I know many people, friends and family members, who have been in therapy for over three decades, for which they have produced no discernible change, no effective result that justifies the time and money spent being analyzed. And yet these individuals keep writing checks to their therapists and sniffling into their tissues as they rehash childhood traumas for the umpteenth time. In the face of overwhelming evidence that they have received no worthwhile benefits from talking to their shrink, their dogged determination to stay in therapy begs the question: Why? The answer is not a flattering one, to be sure, but necessary if we are to understand the underlying motive of the therapy patient. The real purpose of therapy is to indulge the patient’s appetite for talking about himself, with the zeal of an exhibitionist, not only to his therapist but to everyone, strangers and intimates alike. In other words, the therapy patient is a gasbag. His grotesque exhibitionism is encouraged by therapeutic dogma that would have the patient believe his recovery is contingent on his willingness to divulge his darkest secrets to the public. The patient’s confession, according to therapeutic orthodoxy, empowers him because he is no longer running away from the demons that haunt him. He is confronting his demons head-on and in the process cleansing his psyche through his fearless ongoing purgation. If we accept the premise that therapy provides at best marginal benefits while being, at close to $150 an hour, an expensive pursuit, we can conclude that therapy, as a business model, targets well-to-do, narcissistic gasbags who find in therapy justification for their compulsion to talk about themselves all the time to all people at any place and in any circumstance. We can further conclude that if we were to take away the world’s gasbags who enjoy a deep reserve of discretionary income, psychotherapy, as we currently know it, would cease to exist. Unfortunately, there is no such shortage of gasbags who are eager to find in therapy a way to give their urge to talk about themselves validity. The shrewd, entrepreneurial therapist knows that giving the gasbag a rationale for talking about himself will keep the gasbag patient satisfied with the therapist’s service. Therefore, the therapist who wishes to enjoy a lucrative career would be wise to study those principles that help encourage the gasbag’s proclivity for making himself the center of discussion. The first principle the aspiring therapist must grasp is that the patient, eager to reveal his most salacious secrets to all, must have the therapist’s assurance that there is nothing too grotesque or shameful for public consumption. To the contrary, it is the therapist’s job to indoctrinate his patient with the belief that the more scandalous the patient’s revelations, the more worthy they are for public viewing. The Nothing-Too-Shameful Doctrine is well described in Wendy Kaminer’s book-length critique of recovery and self-help movements I'm Dysfunctional, You're Dysfunctional. One of her criticisms is that people in recovery who meet in support groups don’t achieve any real intimacy or community. Instead, they are all trying to outdo the other in a sort of victimization competition where the so-called recovery patients embark on a confession-fest, the more lurid and revolting the details the better chance they have of winning center stage. In some cases, if the gasbag is dramatic enough, he can enjoy visibility on a day-time television talk show. What these recovering gasbags are aspiring towards, Kaminer suggests, is a sort of quasi celebrity: On talk shows, ordinary people, subject of tomorrow’s scholars, find their voice. Men and mostly women distinguished only by various and weird infidelities or histories of drug abuse and overeating get equal time with movie actors, soap stars, and the occasional hair stylist. Now everyone can hope for sixty minutes of fame, minus some time for commercials. The aspiring therapist would be wise to heed Kaminer’s observation that for many, the appeal of therapy is to jumpstart one’s career in acting, to become a spokesperson for some cause or other, or to simply enjoy celebrity-scale visibility. Therefore, the successful therapist must understand that he is not so much a therapist as he is an acting coach or an entertainment manager. Making his patient more entertaining is the second principle the aspiring therapist must grasp. Many therapists will scoff at this notion. They will say that their patients don’t need to be entertaining. What they need is positive change. This is an erroneous assumption. The patient is in fact not at all interested in change. What he desires above all is to be more of the self-centered bore he already is. One tool that the successful therapist knows is effective in his patient’s quest for self-promotion is the fluent knowledge of pretentious psychological jargon so that the patient can use his newly-acquired language at cocktail parties and other venues where he will have a beholden audience. The cunning therapist will therefore during therapy dole out a grandiloquent linguistic bouillabaisse, not only of standard psychological terms borrowed from Carl Jung and Sigmund Freud, but comprised of the fashionable German philosopher Friedrich Nietzsche. A therapist’s cheat sheet or lexicon that he will have taped to his sleeve will include the following: catharsis, collective unconscious, Dionysian, ennui, hubris, hypermasculinity, megacognitive, metamorphosis, nihilistic, Oedipal, pathos, scatological, schism, stream of consciousness, succubus, synchronicity, thanatos, transpersonal, Weltanschauung, Weltschmerz, Ubermensch, Zeitgeist. Once the patient becomes fluent with the above lexicon, the therapist can be confident his patient will insert the above terms every opportunity he can and that some listeners, envious of the patient’s seemingly esoteric knowledge, will ask the patient for the name and phone number of his therapist so that the envious listener, too, can undergo the rigors of therapy and in turn enjoy the pleasures of a being a pretentious bore. Another benefit from learning an esoteric vocabulary is that the patient, like the therapist, can use big words to couch obvious and self-evident observations about the psychoanalytical process. Inflating his “recovery journey” with fancy jargon is necessary so that the patient and the therapist are less inclined to see the truth of their endeavor, which is that what they’re doing is vapid and inane. Wendy Kaminer points out in her book that many therapists and self-help gurus are “more like superfluous consultants, mystifying the obvious in jargon and italics to justify their jobs.” To further add to the therapist’s arsenal of lame jargon, he would be well advised to write a self-help book so that the patient can consult the book for even more in-depth fatuities about the “healing process.” Another way the therapist can make the patient feel remarkably important is to write down the patient’s dreams and to claim that the dreams are so original and so poignant that the therapist would really love, with the patient’s permission, to publish the dreams, in all their surrealistic detail, in one of his books. The idea that the patient’s dreams will be published in the context of some fashionable psychological movement or other will make the patient feel that he is part of history and that his dreams, as case studies, will be poured over and scrutinized by psychologists, professors, and students of psychology for decades to come. Eventually, the patient’s dreams will become as familiar as Pavlov’s dog. Titillating the patient with these celebrity possibilities will bolster his confidence as a gasbag who is entitled to enlighten others with his unflinching confessions. Another effective way to embolden the recovering gasbag is for the therapist to indoctrinate his patient with the belief that therapy makes him more sensitive and morally superior to those who are not in therapy. To accomplish this, the therapist must convince his patient that therapy is a heroic journey complete with the slaying of dragons (exorcising one’s inner demons) and the acquisition of the Holy Grail (the attainment of serenity, wisdom, and equanimity). This heroic journey is not limited to neurotics and recovering addicts. It is a journey that all responsible citizens must undertake and it is the recovering gasbag’s obligation to spread the way of his serenity to others. As an enlightened patient, he must now go on a crusade based on his newly-found moral authority. It is an authority, Kaminer tells us, not based on research or science but of experience. Therefore the aspiring psychologist would be wise to teach his patient that his personal experience is the bedrock truth from which all other empirical evidence is measured. That empirical evidence contradicts the claims of therapy should be concealed by the therapist who must not let his patient know the frightening truth about therapy, which is that self-rumination overemphasizes the self to the point that it is an absurd exercise in excessive naval-gazing. To sink deeper into his bottomless abyss of self-absorption, the patient accrues more and more tools to analyze his “condition.” He develops a sophisticated language to define who he is to himself and to others. He learns how to interpret his dreams, how to hug himself, how to give himself a self-esteem lollipop whenever his feelings are hurt or whenever he’s feeling rejected. And as he turns more and more inward, the world around him disintegrates and fragments into millions and millions of self-absorbed islands of self. Psychologist James Hillman and writer Michael Ventura have collaborated to write a book that addresses this relationship between the “healing self” and the fallen world outside that self. The book appropriately is titled We've Had a Hundred Years of Psychotherapy and the World's Getting Worse. Hillman observes that “We’ve had a hundred years of analysis, and people are getting more and more sensitive, and the world is getting worse and worse. . . . We’re working on our relationships constantly, and our feeling and reflections, but look what’s left out of that.” He answers his own question. What’s left out, he writes, is a “deteriorating world.” Therapy hasn’t noticed its failure to address the “deteriorating world, ” he writes, “Because psychotherapy is only working on that ‘inside’ soul. By removing the soul from the world and not recognizing that the soul is also in the world, psychotherapy can’t do the job anymore. The buildings are sick, the institutions are sick, the banking system’s sick, the schools, the streets—the sickness is out there.” The aspiring therapist will know that his patient doesn’t want to focus on what is “out there.” He wishes to turn inward and to be the sole focus of the discussion. He is after all the gasbag for whom the therapist is the helium tank forever infusing his patient with the inflated self-importance he demands.
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