I’m an avid lover of theory, all kinds of theory—psychoanalytic, systems, humanistic-existential, and so on. I think my appreciation of theories grows as I age, as does my appreciation of people, relationships, music, art, and politics. As I grow older and hopefully wiser as a clinician and educator, my appreciation increases for the various approaches to psychotherapy available today, just as the illusion decreases that my particular approach to couple therapy is better than the other ones out there. In the couples arena, I greatly admire the work of Sue Johnson, Ellyn Bader and Peter Pearson, David Schnarch, John and Julie Gottman, Esther Perel, Dan Wile, Harville Hendrix, Marion Solomon, Terry Real, Rob Fisher, and many others. These are not only master therapists, but enormously creative producers of inspiration to couple therapists worldwide.
Having developed an approach myself—in part, a result of having been personally influenced by other approaches—I have come to understand that the success of any approach hinges not only on its utility in providing clarity and organization for the therapist, but also on its ability to inspire personal meaning. In other words, therapeutic approaches are first “sold” (wholesale) to clinicians, who “buy” its organizing principles because it speaks to them, fits their personality and style, and works for them in a deeply personal way. The clinicians then sells (retail) this template for organizing experience to their patients (consumer). Theory and approach are for the therapist directly, and therefore only indirectly benefit the patient.
I think it is fair to say that people who are attracted to PACT are attracted to my particular thinking about the problem of adult romantic relationships. With EFT, students are attracted to Sue Johnson’s epiphanies about relationships. Same with Gottman, Schnarch, Hendrix, Perel, and so on. Interesting, to me at least, is that the people I mention here agree with one another more than they disagree, although it may appear differently at times to others. We’ve all put our finger on something that rings true about relationships, and many of our ideas are similar, give or take some terms and nuances.
John Norcross, a specialist in psychotherapeutic approaches and their effect on behavioral change, has collected compelling evidence that what changes people is not any particular therapeutic approach or theory per se, but rather the relationship that develops between clinician and patient. He argues for integrative approaches that allow therapists to tailor interventions to respond with flexibility to the unique demands of each patient or situation in a manner that best fosters change. The matter of effectiveness in psychotherapy, therefore, may be as elusive as is our understanding of the complexity of the human mind, and more mysterious still, the phenomenological, intersubjective nature of human relationships.
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