#GatheredWisdom

#MentalHealth

In my opinion, very relevant to the gross over-reliance on CBT (cognitive-behavioral therapy) as the “end-all, be-all” of “evidence based” mental health treatment (especially when “workbook” based):

“As we identify one critical element in our technique and take delight in learning more about it, we lose elements which we practiced intuitively.”

J. P. Gustafson quoted in “Forms of Brief Therapy” 1981

24#

#GatheredWisdom

#MentalHealth

"The capacity to leave familiar ground and to stand uncertainty is precisely a quality so frequently missing in individuals who may on first sight appear intelligent and capable of understanding but who, upon further investigation, reveal that whatever natural potential is at their disposal is put into the service of avoiding the new, the unexpected and the unfamiliar.”

Edwin Singer Key Concepts of Psychotherapy 1965

23#

#GatheredWisdom

“Nothing harms science more than the denial or trivialization of enigma: though the prudence of the sensible man is to be surprised by nothing, the power of the tinker is to be surprised by everything.

Roberto M Unger Am J Psychiatry February 1982

22#

#GatheredWisdom
#MentalHealth

“…the term ‘unconscious’ is not limited to meaning that ideas & emotions have vanished from consciousness; it may mean the connections between elements previously belonging together have been severed; the elements remain isolated in the mind... affect may be separated from ideas & ideas themselves may be divided into component parts [losing cohesiveness & context].”

H Nunberg "The Synthesis Function of the Ego"
Intern J Psychoanalysis 12: 123-140 1931
21#

#GatheredWisdom
#MentalHealth

“…the term ‘unconscious’ is not limited to meaning that ideas & emotions have vanished from consciousness; it may mean the connections between elements previously belonging together have been severed; the elements remain isolated in the mind... affect may be separated from ideas & ideas themselves may be divided into component parts [losing cohesiveness & context].”

H Nunberg "The Synthesis Function of the Ego"
Intern J Psychoanalysis 12: 123-140 1931
21#

#GatheredWisdom

#MentalHealth #Freedom

“One tries to evade freedom to avoid noxious knowledge… To abandon freedom… is so tempting because in the final analysis it absolves one of responsibility.”

Edwin Singer
Key Concepts of Psychotherapy 1965

20#

#GatheredWisdom
#MentalHealth #Uncertainty

From my good friend and colleague Harold, et al

https://www.americanbioethics.org/who-we-are/harold-j-bursztajn-m-d-president/

“We are all, to some degree or other, afraid of uncertainty. Because our conception of ‘rationality’ is grounded in the ‘Mechanistic Paradigm’ that has no place for uncertainty, we find it difficult to be rational about uncertainty. Instead… we become anxious – most of all when our lives are on the line…

19a->

#GatheredWisdom

#MentalHealth

“…Very vigorous defensive processes [necessary] in the past… become dissociated from original situations… developed into permanent character traits; the ‘armor plating’ of character.”

Anna Freud
“The Ego and the Mechanisms of Defense” p33 1936 18#

#GatheredWisdom

#MentalHealth
#Psychotherapy
(from 1982 but IMO, applicable to the current reliance on CBT)

“We expect there to be an immediate & well-defined homology between the causes of a disorder & its manifestation in the structure of behavior & cognition… But the principle of homology [deriving from a common predecessor] may apply only at a level far deeper than we suspect.”

Roberto Mangabeira Unger
“A Program for Late 20th Century Psychiatry
Am J Psych 139:2 February 1982 17#

#GatheredWisdom

#MentalHealth Psychotherapy

Another quote from “Models for Clinical Pathology” 1981

“…[in] the practical case, the distinction between cause and meaning as terms by which to characterize [psychotherapy]… is essentially a distinction without a difference.”

W.E. Fordyce

https://www.cambridge.org/core/journals/psychological-medicine/article/abs/models-for-clinical-psychopathology-edited-by-c-eisdorfer-d-cohen-a-kleinman-and-p-maxim-pp-280-illustrated-1475-mtp-press-lancaster-1981/884B4337C6420A4BBD1DA80CD01AE581

16#

#GatheredWisdom
#MentalHealth

“The process of evaluating the significance of a transaction for one’s wellbeing… come in 3 forms… 1-irrelevant; 2-benign/positive; 3-stessful. There are 3 subtypes of stressful appraisals: 1-harm/loss; 2-threat; 3-challenge. Harm/loss: injury or damage already done… Threat: injuries not yet occurred, but anticipated. Challenge means an opportunity for growth, mastery or gain."

Richard Lazarus
“Models for Clinical Pathology” 1981

https://www.cambridge.org/core/journals/psychological-medicine/article/abs/models-for-clinical-psychopathology-edited-by-c-eisdorfer-d-cohen-a-kleinman-and-p-maxim-pp-280-illustrated-1475-mtp-press-lancaster-1981/884B4337C6420A4BBD1DA80CD01AE581

15#

#GatheredWisdom

#Mental Health from 1950:

“Is [mental] health a natural state of equilibrium? Do processes exist in the mind which, if unhampered & undisturbed, would lead development toward equilibrium? Or is health the result of a luck chance, a rare or even improbable event, the reasons being that it’s conditions are so stringent & so numerous that the chances are very heavily weighed against it?”

Michael Baline “On the Termination of Analysis” Inter J of PsyAnalysis 31:196-199 1950 14#

#GatheredWisdom

"[Psychiatry’s] …tendency is to hesitate between two unwise responses toward its own major problems. There is an attitude of obsessional sectarianism that fixes on one well-established perspective [biochemical, psychodynamic, cognitive-behavioral]… and then disregards or downplays the insights that are not readily assimilable to it... 13a ->

#GatheredWisdom
Another 40-year-old article – never in history irrelevant but even more relevant today:

“We have, in large measure, been morally neutralized, robbed of the capacity for appropriate reaction. That, of course, has a lot to do with the sheer volume of stupidity, both malignant and benign, with which we are faced daily. 12a ->

#GatheredWisdom

(I haven’t posted one of these for a while due to various distractions. Back at it – I hope of interest to some)

This quote goes back over 40 years, but remains relevant (frequently given lip-service; often unimplemented – EMPHASIS mine):

“With increasingly rare exceptions, it has been impossible to control illnesses without construing them in their biological, psychological and sociological contexts…
11a ->

#GatheredWisdom

As individual therapists working with individual people, progress is often made. As a society, I’m neither sure of progress nor particularly optimistic

“The fundamental and optimistic notion concerning human nature upon which the idea of psychotherapy is based: the image of humans being capable of being/becoming free to understand and to make responsible choices on the basis of knowledge… 10a->

#GatheredWisdom

Perhaps can be extrapolated to how #ConspiracyTheories can be built up from breaking down reality into (truly existing) component parts that are then re-combined in an irrational manner that has no actual connection to the reality that has been de-constructed:

“There is no natural mapping from the individual letters into the real world. The natural [realistic] mapping occurs on a higher level, between works and parts of the real world. If you want to describe a book…

9a ->

#GatheredWisdom

Relevant to the (all too common) denial of reality/rationality [bracketed comments mine]:

“To the degree to which an individual must constantly guard against development of potentially threatening inner states… (one) is forced to exclude perception of outer stimuli [i.e. EXCLUDE reality and/or logical/rationality] in order to prevent triggering recognition of inner tendencies [threatening internal mental/emotional experiences].”

Edwin Singer Concepts of Psychotherapy 1965
8#

#GatheredWisdom

Focusing on the deep complexities of human behavior, one must never lose sight of understanding the contribution of the most basic needs and drives:

“Although little is mentioned about drive in the formal statement of behaviorist theory, it is implicit in the experimental manipulation…

7/a ->

#GatheredWisdom

Brief and pithy

(Albeit the original 1975 terms [in brackets] are now recognized to carry unacceptable social/racial implications; substitutions of words are mine)

“Theory: a useful [servant] employee; a bad [master] executive.”

Harry Guntrip

My Experiences of Analysis with Fairbairn and Winnicott
International Review of Psychoanalysis 2, 145 1975

6#