23 January 2011

The Gloria tapes

In 1965 a patient ("Gloria") participated in a teaching film with three world-renowned psychotherapists: Carl Rogers, Albert Ellis, and Fritz Perls. She was a young divorced mother and volunteered her problems with parenting and dating to the scrutiny of these three fellows and their three psychotherapy techniques: Client-centered Therapy, Rational Emotive Therapy, and Gestalt Therapy. The film Three Approaches to Psychotherapy has been shown to thousands of psychology students. I don't know what the copyright status is, but last week I watched all three of the thirty minute experiments on youtube.

The lesson is intended at the most superficial level, as nobody expects anything transformational to be possible in one thirty-minute session. Nevertheless, the film is informative. I have all of these fellows in my library and have studied them off and on for many years. This was the first time I had seen any of them in action and it was really great to have them working with one common patient.

Rogers is the one who I have had the least regard for. He is best known for a method of working with patients, not for any specific ideology of mental function or malfunction. He said the most important factor in a successful patient outcome is the nature of the relationship formed between patient and therapist. An oft-quoted quip is that it is "the relationship that heals." And his recipe for the therapist to form this healing relationship is to treat the patient with unconditional positive regard. The patient may suffer from guilt; the patient may judge their self harshly, but for the therapy to work the therapist would best consider their task to defuse all guilt and all negative self-judgment present in the patient's thought and action.

Considering where psychotherapy as an art was when Rogers began his work in the middle of the twentieth century, I can sort of see how this could have been a refreshing and useful tack. In 2011 this looks to be less useful to me. This is an attitude which may have been a big component in the self-esteem fashion that was so prevalent in the generation after Rogers. Optimism and Up With People and all that certainly has a place, but if the patient is so great, then what are they hiring a psychotherapist for? Rogers' method has a logical contradiction at its heart. These are ideas I had before watching the Gloria tapes, and there was nothing in Rogers' interview with Gloria which changed my mind.

Ellis is really the star of these tapes, and mainstream psychotherapy today in the United States really is the product of Ellis (on the psychology side) and his peer Aaron Beck (on the psychiatry side). Beck used almost exactly the same ideas, and he referred to his technique as Cognitive Behavioral Therapy. I am sure the doctors of Psychology and Psychiatry have all their arcane small differences, but in my limited understanding Cognitive Behavioral Therapy and Rational Emotive Therapy are identical. If I woke up with a mental health problem tomorrow requiring professional help, I would look for one of these guys.

In the Gloria tape Ellis does his straight Rational Emotive Therapy schtick, but it looks to me like it is a little much for her. He is trying to ram a lot of information into his thirty minute allotment, and he is talking fast, and I had a hard time following it all. Since I have read his books and knew all this stuff, I can only imagine what it must have been like for the poor patient trying to keep up with the guy. At a couple of points in the tape, it is obvious that he is a little stressed at why this seems to be taking so long; that is poor practical psychotherapy despite the sound theoretical underpinnings. In the session summary after, Ellis states that he was sorry that he tried to do so much and that it probably would have been more helpful to Gloria if he had tried to do less.

This is exactly the dimension in which Perls managed to work effectively in spite of the thirty minute limitation and in spite of his having an inferior therapy theory. Although Gestalt Psychotherapy was once one of the most promising techniques, it has largely fallen into disfavor amongst professionals. I do not know why that is, because my experiences with it have included a number of important personal discoveries for myself about myself. (See here for example.) One distinct disadvantage it has is the quality of the written source material. Beck and Ellis wrote fabulous books, and I have yet to find one excellent book on Gestalt therapy.

(The best Beck book. The best Ellis book.)

With Gloria, Perls sticks to very simple questions and observations. The only thing which I can distinctly recall from all three of the tapes is an observation that Perls makes. Gloria says she is afraid, and Fritz says to her: "you say you feel afraid, and yet you are smiling. Do you know why that is? People who are afraid usually do not smile."

Yet it just so happens to be true that people who are afraid (especially women who are afraid) often do smile. Do you know why that is? I would love to know why that is. I am pretty sure Fritz was aware that women who are afraid often do, inexplicably, smile. If Gloria left her interview with Fritz and thought long and hard about that excellent question, I would bet she got a great deal out of that thirty minute interview.

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About Craig

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Houston, Texas, United States
I have been living in the lovely neighborhood of Spring Branch in the great city of Houston since late in 2005. I started out with the idea of making this blog about my life in this neighborhood. That did not last long. Right now I am posting every five days on the alternating topics of literature, philosophy, psychology, and metaphysics. This project has been ongoing since July 27, 2010 and I believe it will continue for at least a few more months.