I’ve never been enthusiastic about categories, whether aligning myself with a particular therapeutic approach or assigning a diagnostic label to a client. Any order achieved seemed to come at the expense of freedom and possibility.
Lately, however, I’ve found myself feeling an affinity for a particular classification scheme. Maybe its my age. In July, I turn 65. On that birthday, I will have worked as a psychologist for longer than I had been alive when I entered the profession! And according to psychoanalyst Erik Erikson — a person whose work I’ve not thought about since my undergraduate days — that puts me at the doorstep of the eighth, and last stage of psychosocial development: integrity versus despair.
I’d forgotten Erikson coined the term, “identity crisis.” It was central to his theory of personal growth. The nature of the dilemma one faced was different at each stage. Successful resolution led to the development of character strengths a person could use to manage life and circumstance; failure, to an unhealthy sense of self and reduced capacity for fulfillment.
From the time I first heard them, Erickson’s “stages” had struck me as similar to a horoscope. You know, statements that feel personalized and specific but in fact are so vague and general they apply to everyone. That said, with fewer years of my professional life ahead of me than behind, that last stage had started speaking to me. More and more, I found myself thinking about where we were as a field, if we had made any progress and could feel proud of our work?
The challenges were stark, and frankly overwhelming. To name a few:
*An unprecedented rise in the number of people suffering from mental and emotional problems;
*No improvement in the outcome of psychotherapy over the last 50 years;
*No evidence that traditional training models or clinical experience (e.g., diagnostic specific treatments, ongoing supervision, licensing, mandated continuing education) contributes to clinician effectiveness despite widespread belief and regulation to the contrary.
Erikson maintained that each person must learn how to hold both extremes of each specific life-stage challenge in tension with one another, not rejecting one end of the tension or the other. How, I wondered, could anyone not give into despair in light of the facts noted above?
That’s when I reached out to my longtime, colleague, mentor and friend, Dr. Bruce Wampold. Together, we confront the the present and future state of psychotherapy research and practice. Should we feel discouraged or hopeful? Listen for yourself.
Until next time,
Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence
P.S.: Registration for the upcoming FIT Supervision intensive is open. It’s one of the courses required for certification as a FIT practitioner and trainer. Join colleagues from around the world to learn the approach shown to improve individual clinician outcomes.