Cultures of Healing: Correcting The Image Of American Mental Health Care
a book by Robert T. Fancher
(our site's book review)
Even though the book is about correcting the image of American health care, we focused only on its cognitive therapy elements, as the balance of the book seemed irrelevant for our purposes. The main demonstrable accomplishment of cognitive therapy is in the treatment of depression. But people use the self-talk methods that evolved from this therapy in simply trying to become happier and more successful. They use it for self-esteem building and growth, and for attitude adjustment. Some people use it via self-help; others go to seminars or therapists. The most self-helpful book using cognitive therapy methods (we recommend it wholeheartedly to everyone) is Feeling Good: The New Mood Therapy.
Feeling Good is a great book to empower the treating of depression as well as ridding oneself of negative thoughts and emotions resulting mostly from parenting errors
One seminar type from the 70s and early 80s—called est—used to help people cease identifying with the stuff/beliefs in their minds and to shift the identifying to their beings/selves, which refocused attention from needing, deficiency, incompleteness, wanting, and an unacceptability attitude to accepting themselves and the world and learning to “be” in the world. This was all about being at cause rather than at effect, and it was about an inner paradigm shift towards autonomy, rather than acting like a mechanical automaton, or being run by life, or being run by others or any other forces except one’s own. The central element—ceasing to identify with one’s beliefs and identifying instead with one’s being—is closely related to self-talk’s goal of undermining one’s negative self-talk as one concomitantly supports a new habit of positive self-talk. Est was a bold new way to start getting ones ontological act together. It helped people find themselves quickly, rather than after months or years of therapy. Cognitive therapy is relatively rapid self-help as well.
The est seminars were seen as brain-washing or mind control or simply conditioning by a few, but perhaps there was no other way to get through the formidable defenses and barriers of the normal Adjusted American, and in this light, may be forgiven for any excesses. Most participants reported the experience to be very valuable—even enlightening. Est evolved into The Landmark Forum, Landmark seminars, and Landmark courses that 2.4 million people in 19 countries have taken—and 94% say the experience had a profound and lasting influence on their lives. In 2015, Est's founder, Werner Erhard, is 80 and mostly writing academic articles for the Social Science Research Network.
The question arises: Can we really effect the transition from deficiency-cognition-based, needful, dependent, insecure people to being-cognition-based, unneedful, independent, secure people in two est weekends, or even as a result of more extensive cognitive therapy?
The answer is: One can make a good start, but unless people’s environments and activities support the growth of further awareness and security and maturity (as in MCs; see Why Register for an MC?), the transition to being-cognition will not be likely to really occur.
Registering for MC search and match
Environments can tear people down as fast as seminars or therapy can build people up. Many decades ago (1962) Maslow, a humanistic psychology leader and hero, discovered that loving, secure, exploration-encouraging environments produced being-cognition, but this type of environment was rare. He also discovered that what was prevalent and normal were the more insecure and inconsistent and self-negating environments which defined the explorations of our youngest people to be annoying and worthy of overt or covert discouragement—they're simply not "convenient" for adults. (And cognitive therapists say that ¾ of the childhood programming we receive is negative—for some the number is nearer to 100%.)
Hence the epidemic of deficiency-cognition and the dearth of being-cognition, as well as the prevalence of people of low self-esteem, unintentionally conditioned to indulge in negative self-talk. Many “encounter groups” of humanistic psychology and the human potential movement were designed—wisely—to address exactly these concerns. Maslow was wise, and like Erich Fromm (The Revolution Of Hope) he preferred that our lifestyles would nurture so well that they’d empower self-actualization, autonomy and being-cognition so we wouldn’t need therapies, as did all the best therapists. But, being a realist, he responded benevolently to upbringing inadequacies in the best way he could, explaining the vital aspects of a nurturing environment so people had guidance in their transformative endeavors. (MCs are defined as places where being-cognition and self-actualization are empowered in every way feasible, and hence no negative self-talk is conditioned so no self-talk affirmations will be needed—but this refers to people who are brought up in MCs. People who are just joining MCs will need to deal with their self-concept problems and negative self-talk habits and will help each other in such pursuits.)
There are naïve and foolish individuals, mostly on the right, who ridicule important tools like self-talk as self-indulgent psychobabble. And in a perfect world, they would be correct. There would certainly be no need for self-talk affirmations and self-esteem work if people weren’t raised so carelessly and weren’t conditioned—however unintentionally—to indulge in self-destructive, negative self-talk habits, habits which cripple them emotionally and severely limit their future potentials, success, and happiness.
But in the real world, this crippling process is an integral part of the normal American lifestyle, and the personal, psychological, and social dysfunctionality this causes is of epidemic proportions (e.g., this is one of the reasons why bureaucracies are staffed mostly with unproductive deadwood, with a few of the people doing most of the productive work). And the stunted careers, business failures, and relationship failure that this process precipitates are the epitome of unnecessary suffering and represent the legacy of ignorant upbringing processes.
The right-wing disparagers of humanistic psychology, self-actualization, and other inward-looking aspects of human nurturance, growth, self-awareness, and being were mostly authoritarians who were more comfortable with other aspects of life such as guilt, obedience, power, suffering, shame, repression, and sacrifice. And the reason they were authoritarians is that they learned it from authoritarian organizations like churches, the military, and bureaucracies, but even moreso from strict fathers who happily helped them to learn all about guilt, obedience, power, suffering, shame, repression, and sacrifice. Looking inwards to such people meant staring guilt, suffering, and shame in the face, so they always opted for repression, distraction, or churchgoing instead. (Whatever blows their hair back.)
Looking inwards to authoritarians meant staring guilt, suffering, and shame in the face, so they always opted for repression, distraction, or churchgoing instead—whatever blows their hair back
Not that there weren't indulgers in self-indulgent psychobabble, narcissists, and egotists in humanistic psychology and the human potential movement. There are always losers and jerks who use trips and organizations to act out and express their superficiality and self-indulgence. But such people were simply too afraid of the pain and chaos of their inner reality to face it, so they found ways to pretend, to fool, and to act out. Humanistic psychology had a lot to offer those with the courage to face fears and strive for self-awareness with honesty and openness. If normal lifestyles included more growth experiences and more nurturing love, there wouldn't be that much to face, and it wouldn't be so scary that some just turned into posers and phony creeps.
Some people were too afraid of the pain and chaos of their inner reality to face it, so they found ways to pretend, to fool, to be posers or narcissists whose self-centeredness hid much pain
But normal lifestyles being what they are, many human potential groups that targeted humanistic self-actualization fell far short of the mark. The result confirmed in the minds of the authoritarians the negative judgments of humanistic psychology adherents who sought self-actualization. These judgments were very short-sighted, however, since they only accurately applied to the phonies on the fringes of human potential groups, ignoring the great many seekers who succeeding in finding themselves and growing in insight, wisdom, maturity, integrity, and happiness. Another way of looking at said movements and groups: GIGO. You get out of them what you put into them and the pretenders gave many a group a bad name—at least to those who were making superficial judgments supported by neither knowledge nor wisdom.
If people react to these negative, self-destructive, painful inner realities stemming from ignorant upbringing processes by simply taking antidepressants and tranquilizers, it merely numbs their awareness of a serious problem needing addressing. If they react by abusing people or substances, then we get social dysfunction. If they react by committing suicide, we get a tragic waste of precious life. Would the right suggest that the proper reaction is to sit around and pray about the problems—or just ignore them? When people on the right get an infection, don’t they get antibiotics like the rest of us? Negative self-talk and the resulting negative self-concept are preventable infections.
Normal non-nurturing environments create people whose psyches have 'infections' that are hard to 'cure'
A great upbringing can prevent them. But since such upbringings are few and far between, we need the antibiotics for the infection that we failed to prevent, as it were. We need the cognitive adjustment, because destructive thinking has a myriad of destructive consequences. We can happily join the right in a goal of eliminating “self-indulgent self-talk affirmations” and other “self-centered” activities from the face of the earth, but only if we do it the smart way. The dumb way is to simply quit acknowledging the problem and let the damage and dysfunction continue unabated.
Cognitive Distortions (ways that our mind convinces us of something that isn’t really true, keeping us feeling bad about ourselves) such as overgeneralizing, black and while thinking, jumping to conclusions, catastrophizing, personalization, control fallacies, fallacy of fairness, blaming, shoulds, emotional reasoning, fallacy of change, global labeling, always being right, and heaven’s reward fallacy need to be faced. By refuting the negative thinking in Cognitive Distortions over and over again, they will slowly diminish over time and be automatically replaced by more rational, balanced thinking. This is much like self-talk.
The smartest and happiest and most nurturing way to not have to deal with all the pain, unhappiness, cognitive distortions, and dysfunctionality is to prevent the negativity in the first place, which will be accomplished most effectively in MCs. Note: It becomes obvious, upon extensive “cogitation,” that the reason the right seems so opposed to fixing the harm that comes from negative upbringings is that they have a vested interest in denying this harm, and the reason for that is that they, with all their authoritarian upbringing tactics, are among the main perpetrators of the negative self-concepts and low self-esteem in people, as well as major sources of negative self-talk conditioning. But the left is usually just about as bad in this area.
And the good news is that the right needn’t resort to denial, projection and self-deception anymore. There are easy ways for them to cease their dysfunctional parenting habits quickly and replace them with methods they’ll experience as godsends once they try them. They will not need to deny and project. They can—as all of us have always desired and will always prefer—simply do it right, have no symptoms of dysfunction to be guilty about or deny, and enjoy life as a celebration of positive power (absolutely proven to be more effective and benevolent than authoritarian negative power), empowerment (it’s at least as good for humans as it is for corporations), growth (it’s at least as good for humans as it is for stock portfolios) and wisdom accumulation. (MCs are lighting the path out of dysfunctionality.)
Now, back to cognitive therapy: Sets of beliefs and inappropriate habits of thought impede the ability of people to correctly understand their situations in life. Kind of like a filter, everything in life is filtered through the negative beliefs which so many of us hold as our life context. (Maslow would consider this filter to be caused by unfilled childhood needs that cause a deficiency-cognition perceptual distortion process which prevents a person from being able to perceive accurately, mature properly or attain a being state or peak experience of oneness). In cognitive therapy, whether this filter-distortion process is chronic (long-term) or acute (short-term response to some negative situation), negativity rules. The more negativity, the more “psychopathology,” in most cases, according to Aaron Beck, the father of cognitive therapy. Most noncognitive therapists disagree that negative beliefs are necessarily a sign of mental disturbance, however:
The social psychologists have discovered that “in fact, the ordinary mental processes of most people are irrational.” Illogical thinking is normal, not abnormal. “The rules of reasoning used by most people most of the time are quite at odds with basic standards of logic and evidence. Furthermore, we know that only about thirty percent of adults are able to function fully at the level of formal reasoning; fifteen percent are incapable of abstract thought of the sort required to question one’s beliefs, consider alternative views, and weigh the evidence for each. Most people are not cognitively capable of what the cognitive therapists characterize as healthy thought. . . . Most people’s characteristic ways of understanding themselves are, in fact, inaccurate and overly positive [they repress the negative in order to cope]. . . . In one interesting study involving parents and children over several years, parents consistently misremembered their earlier parenting techniques so that they were in accord with whatever was currently considered good parenting.”
To Fancher, the author of this book, the normal irrationality of normal thinking is evidence that cognitive therapists may be getting good results (no therapies are getting better results) but their theories on how this is happening are not accurate. He concurs with Jerome Bruner’s assessment that negativity relates to the realities of a person’s actual life experiences and in itself doesn’t necessarily represent logical or psychological distortion. He feels that Beck’s ideas are reductionistic, whereas his own take full account of the human social system in which these attitudes occur. It may be a bit of a moot point, however, since good results can be obtained by cognitive therapy methods. See Does Therapy Help?.
Therapy results of Cognitive Therapies are the best of any therapies
Fancher feels that Beck’s version of cognitive therapy may indeed help those who accept the status quo and the prevailing values without question or reservations, but if the status quo seems inadequate to someone and some of society’s beliefs seem misguided to this person, then this therapy will not work well for such a person. He seems to be saying that using rationalism to adjust people better to the status quo makes cognitive therapy a tool of conformity. Beck equates optimism and mental health, which puts difficult or dismal truths out of bounds, according to Fancher. This means that when circumstances support a negative outlook, Beck is saying that when life sends you a lemon, make lemonade (i.,e. find a way to retain a positive outlook). This is a good rule to live by, as long as one is reasonable about it.
'When life sends you a lemon, make lemonade' is fine but what about de-lemonizing your life and environment and relationships?
Many people (such as Laing and the radical psychiatrists like Claude Steiner) have complained that mental health care is just a way of making people conform to the values of the dominant culture, and Beck seems to be an example of this, in Fancher-think. (After all, the radical psychiatrists' motto was "Therapy means social, political and personal change, not adjustment". We cannot help but concur. "Adjust" to a great MC environment, not a negative, oppressive environment.)
Fancher would advocate taking a position more like David Riesman (see The Lonely Crowd) and Fromm, who consider autonomy as the ideal to strive for, and who would want people to be at cause and select their own values as free and thoughtful humans, regardless of whether they dovetail with society’s values. They would be against therapy for conformity (which is what the U.S.S.R. practiced for decades, and what the subtext of most therapy anywhere is if the truth be known) but they would support therapy for freedom, growth, insight, problem solving and self-actualization. Beck and est would say that having negative feelings of loss is healthy and constructive after the loss of a loved one, but having negative thoughts (e.g., “I’ll never be happy again”) is misguided and counterproductive, and can lead only to misery and dysfunction.
Since Fancher and Bruner would help the person have more constructive thoughts, while encouraging feelings, and Aaron Beck and David D. Burns (Feeling Good) would help the person towards more constructive thinking as well, and the end result of either process would eventually be more positive emotions, the underlying dynamics of all this may often be irrelevant. Beck concentrating on thinking correctness and Fancher concentrating on coping and adjusting to the new reality constructively with the aid of positive thinking are both actually getting to much the same place by different doors. Whether Maslow, est, or a guru convinces such a person to be with their new loss and go through whatever feeling processes feel necessary as they specifically avoid negative thinking, or whether Beck or Fancher or a professional counselor or even just a friend help the person cope as constructively as possible, it’s all healing, it’s human nature to want to help such a person, and as long as it guides the person toward positive rather than negative outcomes, it’s good.
As long as gurus or therapists guide the person toward positive rather than negative outcomes, it’s good
The book doesn’t really deal with self-talk per se, but Beck and his disciples David D. Burns (Feeling Good) and Shad Helmstetter (The Self-Talk Solution) do. The essence of their books is that most people’s conditioning/programming from childhood is at least 75 percent negative, and if they do nothing, such things will distort their feelings and thoughts and run their lives; so to get the most out of life and be happy and in control of their lives, people need to eliminate the negative programming, establish positive programs in their place, and in some cases get help if they cannot manage to get this process going right on their own.
Many people need to use therapists for this, according to Beck and Burns, but Helmstetter is championing the idea that people can use his self-help books (and tapes—or they can create their own tapes) and do it without extra help. Burns has books designed for the self-helper do-it-yourselfer as well. This is helpful and empowering, since most of us are very hesitant to seek the help of professionals when it comes to good mental and emotional health. The self-talk track record is better than that of most other therapeutic techniques, so professionals in related fields are also adopting these approaches. Very wise people as diverse as Wayne Dyer and Louise Hart also find it very helpful for people they help. So the jury—and the research results—are in and self-talk is quite effective, and for those who need emotional nurturance along with regular self-talk there is John Pollard’s self-parenting or John Bradshaw’s work with the inner child. As you can see, there is no shortage of approaches to choose from for supporting your self’s health and happiness.
Fancher would have been well served to present all of these positive realities along with his theoretical criticisms. This would have led to a more balanced and constructive critique.
One issue remains: Is self-talk a force for conformity and status quo, or growth and liberation? If a person is in an environment containing oppressive negativity and uses self-talk or actual cognitive therapy to convince himself that he’s just thinking incorrectly, this will be good mood enhancement but bad social strategy, and conformity and status quo will indeed have been preserved in an unconstructive manner. One is reminded of the homemaker mothers of the 50s that complained to therapists about their stifled lives and were given tranquilizers so they’d shut up and conform to what radical therapists later correctly labeled sexist oppression.
But a more careful reading of Helmstetter quickly dispels the idea that his self-talk strategies are about conformity to negative milieus. They represent quite the opposite. He shows you how you can free yourself from the oppressive inner environment of negative programming that was instilled when you were young and vulnerable. He shows you how you can transcend the limits that such careless upbringing realities imposed upon you. And he lets you know that if current realities attempt to instill yet more such anti-self programs, you should avoid them, not buy into the oppressors’ games, and continue to keep inner and outer environment constructively positive and benevolent.
In other words, if anyone has ever used cognitive therapy in the service of persuading people to submit to oppressive realities, they were engaged in a negative action. But if cognitive therapists simply helped people face some of life’s necessary discomforts, such as the need to make a living or face losses, then this force for adjustment to life is a positive one. Here one can see that if the values of the therapist were overly conservative, sexist, or rigid, it would be easy for a person to be encouraged to submit to unnecessary oppression which the therapist felt was simply facing reality, even though a more enlightened therapist would see the unnecessarily negative situation for what it was. Hence, potential values clashes between therapist and “patient” are an intrinsic situational risk here, and this further underscores the hesitation many of us feel about having anything to do with therapists, because while most of them have their client’s best interests in mind, the political question of “based upon whose values?” is bound to raise its disturbing head in this deliberation.
Keep in mind that most of us have status quo-obsessed negative programs operating much of the time and self-help via self-talk can free us from these oppressors, and this is the method we support: People taking responsibility for their lives, both internally and externally.