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

[Dr. Richard Grossman]

Hi everybody,

I understand that my book challenges many of the fundamental beliefs about therapy that have evolved over the past century including (in no particular order):

1)   Psychotherapy is a technique to be applied by neutral practitioners,
2)   Psychotherapists’ personalities—and the damage they can cause—can be neutralized by their own personal therapies,
3)   Dividing the brain into small pieces and applying therapy to one of those pieces can make the biggest difference in a patient’s life,
4)   All books on therapy should be written from an objective, research based, scientific perspective—not from one therapist’s own personal experience,
5)   Faulty parenting is the primary reason for most people’s psychological problems,
6)   People should be divided into categories and treated according to those categories—after all, isn’t that what the science of psychology is all about?
7)   The people with the most training and who work at the most prestigious institutions know the most about psychotherapy, and should be trusted the most, and
  Therapists are psychologically healthier than the people they treat and therefore need not pay attention to their responses to patients.


Largely because the book challenges so many of these beliefs (and others)—and because it has been written in an atypical, non-academic form (illustrating, by design, my autonomous “character,”), most people/therapists will not be interested in reading it—and will disagree with much or all of it.  The flip side is that a few people—and especially, people who are willing to question prevailing viewpoints, have loved/appreciated it (one of my ex-Massachusetts General Psychiatry colleagues told me it should be required reading in all of the therapy training programs in the Boston area).  This is the feedback I have gotten from readers—all of which, negative and positive, I have much appreciated! 

I want to thank again all those who have read the book.

Richard

[Dr. Richard Grossman]

Hi everybody,

The striking results of this survey as reported by NPR will not be a surprise to many here:

"Most Americans Are Lonely, And Our Workplace Culture May Not Be Helping"

January 23, 20206:00 AM ET
ELENA RENKEN

https://www.npr.org/sections/health-shots/2020/01/23/798676465/most-americans-are-lonely-and-our-workplace-culture-may-not-be-helping

Aloneness, the main focus of my work/book, has reached epidemic proportion in our society.

Richard

[Lollie]

I know I'm way too late on this, but congratulations on the book! I am going to order it right now!

[Dr. Richard Grossman]

Thanks, Lollie!  And welcome back!!!  Just a warning—my goal in the 40 plus years of doing therapy was to make the biggest difference in my patients’ lives that I could, and in pursuing this goal, I had to learn, from my patients, to see therapy in a totally different way.  As a result, most people have disapproved of the book and its stated beliefs—but, surprisingly (at least to me), some people loved it.  I know one couple who read it and were on “opposite sides of the fence” who argued about it, vociferously, back and forth, for a whole day!  I loved that!  But the book is completely out of the box for a book on therapy.  The prologue of the book is a 10-minute play that I wrote—the reason for its being there is only explained at the end of the book. And then, the first part is told from a personal, first person perspective—something that therapists are taught never to do.  BTW, most readers (including acquaintances) would not even talk to me about the book.  And, of course, some told me they wished I had written a more traditional academic book on the subject.  Of course, all of my patients fired me after reading it.  Just kidding—I really enjoyed hearing their individual reactions to it, and most important to me, none of it surprised them.  Anyway, I’ll leave the rest to you, and if you feel comfortable about commenting on it, all of your negative thoughts/feelings about it will be much appreciated, and if you have some positive ones, I’d love to hear them, too!

Again, and most important, welcome back!!!

Richard

[Lollie]

Dr. G.

Thanks for remembering me! I am patiently waiting for Amazon to deliver.

[Dr. Richard Grossman]

Hi everybody,

Given the book that my patient wrote about her therapy with me, some may wonder whether I have treated other patients with a severe, life-threatening Adult Attachment Disorder.  And the followup question:  did I use the same out-of-the-box approach with these patients?  Unfortunately, I haven’t treated any other patients with this extremely rare, VERY hard-to-treat disorder, so I can’t provide any more data.  I can say that my ex-patient continues to do very well in all aspects of her life, including the relationship aspect, and is very grateful.  But, no, I haven’t used this approach again.

Also, it is very unlikely that any of my other patients will write a book about their long-term therapy.  Almost all fit into the categories:  senior professors/department chairs, surgeons, business owners, hospital heads, lawyers, psychologists, etc., so they could not risk being exposed.  Plus, we all know that very few people (including therapists) read personal books of this nature unless the writer is a celebrity.  So, there would be little point in writing such a book.  This is too bad, because, as I wrote in my book, the data from the patient side of the room is most important, including an answer to the question: “How big a difference did the therapy make in my life?”  Sadly, that question answered by therapists—and even researchers—have been inaccurately reported.  Freud, for example, fabricated significant elements/descriptions of his patients’ lives, and I know of one incident where a world-famous researcher in the mind-body area used fabricated data.  It is far better that patients, ideally who have tried multiple therapies, report the long-lasting difference a particular treatment has made.

Richard

[lighter]

That makes sense, Doc.

Lighter

[Dr. Richard Grossman]

Hi everybody,

So, for me, where was the line drawn between doctor/therapist and friend?  After all, like it or not (!), I am the same human being in both “roles.” Aside from the fact that my doctor role is patient-centered (or, as Carl Rogers would have said in the 1960’s, “client-centered”), for me, this is not such an easy question.   A stranger stopped me on the street while I was walking my dog some months ago and reminded me of the eulogy I had given for one of my dear friends a decade earlier.  Apparently, she remembered it well.  I pulled it out of one of my many file cabinets and re-read it.  The eulogy spoke to what I believe and practice as a therapist, though crossing the fine “patient-centered” line to “friend.”  So, here it is:

“About 10 years ago, Don and Betsy invited Hildy and me to spend a day at their house on the south shore of the Cape.  Don had Bat Mitzvahed our daughter Micaela a couple years before, and we had been friends ever since.  When we got there, Don asked me if I wanted to go for an ocean ride in his boat.

When we went around to the dock behind the house, I looked at the boat.  It was not much bigger than a rowboat, with a body of what seemed to be ancient wood, and a puddle of water splashing around in the bottom.  The outboard motor looked like it had last been started in the 1960’s.  Not being much of a swimmer, I asked myself:  Are we really going out into the Atlantic in this?  But I trusted Don, and luckily, there were oarlocks on the side and a set of oars in case all else failed.  Don held the boat steady as I got in, and then he stepped in and pulled the starter rope nine or ten times with no results, each try followed by a minor adjustment to the carburetor.  I looked at him to say:  well, how about a margarita on the dock, with the usual seltzer and twist for you?  But he was unconcerned about the motor:  he smiled with every pull.  Suddenly, and I must say, somewhat to my dismay, the motor coughed and then came to life.  And out we headed.

On the ocean, we rode in and out of the swells large enough to swallow us whole.  Large waves slapped fiercely against the ancient gunwales sending spray into our faces, making me wonder what pieces would be large enough to hold onto if the whole thing came apart.  But the boat held.  And in that tiny, wooden skiff on the edge of a vast ocean and separated what seemed to be a thousand miles from the rest of humanity, Don and I began sharing stories of our lives with each other.  Stories of childhood, stories of family, stories of illness, stories of pain, stories of happiness, stories of life.  And with sharing those stories over the years, as it so often does, came love.  Many of you knew Don as a gentle, patient, wise mentor.  He was.  But I also came to know a very different side, his vulnerable side—a side that he shared with me for over a decade.  It was this vulnerable side that I most valued, and the side, I believe, from which his other sterling qualities emerged.

But suddenly I find myself back in the tiny wooden boat again, miles off shore.  The old motor has stalled, the boat is drifting with the ocean wind in and out of the swells, and this time there is no Don.  All I have are the oars—and my memories of his love.

But that’s good enough.  Stroke by stroke, they will get me home.”

Richard

[Hopalong]

This touched me a lot, Doc G...
it's beautiful.

How very lucky Don was that you knew how
to listen, how to be present, how to value another person.

I'm sorry you lost him but how beautifully and poignantly
you rendered your deep appreciation for him.

Thank you for sharing this.

love
Hops

[lighter]

Doc:

I wanted to read every word you wrote.  You had my full attention, then Don took my heart.

I love the trust he had in his little boat.  I love that experience helped you understand all will be well, even if the motor goes, and you have only the oars and yourself. 

All will be well. 

Those were lovely words, Doc.

I'm glad you shared them with us.


Lighter

[Dr. Richard Grossman]

Thank you so much, Hops and Lighter!  So often it is our loving memories, if we are lucky enough to have them, that help us through tough times—including the current one.  Stroke by stroke…

Take care!

Richard   

[Dr. Richard Grossman]

Hi everybody,

We’re finally getting there (!) on the research side concerning what I write about in my book. Here’s an article that just came out:

"Study identifies social connection as the strongest protective factor for depression"
by Massachusetts General Hospital

https://medicalxpress.com/news/2020-08-social-strongest-factor-depression.html

It’s ironic that it’s coming from the very same institution that I quit some 35 years ago, in part because my colleagues would never listen to such “nonsense.”

But, many of you may ask, why is such a "connection" necessary with a therapist?  Why shouldn't therapists just help people find it elsewhere?  And, of course, my answer from the book is:  People, in general, at the deepest level, are poor listeners—and this, as I learned from my therapists and teachers, applies to many therapists/university faculty as well.  So, the "connection" often has to come first from a therapist capable of listening, in order that the person experience and learn--often for the first time--what this is really like to be heard and valued, and then another person when/if the patient can find someone else who can truly hear them.

Richard

[lighter]

THIS is why I haVe such a problem with Western medicine..... white men telling me what I must and musn't do.... what I must do for and with my children without listening to what's going  on in our lives.....behaving as though they have all the answers, and our little problems are a nuisance to them, bc we aren't magically righting our boats according to their theories of treatment and healing... if ONLY we'd just DO what they tell us to... all egos and looking down their noses from afar. 

::shaking head::.

And....
blech. 

I don't think I could be driven into a white male psychiatrist's office..... not with a blow torch, even.  With all the suspending of judgment (and getting very curious) I've managed to do lately.... I don't think I could get there in that scenario.  Nope nope nope.

It's like a big collage of negative images and experiences pop up.... an entire wall....no.... BILLBOARD of them, and it's a lifetime of negativity.

SO, NOW they're willing to consider... or MAYBE accept what you figured out intuitively all those years ago, Doc. 

::sigh::. 

And I just don't think the old (willfully ignorant) guard will be responsive enough to accept and incorporate the new data, as they've been practicing ar5se backwards too many years. 

GRRRRR.....

::breathing::.

gr.

Lighter

[Hopalong]

Amen, Doc.
I couldn't agree more that it's that concentrated and genuine (even if paid for) listening that allows transformation. It's a rare friend who can give that in 3-D, so we turn to therapy.

In a way, you've created that for all of us here. We can write and write and free-associate and narrate and ramble out our lives, and somebody will hear, all or parts of it. Until we can hear our own healthier selves. And that's an amazing gift.

Gratefully,
Hops

[Dr. Richard Grossman]

Thanks, Lighter and Hops, for your thoughts.  I had no idea that people were unable to listen when I went into this field—I had to learn this crucial truth through experience.   sKePTiKal makes the same point in a terrific post on another recent thread:  “And lately, I'm relearning the "discretion is the better part of boundaries" lesson again. Even with people I trust. The misunderstandings, endless clarification, twisting things around into their own frame of reference that goes on when people open up with each other can be endlessly frustrating for me, at times - when all I want is to be heard, taken at face value, and not have to endlessly support those statements of emotion with explanations, footnotes & bibliographies.”

https://forum.voicelessness.com/index.php/topic,10639.msg184634.html#new

She could have written a wonderful introduction to my book and explained why I chose not to write it in a more “professional” manner/style!  The divergence of status and truth has been one of my most important life-long lessons—although sometimes I laugh at myself for thinking I’ve become an expert on not being an expert.

Hops wrote above:

“In a way, you've created that for all of us here. We can write and write and free-associate and narrate and ramble out our lives, and somebody will hear, all or parts of it. Until we can hear our own healthier selves. And that's an amazing gift.”


Thanks, Hops!  That’s exactly the reason I’ve kept the Board running for all these years.  In a sense, each of you have been wonderful therapists to others on the Board and listened in ways that most therapists cannot and will not.

And while we’re on the topic of listening, it is so telling to me to see the two reviews of my ex-patient’s book—“The Mathematician and the Teddy Bear” by Sara Field--on Amazon:

1)    “The author describes how they feel about an experience, but without saying anything about the experience itself. I couldn't find anything that would help anyone who read the book with their own therapy. Contrary to the title, she was besotted by her therapist within the first month, and went on for 9 years at up to 5 meetings a week, for around $170,000 for 1353 sessions. Vanity publishing.”

and

2)   “I read this in two days, which is pretty unusual for me. It was gripping. It was like witnessing the birth of a person -- something the author suggests was happening. At first I was skeptical. Why is this person seeing a therapist 5 days a week and spending so much money? But I quickly became convinced of the authenticity of the need. It was necessary for there to be that much time spent in the basement with a therapist. Later I became convinced that the effort paid off. I could see the transformation taking place in the author's notes over the years. I think this is one book that I will think of often and use in my own life.”

I’m sure that at least 99% of people in the world would “listen” to what my patient wrote in the same way as # 1.  In fact, the only comment I received from my friends who read it was that the book was “creepy.”  And yet, # 2 “listened” accurately and empathically and saw that the “out-of-the-box” attachment therapy was necessary and allowed the person to finally have a life for which she remains most grateful.

Again, the lesson is:  the vast majority of human beings cannot listen accurately to another person’s inner experience.  They feed it into their own “systems” and then respond accordingly, thinking they’re being helpful.  The result is a world filled with both fiction and “aloneness.” As I wrote in my book, I have spent my entire life/career trying, as best I could, to address this problem.  And I thank all of the message board participants for helping me!

Richard