's methods align with my journey.  Every patient will have their own journey.   Isn't that why you advise us to interview different Ts and ask questions to test the fit?  It helped me to widen my gaze, and not assume all Ts would fail to help me, bc a fistful had.


If anything, Seligman seems to condemn Ts who not only fail to help their clients, but who refuse to examine their treatment plan, or their part.  No one T will be a perfect fit for every client, and the Ts who tell clients that, or assume the standard of practice they were taught 40 years ago is THE ONLY way to practice... they're failing their clients in Seligman's opinion, and mine... likely yours too.   

Your patients are healing, and their lives are positively impacted through their therapeutic relationship with you.

I think he'd call that effective, and successful.

Maybe he's frustrated with the same Ts you take issue with?

Lighter

[Dr. Richard Grossman]

Hi Lighter,

Sorry for the delay in getting back to you.  I haven’t read/seen Seligman’s work since the days of his book, Learned Optimism.  That’s great if he considers patient progress far more important than the method used—and that patient progress far outweighs therapist fame, status and methodology.

It sounds like you have a terrific therapist—and a terrific match.  Yes, that’s why I always recommend people “audition” therapists.  I can’t tell you how many times I’ve responded to e-mails from people around the world looking for a referral where they live with “…make sure the therapist ‘gets it’ and that you feel comfortable…”  Every therapist is different and while you may agree with the techniques used, you may not appreciate/like/feel respected by the human being sitting across from you.  As I wrote about my experience in my book, I learned this the hard way.

Thank you, Lighter, for all your “work” on this board. You, too, have helped so many people, and I so appreciate it!

I am also incredibly grateful for my long-term patients who taught me what I needed to know about doing therapy.  One of my dear patients has come for 40 years and he is still willing to teach me!  Such patient patients!

Richard

[lighter]

Thanks, Doc G:

It feels right when you say the T has to "get it." 

Feeling met where we are, understood, respected... not pushed into places we aren't ready or able to go... not feeling judged for not being able to go there seems super important,  IME. 

I'm glad your patients feel safe with you.  That's everything, IME.

Thank you for sharing your stories, essays, plays, books, and this forum with me, and everyone else you've helped.  I really appreciate the time and care you've gifted to so many.

Lighter