Family Therapy as an Alternative to Medication: An Appraisal of Pharmland

The only war that matters is the war against imagination. All other wars are subsumed.

—Diane Di Prima, from “Rant, ” in Pieces of a Song

Psychotherapy is a work of the practitioner's imagination. The imagination is what shapes and gives meaning to our experiences. Psychotherapy is a countercultural process. It is a process that is defined by whoever is looking at and thinking about it. It pays attention to enriching the human spirit—the only war that matters (Auerswald, 1995). It balances the complexities of freedom and responsibility, helps negotiate the dialectic of individuation and belonging. Psychotherapy depends upon creative emotional investment by the therapeutic practitioner. Much of what society does to “protect” “consumers” interferes with fundamental therapeutic processes. Psychotherapy, by disrupting the patient's relation to the culture, adds alertness and enriches relationships. It has an obvious relation to morality, insisting upon our taking responsibility for what we do. But it is further informed by a sense of beauty, which manifests in our own organization and relations, our own completeness and growth. Psychotherapy is a process of constant learning and innovation by practitioners, as is demonstrated in the following articles. They describe experiences and methods. ways of looking at therapy, that deepen our awareness of what therapy can do. Psychotherapy is not a scientific enterprise but has much in common with performance art—like music or theater.

We are presenting this diverse series of papers in the interest of stimulating your thinking about family psychotherapy. The processes outlined in other sections of the book emphasize that psychotherapy has been diluted by standardization of practice methods and the bureaucratization of mental health care. Psychotherapists are dumbed down by the promotion of drugs, the simplistic thinking of managed care, by what Pakman refers to as “globalization” of mental health practices. The most prevalent form of psychotherapy usually represents a pattern of guided social adaptation and

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