Talk Therapy: East Meets West

Article excerpt

Two Eastern forms of psychotherapy have an important place in the development and influence of many types of current behavioral therapies.

The Morita and Naikan therapies, both developed in the first half of the 20th century in Japan, are directed at conflict resolution of anxiety and adjustment disorders as we define them in DSM-IV. Their strength lies not so much in their methodology--which in Japan requires inpatient stays and long periods of meditation--but in the concepts of learning new skills for living, coping with here and now issues, and developing action-oriented thinking and behaviors to overcome difficulties.

In short, these therapies focus on the use of readjustment strategies to treat distressing emotional issues as defined in the Eastern culture. Does this sound familiar as we define our cognitive therapies?

Today, the popular press seems to be focusing more and more on the efficacy of talk therapy. Does talk therapy have a place in medical care? Can it be codified and measured? What do outcome studies show, and who and what works best?

The answers, of course, are far from clear, but as a behaviorist/cognitive therapist who developed the learning, philosophizing, and action (LPA) technique, I can assure the doubting public that talk psychotherapy works and that its effect is, indeed, measurable.

Years ago, when I was a resident at NYU Medical Center/Bellevue Hospital Center, the residents were mainly divided into two groups: those who were committed to psychoanalytic psychotherapy and planned to continue at one of the psychoanalytic institutes in the area, and those who wanted to focus more on how we can make it better for our patients in the here and now. As you might guess, I preferred the latter group.

Over the years, I've learned to appreciate the Morita and Naikan therapies, which emphasize learning new skills based on what we expect to encounter in daily life. To me, these therapies fit in with several other Western psychotherapies that were being developed around the same time.

Group and family therapy, for example, began to develop alternatives to traditional psychotherapies. Using techniques involving education, insight, learning, relearning, and the building of hope for a better set of adjustments in one's life, Dr. Irvin D. Yalom and Dr. Salvador Minuchin made enduring changes in the way psychotherapy was delivered to groups and families. Albert Ellis, Ph.D., Dr. Frederick "Fritz" Perls, and Carl Rogers, Ph.D., all made substantial contributions to the processes of rethinking maladaptive behaviors, ideas, and perceptions, and adding new and more effective skills in living more comfortable emotional lives.

Even group awareness programs such as the Erhard Seminar Training (est), where thousands of participants had to get "it" in learning redirecting techniques, became popular. The most important development in rethinking approaches to psychotherapy, I believe, came in the cognitive-behavioral therapy as put forth by Dr. Aaron T. Beck. His codified and measured approach made it possible for an organized medical model of helping and healing to be followed.

Today, "cognitive therapy" has become an almost household term, and more and more mental health consumers ask for it. Unfortunately, far too many therapists are committed to unsubstantiated historical conflict resolution theories with little or no interest in more successful relearning/rethinking approaches. …