Story of Psychology - Morton Hunt [392]
There is no available statistic concerning the total number of people currently receiving CT and CBT, but it is undoubtedly large—and would be considerably larger except for the recent trend toward the medication of mood disorders. “Where have all the ‘easy cases’ gone?”
Aaron Beck recently mused. “Our hunch is that most patients respond reasonably well to their first-line treatment—by primary care doctors or psychopharmacologists. The relative nonresponders eventually may be referred to cognitive therapy—which now represents a secondary or even a tertiary—level of care.”94
But in his introduction to a book by Judith Beck about treating these more difficult cases, he points out that she regards them as a challenge rather than a burden. Such is the admirable ethos of the cognitive therapist.95
A Miscellany of Therapies
The three families of therapy we have looked at—dynamic, behavior, and cognitive—are presently the major forms of psychotherapy, but a great many other kinds are available, nearly all said by their developers to be more effective, cheaper, quicker, or better in various ways than any of the big three. Before 1950, there were only about a dozen or so versions of psychotherapy, but by the early 1970s Morris Parloff, then director of psychotherapy research at the National Institute of Mental Health, counted 130; by 1988 Alan Kazdin, of the University of Pittsburgh School of Medicine, searched the key resource material and offered “a conservative estimate” of over 230 alternative treatments; and currently Paul Crits-Christoph, who, you will recall, is the director of the Center for Psychotherapy Research at the University of Pennsylvania, says that recent estimates have put the number at around 600.96
Bewildering as this may seem, the therapies actually fit into a relatively small number of categories: the three we have already seen, a few others that have had some significant impact on psychotherapeutic thinking and practice, and a host of others that have been flashy and newsworthy but account for very little in the real world of psychological treatment.
First, then, some of the few that are serious entrants in the historical record:
Humanistic therapies: In the 1950s humanistic psychology, the core of the “human potential movement”—whose leading spokesman was Maslow—emerged as a “Third Force” or alternative to Freudian psychoanalysis on the one hand and behaviorist psychology on the other.
The humanists, more philosophic than scientific, objected to the psychoanalytic doctrine that the individual’s personality and behavior are totally determined by his or her life experiences, especially those of childhood, and also to the behaviorist view that the individual’s behavior is only a set of conditioned responses to stimuli. Humanistic psychology stressed the individual’s power to choose how to behave and the right to fulfill oneself in one’s own way; it held that behavior should be judged not in terms of supposedly objective scientific standards but in terms of the individual’s own frame of reference. If a person considered an easygoing, noncompetitive, “laid-back” life ideal, that was a valid goal for him or her, not a symptom of a character flaw; so, too, with singleness rather than marriage, sexual freedom rather than monogamy, and other departures from social norms. Humanist psychology therefore had great appeal, especially for the young, during the individualistic, rebellious 1960s.
Out of this psychology emerged a crop of variant related therapies. Though widely disparate, they are all based on the doctrine that everyone