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Five Predictions on the Future of Psychotherapy By Julie Diamond
06.08.2011, 18:42

Five Predictions on the Future of Psychotherapy

By Julie Diamond

ã 2003

On the eve of the millennium, I dreamt I was dining with the founder of modern psychotherapy, an old, fierce looking woman. She turned to me, and asked, "So, what do you think the next one hundred years of psychotherapy will bring?” Though it seemed clearly she had her own opinion, she asked me for mine. And so I offered it.

When I awoke, I was intrigued. What will the next one hundred years of psychotherapy bring? Will it even exist? The future direction of psychotherapy is not a new topic. James Hillman and Michael Ventura contemplated the future of psychotherapy, while lamenting its current condition in their book, We've Had a Hundred Years of Psychotherapy and the World is Getting Worse. In my mind, Process Work is already putting into practice many principles that I believe will be characteristic of psychotherapy in the future. The following five predictions may have nothing to do with what really will happen, but they do help to clarify my own direction, and what I see as some of the main contributions of Process Work to psychotherapy today.

1. From Pathology to Creativity

Psychotherapy was born as a response to psychopathology, as a cure for neurosis, psychosis, hysteria, and other forms of mental illness. Coming as it did from the medical field, it is no surprise that for its first hundred years, psychotherapy focused on definitions and diagnoses of normal and deviant, healthy and sick, adjusted and maladjusted.

Questions guiding psychology in the 21st century and beyond will increasingly focus on how solutions spontaneously emerge from problems rather than focusing on how the problems got created in the first place. It will ask, how do stress, conflict and pressure help us evolve? It will include an interest in 'positive psychology,' how people are able to find happiness, overcome adversity, live creative and fulfilled lives. This approach will be informed by a teleological, evolutionary perspective, instead of the causal-reductive model that has been guiding it until recently.


2. From doctor-patient to partnership

As human development is increasingly understood as a process of self-organization, the paternalistic doctor-patient model will be seen as an ineffective means of accessing the individual's self-organizing potential. The hierarchical, paternalistic nature of the therapist-patient dyad was consistent with a paradigm that saw childhood experiences as the source of adult psychological problems. The doctor-as-authority figure helped stimulate the transference, necessary to work through these early issues. However, research has shown that even in the field of medicine, the patient's participation and initiative in the treatment program yields more positive results than a passive approach to getting well. As psychotherapy moves out of its traditional medical framework, the role of psychotherapist will change from expert, medical specialist or parental figure to facilitator, coach, and other 'partnership' roles. Partnership models stimulate the client's creativity and initiative, making her a more active and central part of the change process.


3. Collapse of individual/collective dichotomy

Since its early beginnings, psychotherapy has had an individual/collective split, which is reflected in its various sub-disciplines and specializations. We must choose whether we want to focus on ourselves in individual therapy, or go to family and relationship counseling. In our organizations, we have teambuilding and group activities to strengthen the cohesion of our team, but if we have individual problems, we seek out a private counselor, coach or psychotherapist. Psychotherapy in the 21st century and beyond will eliminate this false dichotomy. It will see individual and collective as one and the same.


The dichotomy between individual and collective stems from Enlightenment thinking that the individual is an entity separate from the group, whose problems can be studied separate from its social context. This belief, long dominant in Western psychotherapy, has been challenged along the way by various counter-movements within the field of psychotherapy, notably Jung's concept of the collective unconscious, community or milieu psychology, systems and family therapy, psychodrama, group therapy, and of course, Process Work.

Future psychotherapists will work with a decentralized, fluid sense of self, and will place less emphasis on static identities and fixed boundaries. Personality will be seen as a fluid continuum or network of identities, rather than an historical or biologically determined unit. As the boundary between individual and collective breaks down, therapy won't just be a one-to-one, private affair, but will be a social, political event. Individual's problems will be seen in their social and political context, and as expressions of cultural and community issues.


The end of the individual and collective dichotomy will also change our social structures. Communities, organizations, cultural groups and nations will see themselves as organisms with the capacity to evolve, change and learn. Social and political issues, from war to economics, will be seen as reflections of the group's psychological development, not just as policy issues.


4. "Just-in-time" therapy

As the distinction between individual and collective diminishes, specialized forms of psychotherapy will become increasingly redundant. Specializations reflect static problems and static units of identity. Future, fluid perceptions of identity will shape the form of therapeutic services. Therapy will become a "just-in-time" service, delivering its services on an as-needed basis. Rather than engaging a specialist course of treatment, the individual will be able to focus on whatever issue is current, regardless of the arena in which it occurs. For instance, the "just-in-time" therapist will work with a client and his family on relationship problems one day, then, at another time, will work with the same client on work place issues, addictions, or body symptoms. This "just-in-time" therapist will be a flexible and responsive facilitator, able to move fluidly amongst a variety of issues.


5. Weirdness Happens

By the end of the 20th century, science and philosophy had already embraced multiple and simultaneous realities and truths. Parallel worlds are now deemed possible and even likely. Along with an appreciation of cultural diversity, psychotherapy in the 21st century and beyond will include inner diversity. There will be greater freedom to enact unique, individual forms of expression. As objectively defined standards of socially appropriate behavior and lifestyle become less influential, radical, creative uniqueness will flourish and no longer be deemed 'weird'. The loosening of a centralized, static identity will allow more inner fluidity of identity and experience. Identity politics, based on cultural and ethnic membership, will be challenged by a dreaming politics, an identification based on dreams, creativity, and other subjective experiences.

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