A Plan for Unifying Psychotherapy

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The date has greater significance, in that the idea of unifying psychotherapy schools based on understanding how they work is beginning to take hold.

A lively debate has been taking place on the Listserv of SEPI, the Society for the Exploration of Psychotherapy Integration. What’s remarkable is that we all pretty-much agree on what I have been writing about, a basic understanding of the infrastructure that explains the action of all therapies. However, there is still a reluctance actually to join hands and quit fussing about our differences. Here is a response I wrote explaining why I think leaders from various camps need to “loosen up” and how that can enable moving towards one therapy with multiple techniques and useful conceptualizations.

So right, Marv! [Marvin Goldfried, PhD, one of the founders of SEPI, who has asked why many of the most influential supporters of psychotherapy can’t seem to get together.]

That’s the big question. Perhaps I can shed some light. I think those with the most influence have been steeped in certain aspects of their favorite school of thought, and need to loosen up. What do you all think? My own background was originally psychodynamic, so I’ll start there.

1. Psychodynamic people have a taboo against telling clients what to do, that is, focusing on behavior. I disagree for two reasons. 1.) PP [Predictive Processing] and MR [Memory Reconsolidation] tell us that clients need to have a newer, better pattern from which to re-program schemas for automatic deployment. Learning new patterns and adapting old ones takes practice and work, made less scary by common factors adding up to a trusting relationship. Therapists can and should help out and support this type of new learning. The old fear of infantilization is real, but with awareness, can easily be worked with. It doesn’t require a blanket prohibition. And 2.) Adopting new behaviors is one of the most powerful ways to send nonverbal disconfirming information to the subcortical places where schemas mainly reside. Anyone who has tried adopting a new posture or way of dressing has experienced the power this has on the inner mind. In my early career, working with addictions, I quickly learned that paying attention to behavior is crucial if one is to be effective. Wilhelm Reich thought so, too!

2. Behaviorally oriented people, if they want to publish, are discouraged from mentioning nonconscious information processing. Perhaps I’m exaggerating, but the bias is real and results in a rich source of indirect knowledge being left aside. It is true that in everyday life, it is hard to make a sharp dividing line between automatic, unconscious, Type 1 thinking (related to “thinking fast”) and Type 2 thinking. However, in our world, where old patterns become frozen in time and change is treated (consciously and unconsciously) as a threat, the two become dis-associated and separate. PP and MR do their work mostly automatically and outside of consciousness with some awareness trickling into our conscious processes. It would be a great help for the behavioral world to open its arms to the reality of automatic, survival-oriented processes that are not under conscious control, but can be influenced consciously by changes in thinking and behavior, as Ecker has laid out in detail. Once we recognize that the two modes of processing are different, the two-way paths between the subcortical mind and consciousness are very interesting and worthy of study

3. Finally, experiential therapists have a long tradition of focusing on the nonverbal, which is the native language of nonconscous information processing. They could take a more lively interest in the underlying mechanisms without losing sight of the richness of the nonverbal world. For a start, without much oversimplification, PP is a sophisticated form of pattern recognition that operates iteratively on multiple levels of abstraction at once. That’s how the subcortical mind recognizes and mis-recognizes the meaning of what the senses bring in and how it matches meaning with patterns of response. And the value of understanding MR is that it’s known requirements, as documented by Ecker, point towards what we need to do clinically, and what experiential therapy is especially good at: Awaken (neurologically activate) the old pattern, and supply a disconfirming nonverbal experience. This is also known as “changing emotion with emotion.”

So let’s follow Marv’s call. By letting go of historical reluctances, we will all be better therapists, as well as moving beyond the pre-paradigmatic phase into “normal science” where theory precedes data and data tests theory.”

Jeffery Smith MD