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Shrinks are Partisan Morons: A Comment on the Treatment of Nightmares

Posted Jul 30 2010 7:34am

There’s an article in a recent edition of the New York Times that discusses a relatively new approach to treating distressing, recurrent nightmares. You can read that piece here to learn more about this treatment technique. In short, it teaches patients to script their own healthy dreams while in a waking state, and when people engage in conscious imagery of anxiety-provoking visuals and resolve them in a positive manner, evidence suggests they are able to change the nightmares experienced during the sleep state.

As I pointed out here , the Shrink World can never accept something that benefits people if it doesn’t suit its personal agenda or mode of practice. The aforementioned techniques are promoted by those who are known as Cognitive-Behavioral Therapists, those who often practice with a “here and now,” pragmatic approach that is focused on symptom relief. Freudian therapists, on the other hand, are more interested in subconscious conflicts that drive neuroses. While they are not against the alleviation of symptoms, their goal is to delve into the psyche in hopes of greater personal understanding.

To that end, Freudian analysts are not in favor of “changing the image,” mainly based on Freud’s belief that dreams are the royal road the unconscious. They assert that there is much to be learned from these dreams, regardless of the fear and anxiety produced, and that’s it’s imperative to understand these experiences, rather than simply altering them. This is not an unfair assertion – and the study doesn’t suggest that the program is successful with every person – although it is in sharp contrast to the Cognitive-Behavioral therapists who promote a more immediate improvement to mental health.

While these hard-core practitioners battle about this topic, let me pose to them one simple question: why not have the best of both worlds? If there is inherent value in each theory, then instead of taking a “my puristapproach is the best and therefore is always correct,” why not use both approaches. In other words, simply engage the patient in doing his/her best in understanding what these dreams are about, thenteach skills to help change what is troubling him/her?

A practitioner is not required to pick one approach or the other. This was my thesis when I bashed the “anti-medication” people. This is not a “one size fits all” field, no matter how badly some of my colleagues want it to be. That’s why you need to stab purists – as opposed to those who practice from an eclectic approach – in the chest with a wooden stake as if they were something seen on True Blood. They just don’t get the notion that no singular treatment modality can benefit everyone, and therefore end up forcing patients into a box of rigidity that doesn’t actually serve the patient, but rather the therapists personal need to follow through with what he/she perceives as correct in all situations. These practitioners counter my position with statements such as “but that isn’t congruent with my theory of personality,” and “that’s not how I work,” but ignoring useful data seen in the Times article isn’t only stupid, it’s negligent.

So as these two camps go war, insisting that everyone needs to think like they do, think about what other group this reminds you of. If you said “the bipartisan U.S. Congress,” you’d be right. And given that this government is basically BFF’s with everyone and overflowing with fans on Facebook for their superior ability to put their own agendas aside and come to reasonable agreements, maybe my colleagues might give this post a little thought. Or, more likely, simply continue to sit in their posh offices or ivory towers and keep telling themselves they are right, no matter what data comes their way. Either way, they’re fools, and feel free to say so at your next session.

Note: This post was written on my brand new, 21” IMac while I jammed to Led Zeppelin’s “The Song Remains the Same” on its killer speakers. I’m pretty sure this computer could tear apart an unabridged dictionary with its bare hands and score with dozens of lingerie models if it wanted to. It’s just that awesome.

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