Oct 15, 2013

The short shelf life of mental health theories

The way we think about mental health might be seriously out of date.

The author Mary Pipher notes that much of what we believe about human behavior comes from outdated theories connected with long-gone times and cultures. In her 1996 book The Shelter of Each Other, Pipher writes
Theories have zones of applicability and work best for particular places and times. Freud knew middle-class families in Vienna in the late 1800s and Perls knew German families of the 1940s and 1950s. The dysfunctional family theory worked best for the families for whom it was invented, those of longtime alcoholics. The humanists understood American families in the 1960s. Most children had two parents, one of whom was a stay-at-home mother. Parents had more control, communities existed, and families had walls. Certain kinds of therapies made sense. But psychological theories have a short shelf life. Our old ideas about how to help are useless in the face of new realities. We attempt to solve problems with theories developed for a world that no longer exists.


Many theories are as out of place and time as dinosaurs in a shopping mall. How do we discuss sexual repression in the world of MTV? How would Alice Miller handle date rape? How would Fritz Perls help a family who lost their only source of income in a corporate takeover? Each of these therapists was helpful in his or her own time. But in a war zone, it’s crazy to ask people if they were breast fed as babies or to analyze their dreams.
Pipher goes on to identify some of the weaknesses of family therapy.
Ten mistakes that therapists make.
1.    Family is the cause of all problems.
2.    Therapy has been hard on women.
3.    Therapy has pathologized ordinary human experience and taught that suffering needs to be analyzed.
4.    We have focused on weakness rather than resilience.
5.    Some of our treatments have created new problems.
6.    We have encouraged narcissism and checked basic morality at the doors of our offices.
7.    We have focused on individual salvation rather than collective well-being.
8.    We have confused ethical and mental health issues, empathy and accountability.
9.    Some therapists abuse their power.
10.    We’ve suggested that therapy is more important than real life.
The lessons for the world of mental health is that theories don't last forever, and methods don't stay mandatory. We are free to learn from what we have done in the past, and adapt to what we face today.

Photo: Harvey Washington Wiley, a food-safety crusader, at left.   (Wikimedia Commons)

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