Spitting in the Client's Soup

Spitting in the Client's Soup

Don't Overthink Your Interventions

By Jay Efran and Rob Fauber

Therapists sure have a knack for creating complications. In the search for simple explanations for their clients' suffering, they tend to find an attachment injury behind every relationship issue, a traumatic event to account for any symptom, and brain research to support every clinical maneuver. New problem categories continue to be devised. For instance, the list of possible types of trauma has now expanded to include insidious trauma, intergenerational trauma, vicarious trauma, microtrauma, and betrayal trauma. Recently, just-world trauma has been added to the list. This is when an event shatters a client's belief in a benevolent world in which good deeds are rewarded and wrong-doings punished. But isn't this what we used to call growing up?

Of course, new therapeutic specialties and novel variations on existing approaches keep cropping up. Among the latest are cognitive-processing therapy, trauma-focused cognitive behavioral therapy, mindfulness-based cognitive therapy, trauma-sensitive group yoga, attachment-focused family therapy, and even forgiveness therapy. The neurobiology craze has many therapists offering clients lecturettes on neuroplasticity and myelination, and one Networker author reports showing them PET scans, presumably to prove that therapy really does change the brain. Of course, so does drinking your morning coffee.

The field is as fractionated as ever. And as new and reworked methods continue to attract adherents, the disquieting question remains: are these emerging methods any more potent than the existing strategies? Is all of this specialization and complexity really necessary? Is there any evidence that one theory or therapeutic strategy is really better than the rest? Perhaps client problems are simpler than we (or they) have suspected. Perhaps this chaotic array of specialized techniques can be reduced to a more manageable and straightforward set of principles and methods.

Marsha Linehan, the originator of dialectical behavior therapy (DBT), was once asked if she had any advice for novice therapists. She suggested that they be themselves and stop trying to act like therapists, reminding them that this entire venture is nothing more than "one human being trying to help another human being." We think she just might be onto something.

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