Watching Psychotherapy

by Ed Meidenbauer

Two people talking: picture this activity, and you will easily come up with an image of psychotherapy. Conversation between two people is a basic human activity. Psychotherapy, to the casual observer, looks like two people talking.  It’s been nicknamed “talk therapy” with good reason, but is talk all there is to it?

Whether or not they have actually been to a therapist, most people have a mental image of psychotherapy due in large part to its portrayal in movies and TV shows. Examples of therapy in popular media tend to heighten the drama of therapy for the sake of the plot. This may be done by stressing the personal dilemmas of the therapists themselves or by featuring clients with extraordinarily memorable presenting problems. Is this truly what psychotherapy is about?

APA Books publishes therapy demonstrations on video—hundreds of hours of demonstrations that are used for training mental health professionals. After watching a number of these (or all of them, as I have), a broad overarching pattern emerges that, on the surface, seems simple but, in actuality, is quite profound. Most of these demonstrations show two people talking and include some fairly typical social questions (“How was your week?” “How are things going at work?” “So, can you tell me more about this project you are so excited about?”). These seem like parts of conversation you might hear every day until you realize that all of the questions are coming from one person 99% of the time, the therapist. Even when the therapist is not asking questions, his or her comments or statements always directly apply to the client. This is a major distinguishing feature of the psychotherapy interaction: The client is doing most of the talking, all of it is about him or herself, usually with hardly a question for the therapist. The strangely imbalanced way these two people are talking is at the core of psychotherapy. In no other type of relationship is one person attending another so closely, so consistently, and for such a length of time.

Watching psychotherapy 2

A scene from a psychotherapy training video featuring Dr. Candice M. Monson and a client (portrayed by an actor).

Being listened to, and more important, feeling listened to, is a great experience, one that we can usually only expect regularly from significant others. In the non-therapeutic relationships we have–whether with a spouse, a best friend, girlfriend, or boyfriend–there is hopefully some give and take. Each person in a relationship has to do some of the listening sometimes and show caring and support to the other. In psychotherapy, such mutuality is not expected, and is even—by design—discouraged. The therapist generally maintains strict boundaries, and the psychotherapy relationship is built for the client’s benefit.

If this one-sided listening were the only feature of a psychotherapy interaction that made it differ from your average conversation, it would be unusual enough and would alone have a powerful effect on the client. But behind this one-sided interaction there is something else going on. Psychotherapists are educated in the intricacies of human relationships, the way the mind works, and how emotion, behavior, and general stressors of life can tangle up a person’s thinking. They have also been educated and trained to use a host of solutions to help the client. To the observer, these solutions may look simple—a question posed at just the right time, or a suggestion to try doing something differently—but they are usually the result of much training and research.

How do therapists learn to do this? It comes not just from years of study—learning the theories and interventions involved in psychotherapy—but also from hours of observing therapy before actually sitting down to talk with a client. In past years, student therapists would sit in on therapy sessions to learn how it is done. This is tricky: The dynamics of the delicate interactions I am describing would be affected by someone silently observing. However, over the past several decades, another way to watch and learn therapy has developed: Watching psychotherapy demonstration videos.

The APA Psychotherapy Video Series has more than 200 DVDs, and PsycTHERAPY® , a database product available for streaming, holds 400 psychotherapy training videos. Whereas the video series is available title-by-title and is ideal for individual training, PsycTHERAPY® is a subscription database, accessible through the APA PsycNET® platform.  It was developed to allow clinical students and faculty to observe how therapists use different approaches and techniques and to share clips of therapeutic interactions with one another.

To help students get the most from PsycTHERAPY, all subscribers are given access to a free book, The PsycTHERAPY® Teaching Guide, that features different ways to use the videos in everything from courses on psychopathology or personality theories to providing empathy training to teaching researchers to code psychotherapy sessions. Faculty at institutions with access to PsycTHERAPY® can download the book from the PsycTHERAPY® landing page. In January 2016, in addition to getting the download, faculty can also request a print version of the book, available for free to faculty at subscribing institutions; otherwise, available for sale.

Psychotherapy can be seen as a unique type of conversation between two people. APA Books produces videos and books to aid psychotherapists as they continue to have these healing interactions, so that they may help people lead happier, healthier lives.

 

What Is Wednesday: Rewards or Bribes?

Timothy McAdooby Timothy McAdoo

As any parent knows, the distinction between a reward and a bribe is both critical and hard to define. I may know it when I hear it, but if I hear myself offer a bribe, it’s already too late!

Rewards for KidsSound familiar? Rewards for Kids!, a multi-award-winning book by psychologist and child-development expert Virginia Shiller can help. Dr. Shiller’s book includes “how-to” instructions and 21 sample reward plans for parents. These address problems like bedtime procrastination, sleep disturbances, difficulties maintaining a schedule (e.g., to be ready for school on time), procrastination or avoidance of chores and homework, “establishing hassle-free hygiene,” and more. See more about the reward plans and charts in the table of contents.

So, what’s the distinction between a reward and a bribe? Timing, according to Dr. Shiller: She recommends rewarding 1–2-year-olds for good behavior immediately (or as soon as possible). Luckily, “smiles, clapping, cheers, and wacky antics are all it takes to thrill a toddler” (Shiller, n.d., para. 5). For kids 3 and older, rather than offering them a treat to get them to stop what they’re doing (a bribe), she says “offer rewards for good behavior before your child has a chance to misbehave” (Shiller, n.d., para. 11).

References

Shiller, V. (n.d.). The right way to bribe your child. Retrieved from http://www.parenting.com/article/the-right-way-to-bribe-your-child

Shiller, V. M. (2003). Rewards for kids! Ready-to-use charts & activities for positive parenting. http://www.apa.org/pubs/books/4441005.aspx

Darth Vader and Humanity’s Dark Side

David BeckerBy David Becker

Lord Voldemort, Hannibal Lecter, The Joker. Movies are filled with memorable villains who captivate us with their depictions of humanity’s most evil tendencies. Perhaps one of the most iconic villains of all is Darth Vader—more machine than man, twisted and evil, according to Obi Wan Kenobi. No doubt, Vader’s legacy will be seen in The Force Awakens, the newest addition to the Star Wars franchise that premiered in Los Angeles on December 14 and will appear in theatres nationwide on December 18.

Despite Darth Vader’s legacy as an icon of evil, his son, Luke Skywalker, believed there was still some good in him. In “Darth Vader, Carl Rogers, and Self-Organizing Wisdom,” Arthur Bohart’s chapter from Humanity’s Dark Side: Evil, Destructive Experience, and Psychotherapy, this recognition on Luke’s part is highlighted as a great example of the person-centered perspective in psychotherapy. Largely derived from the seminal work of Carl Rogers, the person-centered perspective acknowledges that no one is fundamentally good or evil. Rather, everyone has the capacity for both morally positive and negative actions. Whether an individual tends to be more or less moral overall can depend on one key motive: actualizing tendency.

Actualizing tendency, according to Bohart (2013), “is the tendency of the organism to maintain and enhance itself” (p. 59) and is influenced by that organism’s environment. Think of biological evolution and how a species will adapt genetic traits that are most favorable to its surroundings, thus increasing its likelihood to survive. Humans also adapt their thoughts and behaviors to their surroundings as a survival mechanism, but they can do so in morally positive or negative directions.

darth-327Carl Rogers saw the actualizing tendency as key component of person-centered therapy. He and the psychologists who have continued his work believe that everyone is capable of self-organizing wisdom, which is the ability to “adapt to life problems creatively and productively in a manner that takes into account the wishes and needs of others” (p. 63). In other words, people can create positive, prosocial change for themselves and adapt to their environment in a wise manner. Person-centered therapists capitalize on this inherent ability by empathizing with their clients, acknowledging their feelings and potential for good, holding them in positive regard, and helping them along a path towards self-healing.

In his chapter, Bohart wonders what it would be like if the Rebel Alliance was able to plant a person-centered therapist on the Death Star to speak with Darth Vader. After presenting a hypothetical dialogue between the two, Bohart says:

We could imagine Darth Vader beginning to open up to implicit and long-forsaken aspects of his personality, to begin to see the broader picture, to begin to incorporate new aspects of his experience into his ideas. He might begin to question his constructs, such as those imposed by the Emperor, he might begin to balance his desires for power and revenge with a more deeply human side. He might actually begin to move toward discovering the “good” in him. (p. 66)

If Anakin Skywalker had gone into therapy with Carl Rogers before joining the Dark Side, Darth Vader may have never come into existence. Anakin could have been a symbol of good, having resisted the rise of the Empire a long time ago in a galaxy far, far away.

 

Reference

Bohart, A. C. (2013). Darth Vader, Carl Rogers, and self-organizing wisdom. In A. C. Bohart, B. S. Held, E. Mendelowitz, & K. J. Schneider (Eds.), Humanity’s dark side: Evil, destructive experience, and psychotherapy (pp. 57–76). http://dx.doi.org/10.1037/13941-003

Fathali M. Moghaddam: On Multiculturalism and Intergroup Relations

Dr. Fathali Moghaddam is a professor of psychology at Georgetown University, where he also directs the Interdisciplinary Program in Cognitive Science. Iranian-born and UK-educated, he worked for the United Nations and taught at McGill University before joining Georgetown in 1990. In 2007 the Society for the Study of Peace, Conflict, and Violence (Division 48 of the APA) awarded Moghaddam with its Lifetime Achievement Award, and in 2012 he received the Outstanding International Psychologist award from the APA Division of International Psychology. He is the editor for Peace and Conflict: Journal of Peace Psychology and he has written or edited over 20 books.

Here he discusses Multiculturalism and Intergroup Relations: Implications for Democracy in the Global Context . In this book Moghaddam applies psychological theories to explore intergroup relations and conflicts across the globe, seeking effective ways to manage cultural diversity and avoid intergroup violence and terrorism in a rapidly globalizing world.

A transcript of this interview is available.

Note: The opinions expressed in this interview are those of the authors and should not be taken to represent the official views or policies of the American Psychological Association.

Reference

Moghaddam, F. M. (2008). Multiculturalism and intergroup relations: Psychological implications for democracy in global context. http://dx.doi.org/10.1037/11682-000

What Is an Agentic State?

by Kristen Knight

In the summer of 1961 at Yale University, social psychologist Stanley Milgram began a provocative experiment to test individuals’ willingness to obey orders from an authority.

In Milgram’s experiment, explained to the volunteer subjects as a study of the effects of punishment on memory and learning, each participant played the role of a “teacher,” who was instructed by an experimenter to deliver an electric shock to a “learner” for each mistake made when recalling word pairs. In fact, the learner was an aide of the experimenter—a confederate—who did not actually receive shocks for his many deliberate errors.

Milgram experiment v2 The shock generator included 30 switches, labeled with values ranging from a mild 15 volts to a dangerous and potentially lethal 450 volts. The learner sat in an adjoining room, unseen by the teacher once the test began. Surprisingly, 65% of participants were obedient to the instructions of the experimenter, continuing to deliver what they believed were shocks of increasing intensity up to the 450 volt maximum despite the vocal protestations and apparent suffering of the learner. The obedience of the teachers has been described as occurring in an agentic state, a psychological condition in which an individual, as a subordinate to a higher authority in an organized status hierarchy, feels compelled as an agent of that authority to obey the orders issued by it.

Milgram’s experiment remains indelible because of both his findings and his controversial methods—so much so that 54 years after those initial sessions at Yale, the man and his work are the subject of a new feature film called Experimenter: The Stanley Milgram Story, starring Peter Sarsgaard and Winona Ryder. The movie touches on Milgram’s later work as well, which is also fascinating if less widely known.

Those interested in issues of compliance and authority also may turn to APA’s 2013 book The Psychology of Dictatorship by Fathali M. Moghaddam, which discusses the importance of psychological processes such as displacement of aggression, conformity, obedience, fear, and cognitive dissonance as tools that aid the development and maintenance of dictatorships. These have remained crucial topics since World War II, the horrors of which were only in the recent past when Milgram began his study at Yale.

References

Blass, T. (n.d.) Milgram basics. Retrieved from http://www.stanleymilgram.com/milgram.php

Elms. A. C. (2009). Obedience lite. American Psychologist, 64(1), 32–36. doi:  10.1037/a0014473

Moghaddam, F. M. (2013). The psychology of dictatorship. Washington, DC: American Psychological Association.

Obeying and resisting malevolent orders. (2004, May 25.) Retrieved from http://www.apa.org/research/action/order.aspx

Singer, U. (Producer), Golombek, F. (Producer), Schoof, A. (Producer), Robbins, I. (Producer), Abeckaser, D. (Producer), Melita, P. (Producer), Almereyda, M. (Producer), & Almereyda, M. (Director). (2015). Experimenter: The Stanley Milgram story [Motion picture]. USA: Magnolia Pictures.

VandenBos, G. R. (Ed.). (2015). APA dictionary of psychology (2nd ed.). Washington, DC: American Psychological Association.