Is Anybody Listening?
A colleague just sent me a great op-ed written by Richard Friedman which appeared in the NY Times this past weekend. (http://nyti.ms/1SABga0). His arguments are spot-on, we woefully underfund psychotherapy research, and have put all of our eggs in understanding the brain and using medication – and as Friedman so beautifully puts it “the brain….won’t give up its secrets easily.” In our lifetimes, there will be no insta-cure that will help us manage mental illness or distress.
We have come a long way in the world of psychotherapy. What was once viewed with tremendous suspicion, is now a bit more acceptable (but just a bit, people are still a hell of a lot more likely to share with you that they have a personal trainer than that they have a psychologist). However, research presented in the American Journal of Psychiatry reveals that only about 3-4% of the population is in psychotherapy. Nearly 60% of mental health visits involve medication only.
Where mental wellness is concerned, just as with most things – we want a quick fix.
The utility of psychotherapy is far reaching – it’s not just a place to “vent” – but also a place to develop problem solving skills, coping strategies, interpersonal skills, and receive informed feedback. The research is clear- it works, and has far better long-term impact than medication alone. Optimally, therapy is non-judgmental, and a place to experience unconditional regard and support as you traverse crises old and new. The waning interest in wanting to understand psychotherapy, as evidenced by the unwillingness of insurers to reimburse for it and research dollars to fund is particularly troubling at a time in history when nobody is listening.
As we become a more technologically dependent society – maintaining the illusion of connection via smartphones, social media and 24 hour access – we actually believe we are being heard. And as the demands of modern life sink in – financial struggles, work stress, interpersonal stress, the stuff of life, and 24 hour workdays – we often turn to these empty platforms wanting to be heard. All the time I observe people on the phone with people, while at the same time checking Instagram on their tablet. They are not listening. I see people out to dinner, checking their phones instead of talking to each other. And when one is talking, the other is scrolling through his phone. They are not listening.
Listening is curative in its own right. To be heard, to be understood, to experience empathy – there is no pill that can do that. I have found in my practice that many times just a few weeks is enough for someone to feel “heard”, to have a sounding board, to shut out the world and focus for an hour, and then manage the crisis at hand with new vigor. In an increasingly narcissistic world, nobody is listening – instead everybody is posting. It’s a one way road – all talk, no hear.
When I trained as a therapist, we still had phones that had dials on them, and used payphones to call a friend from campus. A tablet or a smartphone was not even fathomable. People had to talk to each other in person, and being heard was built into the fabric of life. Interestingly, despite our device soaked world I don’t feel that I am any more productive now than I was as a graduate student, I am just more convenienced. That convenience comes at a cost, and most of us are now more careless and less attentive.
I have similar conversations in therapy with my patients now as I did then, (though if you had told me back when I was in graduate school that I would be dealing with “virtual” cheating with my therapy patients I would have looked at you and your tin foil hat rather quizzically). The difference is that 45 minutes of powering down, of being heard without any distraction, of doing just one thing – is now so unusual, that I wonder if those elements of therapy may be more powerful now than they were once upon a time. Perhaps I am making my living charging for what was once given more often for free from those around us, and that has increased its value immeasurably. Research be damned, when therapy works, it is equal parts magic, mysticism, and science. It’s hard to quantify magic. Perhaps the magic is simply the mirror and the comfort of being heard.
Nobody is listening any more – I spent years learning how to listen.
Little did I know, that much like baking bread I was being trained in a dying art.
But one which we need. Now more than ever.