Great Minds on the Mind Assemble for Conference

A hundred years ago an Austrian neurologist named Sigmund Freud peered under the hood of the human soul and found a previously unnoticed gizmo he called the unconscious. The part tended to break down, causing emotional upsets known as mental illness. The way to repair the unconscious, Freud decided, was through talk.

Freud’s discovery inspired mental mechanics everywhere, who rushed to patent variations of the fabulous talking cure.

Gathering in Phoenix

Those whose inventions got the most attention were men like Carl Rogers, Albert Ellis, R. D. Laing, Bruno Bettelheim, Joseph Wolpe and Thomas Szasz. All these psycho-celebrities of the 20th Century assembled for the first time in history in Phoenix last week for a conference called “The Evolution of Psychotherapy.” It could be the last time the gang gets together, too, because most of them are elderly.

Facing a bank of 26 spotlights, the masters spoke while their images were projected on gigantic video screens. Every other word was lost in the echo of the cavernous Civic Plaza Convention Center. Carl Rogers, who has influenced more therapists in this country than Freud, got a standing ovation from 4,000 people before he even said a word. It was, as organizer Jeffrey Zeig said, the Woodstock of psychotherapy.

100 Years of Progress

The heroes were there to evaluate where psychotherapy has come in 100 years, and where it might be going--except they really could not agree on either.

On the one hand, there were men like British psychiatrist R. D. Laing, known for his work on schizophrenia, who said that he couldn’t think of any fundamental insight into relations between human beings that has resulted from a century of psychotherapy. “I don’t think we’ve gone beyond Socrates, Euripides, Shakespeare, Tolstoy, or even Flaubert by the age of 15.”

Carl Rogers, on the other hand, contended that psychotherapy has made “quite a little progress,” particularly in moving away from medical explanations of mental illness toward a focus on growth of the individual.

Dr. Joseph Wolpe, a pioneering behavior therapist, noted: “An outside observer would be surprised to learn that this is what the evolution of psychotherapy has come to--a Babel of conflicting voices.”

Differing Opinions

The 7,000 practicing and student psychotherapists, psychiatrists and social workers who attended various sessions were undaunted by the debates and differences of opinion. Obtaining autographs was a priority for many. Some stuck close within range of their personal favorite theorists; others, like Linda Paulsen, who does crisis intervention in Orange County said she was trying to get a “smattering” of existential, behavioral and cognitive approaches. She pointed out that while most of the conference-goers had preferences among the 27 big names on the front of the program, “the therapist’s real tool is herself, not any one theory.”

Jeanne Mulligan, 62, a schoolteacher and MFCC (Marriage, Family and Child Counselor) candidate from Santa Ana said: “I’m here to see the gurus, the guys who started it all. I figured these people aren’t going to be around forever.”

For Mulligan, it was Carl Rogers who influenced her more than the others. Mulligan described Rogers’ technique: “He’s the being-there-no-matter-what-you-say-to-me guy. He’s not going to tell anybody what to do. His approach is, ‘You do it. You’re capable of doing it yourself.’

“He’s how I live more than how I practice,” she added. “I raised my kids to Carl Rogers’ (theory); I taught to Carl Rogers. I was hoping to dance with him last night (at a post-conference bash). . . .”

Long before there was a buck to be made off a troubled soul on a couch, there were tribal elders for primitives to tell their worries to, speculated Dr. Murray Bowen. He believes psychotherapy’s roots are in an instinctive mechanism by which people feel compelled to help each other.

Before Freud came along in the late 19th Century, people who acted strangely were treated by “alienists.” The usual prescription involved neurological remedies or rest cures. Freud’s theory of the unconscious--which Bowen calls “an educated guess”--gave rise to a demand for psychoanalysts who would help patients tinker with this new component of their beings.

Bowen, a clinical professor at Georgetown University Medical Center in Washington, said that one of Freud’s lasting contributions was the notion that people replicate early relationships. Thus, problems with a spouse might reflect childhood conflicts with a parent; or feelings toward a parent might be transferred onto a therapist. There was plenty of talk of transference and counter-transference in the long lunch lines--evidence that the notion is still fresh.

Change After World War II

The first 60 years of psychoanalytic practitioners followed Freud’s theories. Even the famous dissenters such as Jung and Adler were dependent on Freud for something to rebel against. It was only after World War II that new schools of psychotherapy began to crop up in this country, according to Zeig, director of the Milton Erickson Foundation, which sponsored the conference. Today there may be as many as 100 distinct schools in the United States, he said, with most of them doomed to fizzle.

Of the groups represented in Phoenix, Zeig said: “These are the contemporary schools that are the most enduring.” Because so many theories flower and wither, it takes a long time to gain credibility as a leader in the field. That explains why the most of the speakers were older men--they started out at a time when women were less involved in professions.

Although Freud undoubtedly would have felt at home with much of the lingo tossed about at the conference, there were some modern developments. For one thing, there was a dial-a-shrink service conducted by a local radio station in the lobby of Exhibit Hall E. “Has life got you a little down around the holidays?” the commentator would ask. Experts such as Virginia Satir were on hand to respond to calls.

Satir has been called the Columbus of the most popular new school of psychotherapy--family therapy. The technique was introduced in 1957, in response to frustration with traditional individual-oriented therapy.

Wizard of Family Therapy

One of the wizards of family therapy present was Dr. Carl Whitaker, who said that he has given up entirely on working with individuals.

“The process of being helpful to someone else has largely to do with helping them discover that what they see in me is what I see in them,” said Whitaker, who has been in practice for more than 40 years. “You take a body apart and it turns out they’re all exactly the same. I assume that’s true for the family and the psyche too.”

Upheavals that influenced modern psychotherapy include the introduction of major tranquilizers in 1954 (Bowen said tranquilizers made it possible to keep patients relatively symptom-free, and decreased the state hospital populations), and the National Mental Health Act in the early ‘60s, which established storefront mental health centers. These popularized psychiatry by making it readily available to the masses, and not just seriously disturbed people.

The ‘60s also brought increasing protests that psychiatry is not really a science, and so began a rift between those who hope that it might become truly scientific, and those who feel it’s no disgrace that it not be. Laing said: “I don’t think psychiatry is a science at all. It’s not like chemistry or physics where we build up a body of knowledge and progress.”

He said that in his current personal struggle with depression, humming a favorite tune to himself (he favors one called “Keep Right On to the End of the Road”) sometimes is of greater help than anything psychotherapy offers.

“But I think there’s always going to be a place in life for one person talking to another person about problems, in private,” he said.

Changes in health care funding may be as great a threat to psychotherapy as what he called “internecine warfare within its ranks,” said Dr. Lewis Wolberg, a neuropsychiatrist in New York. With the advent of DRGs (diagnosis related groupings), which are intended to keep down hospital costs, therapists will be forced to practice short-term cures, he said. They’ll be compelled to prove the cost effectiveness of any treatment attempted. The chief casualty will be “long-term therapy aimed at personality reconstruction,” Wolberg said.

Jeffrey Zeig hoped that the combined therapeutic skills of the mental health professionals who came to Phoenix could begin to resolve the rifts between the schools of psychotherapy. Ideally, he said, modern practitioners should be able to incorporate the best of the wisdom of the last 100 years. “My hope is that the meeting starts to pull people together,” Zeig said. “There are a lot of different roads to home.”