“Exposure!” a choir of professional voices sings, “its the only proven way.”
“No, no,” others insist, “You can tap yourself to emotional freedom.”
“Poppycock!” another group jumps in, “Horizontal saccadic eye movements are the ticket!”
“Beware the dominant discourse,” a few, particularly literate warn, “focusing on what was done to the person can retraumatize, help them reauthor their experiences instead.”
Meanwhile, a smaller and less vocal group shakes their heads in disbelief, saying, “There are no shortcuts. Healing comes only from identifying and ‘working through’ painful unconscious feelings.”
Turning to the research to answer the question–what heals trauma?”–offers little clarity. Advocates of most approaches can offer evidence that their preferred approach works–at least one study, and often more, many more–a fact all should find puzzling. Simply put, how could all approaches work, given they offer competing and often contradictory explanations and techniques? And yet, no consistent superiority of one particular approach over others is exactly what the latest dismantling and meta-analytic studies show (1, 2, 3, 4, 5, 6, 7).
When attempting to account for why all approaches work equally well, the most common argument made is that different models work for different people. Said another way, what may be effective in the aggregate may not work for the individual. “Choice is key,” advocates of this position assert.
More recently, and perhaps in response to the continuing failure to find any meaningful difference in outcome between treatment methods, it has become popular to talk of a set of “mechanistically transdiagnostic…therapeutic strategies…[targeting] the role of a given mechanism in the development and maintenance of a range of psychopathology.” Ironically, the call for a “universal treatment protocol,” is the “go to” position of those who once advocated for the creation of officially sanctioned lists of specific treatments for specific disorders.
So, which explanation holds water? Here again, the empirical evidence offers little clarity. What is important, however, is that these two, diametrically opposed perspectives share a common assumption: healing results from the appropriate application of the right treatment methods.
But what if that’s not true? What if therapeutic techniques–whether specific to a given model or shared by all–have no inherent power to heal? Where would that leave us as a profession? Does it mean that our methods are the therapeutic equivalent of Dumbo’s magic feather?
“A great deal changes, in terms of our ability to help and heal,” psychologist Stephen Bacon suggests, “if we embrace what the research indicates. Psychotherapy, as a science, is not like engineering. It operates in a different reality.”
Recently, I had a chance to interview Stephen about his work, and new, thought-provoking, and imminently practical book, Practicing Psychotherapy in a Constructed Reality: Ritual, Charisma, and Enhanced Client Outcomes.
As you’ll see, he’s a very interesting person–six years in an ashram, a neighbor and student of Krishnamurti, a degree in religious studies, and more. For me, the “enhanced client outcomes” referenced in the title immediately got my attention. Wait until you have 30, uninterrupted minutes available, as the interview is one of my longer, and you will want to watch every minute.
Until next time,
Scott
Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence
