The Miracle of Psychotherapy

Ron Johnson. Miracles: God, Science, and Psychology in the Paranormal. Editor: J Harold Ellens. Volume 2: Medical and Therapeutic Events. Westport, CT: Praeger, 2008.

“I’ll have to talk that over with my therapist.” “I’m in therapy right now trying to figure out what I should do.” “My wife and I are seeing a marital therapist hoping to resolve our ‘issues.’” “My kid is in therapy because of his ADD, ODD, and OCD.” “I wish my husband would get into therapy.” These and similar psychotherapy-based statements are frequently heard these days. We have even had presidential candidates, their spouses, presidents’ wives, and even presidents talking about therapy without much chagrin.

We are, so it seems, in the midst of a time when psychology, psychiatry, and their cognates are at the center of our cultural milieu. Fifty years ago it was unheard of to be talking about one’s therapist. Today, it is commonplace. The very term therapy was infrequently used until about 1970, following the 1960s explosion of emotion and feelings. More accurately, Carl Rogers’s client-centered therapy (1951) and Albert Ellis’s rational-emotive therapy (Ellis and Harper, 1973) initiated this focus on psychotherapy. Behavior therapy and cognitive therapy soon followed, which eventually fused into the most common form of therapy used today, cognitive-behavioral therapy (CBT), and in some spheres has become fused with Ellis’s style to become rational-emotive behavioral therapy. The last half century has seen not only a plethora of therapies and therapists, but people of every walk of life and every stratum of society utilizing the therapeutic process.

The growth of the practice of psychotherapy has not been entirely matched with justifying research. A good bit of research has been done with CBT in order to judge its effectiveness, often in conjunction with psycho-pharmacological treatment. But the established effectiveness of the many other therapies still lies in unfinished research or in clinical lore, promoted by people who are true believers in psychotherapy. I am one of those true believers, having been a psychologist and psychotherapist for 40 years. Yet I must admit that there is scant evidence that psychotherapy actually helps most people. This is a scary thought for someone like me who has devoted his entire adult life to the pursuit of the profession.

It is my contention that when psychotherapy works, it is a miracle. There are times in the psychotherapy process that seem quite miraculous: a person with little self-insight gains genuine insight into herself; a person who has lived primarily so that he could become drunk finds the joy of sobriety; a marriage that has been unhappy for decades finds genuine and lasting happiness; a child who has always failed at school finds academic and social success; a depressed person finds permanent relief. These are miracles, indeed. Psychotherapists are often in the crucible of the human experiment: the intense suffering that all humans seem to have.

What Is Psychotherapy?

Psychotherapy exactly translated from its Greek roots means healing of the mind or healing of the soul. Psychology means the study of the mind, or soul, or spirit. Therapy may take the form of client-centered therapy or rational-emotive therapy, psychoanalytic or psychodynamic therapy, cognitive behavioral therapy (Beck, Wright, Newman, & Liese, 1993), didactic therapy, Gestalt therapy, primal therapy (Janov, 1970), hypnotherapy (Erickson, 1976), family reconstruction therapy (Nerin, 1986), music therapy (Sacks, 2007), or friendly diagnosis (Johnson, 2000).

It may be true, in fact, that one kind of therapy works better than others; one kind might work with a particular problem, or personality style, or individual, or at one time in one’s life and not in another, while not being efficacious for everyone. But success in psychotherapy—real life-changing and freeing success—is a miracle.

What Is a Miracle?

Writers and readers of the current volumes on miracles will doubtless be trying to discern the essence of the termmiracle. Original philosophical thought, at least, considered miracles to be of divine origin. Aquinas (Summa Contra Gentiles III) says those things are properly called miracles which are done by divine agency beyond the order commonly observed in nature. Philosopher David Hume suggested a similar divine intervention (1947) as the source of miracles. Sometimes, however, we use the term miracle without reference to the divine or supernatural, viewing miracles as roughly equivalent to something very special, out of the ordinary, and having a unique positive outcome. I shall be working with the approximate definition of a miracle as being an event, usually involving one or more human beings, having the following characteristics. It has a positive outcome for one or more persons, is of an extraordinary nature, and is demonstrably real, that is, it has some effect that can be seen, felt, or measured.

The Process of Psychotherapy

Most psychotherapies involve some form of (1) healing, (2) self-understanding and self-acceptance, (3) self-enhancement and success in life, and (4) the facilitation of these three elements by some kind of action of a psychotherapist. Consider two clinical cases that have been in my practice recently, one that we might identify as a failure, and one that we might consider a success, or a miracle.

Case Number 1

“John” (not his real name) is a 52-year-old man, professionally trained, single for all his years, and presently unemployed having recently been fired for lack of performance, after being at his latest job for less than six months. John has been a patient of mine, on and off, for 25 years. I have seen him in and through a myriad of friendships and relationships, both with men and women, almost all of which have been unsuccessful. John’s failed relationships have usually come about by his directly or indirectly demanding that his friend or lover reveal his or her depth of feeling and “soul.” John is also functionally alcoholic, and has been for at least all of these 25 years I have known him. He is very bright, probably in the 135 IQ neighborhood, and has also some secondary intelligences including kinesthetics and music. I have seen John through at least six different job changes over the past 10 years.

One of the most interesting aspects of John is his intense self-seeking, self-understanding, and, dare I say, undue self-interest, much of which is seemingly based on his lack of true and adequate development of his self. It is interesting that John is self-interested and curious about his inner feelings despite his lack of a true sense of safety in the world. The principal symptom that John and I are trying to attend to is his nightly fear of a “presence” in his bedroom, a presence that he can never really see, but feels. John has always been intensely interested in his feelings, intuitions, and alleged understanding of other people’s souls. Yet at 52 he is without job, life partner, concrete life direction, and home. He would be diagnosed as having borderline personality disorder, but also suffers from other disorders, including depression, anxiety, and alcoholism.

John is two important things to me: (1) a person I deeply care for, and one to whom I have devoted a good deal of my life’s energy, and (2) a person whom I have failed to truly help to be successful in the world of work, relationships, home, and service to humankind. I have given all that I know to give to John. I have utilized many different techniques in my therapy with him. I continue to give all that I have to give to him. He often seems to profit from my work, but he remains essentially blocked from succeeding in life despite my best efforts, and beside what appear to be his best efforts.

With John, self-understanding and self-acceptance seem to have given him little of what it takes to find happiness and success in life. Frequently, I have wished for a miracle for John, namely, that he would find some way through what appears to be a morass of meaningless emptiness in his life. It would be nice if he could just find a job that he liked, or a woman that he liked, a friend that he liked, a car that he liked, or a geographical location that he liked. Alas, he seems to be able to find none of these despite my best work, his best work on himself, prayers, and his apparent brilliance. Why is that? Could not God find it reasonable to at least grant John one of these small miracles?

Case Number 2

“Jeff” is a completely different story. Jeff is 14. I met him just a couple of weeks ago, after a myriad of e-mails from his mother, who reportedly heard that I did miracles with children. Jeff’s mother and Jeff came into my office together for a few minutes during which time I asked Mom to tell me about why she wanted me to see Jeff. She proceeded to tell me that he has “ADHD, ODD (oppositional defiant disorder), depressive disorder, and probably other disorders” that she did not know about. She further reported that another of her sons has autistic spectrum disorder (ASD), and yet another son has some sort of learning disorder (LD). Furthermore, she herself may have seasonal affective disorder (SAD) and wonders if she has Alzheimer’s disorder (AD). Surely, Jeff’s father has a “never diagnosed ADHD” disorder and some kind of bipolar disorder. All these disorders: everyone in the family had at least two! So Jeff must have one or more of these disorders. I learned that Jeff has not been doing well in school for years, is generally unhappy, and is abusive much of the time to his brothers and to his mother. That was her opener.

I frequently have people coming to my office talking about their disorders, much of it derived from TV shows like Oprah and Dr. Phil, as well as simplistic news magazine articles. It has been interesting to follow the flow of popular disorders over the 40 years of my psychological practice. If we were to believe that these disorders were as rampant as people seem to believe, everyone would be in psychotherapy and on psychotropic medications. Such was the position of Jeff’s mother as she desperately presented her unhappy son to me. She expected me to find out what was wrong with him and fix him. She believed I could do this despite her failure to do so in 14 years, because she had somewhere heard of my powers to perform such miracles.

Understandably, most teenagers do not like coming to a therapist’s office. Teenage years are a transitional time and generally difficult for all teenagers because of the profound neurological changes that occur during these years, to say nothing of the challenges presented by peers, future directions, and drugs and alcohol availability. So when I see a teenager, I am very aware of the complexity of such an individual and his life, and I work diligently to understand what is going on with him given these complexities.

I excused Mom to the waiting room while I attempted to visit with Jeff. Jeff sat slouched in the chair across from me, a position he had assumed at the time he was dragged into my office by his mother. I told Jeff that I wasn’t going to read his mind, find out what was wrong with him, try to fix him, or tell him what to do. Instead, I said, I wanted to understand what was right about him, hear about what he liked to do, and find out what he was good at. It took a few minutes for Jeff to believe me, and that I was not going to tell him how to live life, or psychoanalyze him in some way. An adolescent who does not want to be in a psychologist’s office in the first place and is clearly unhappy with much of life is afraid of yet another adult telling him what he has to do.

I asked Jeff what he liked. Slowly, but quite clearly, he said that he liked snowboarding and skateboarding. That’s good, I thought. He likes at least something. Then, surprisingly, I learned that he actually liked the first half of school, hating the second half. The first half of school was Math, French, Woodworking, and Physical Education. The second half was Science, Social Studies, and English. I already suspected something: this kid was probably right-brained. Right-brained people are visual, kinesthetic, artistic, musical, and tend to be more aware of and expressive of feelings. They usually are much more inclined to seek out and develop relationships.

Left-brained people are usually more oriented toward words, particularly the written word, concepts and theory, and most elements of mathematics. Jeff liked the right-brained experiences of physical activity, snowboarding, skateboarding, and gym; and the visual-spatial activity of woodworking. Why would he like math and French, which seem to be left-brained classes? I learned that he liked French because the teacher was “wild and crazy” and evidently spent a good deal of time relating to her students and entertaining them, making French class fun for Jeff. He liked math because it was easy for him. Evidently, not all of his functioning is right-brained, or maybe his math teacher was also a fellow with an affable and pleasant way of relating to Jeff.

Jeff and I talked first about this right-brained idea, and then about some of his personality characteristics, like being “low boundary” and spontaneous in the “high boundary” world of school, family, culture, and church. We talked further about his deeply feeling-oriented way of judgment, and his interest in ideas more than facts, and finally about his introverted nature. Jeff started to come alive. It probably helped that I was able to talk to Jeff in teenager language replete with the expletives that typify much adolescent conversation. Thirty minutes into this initial conversation with Jeff, he said that he liked me, that he had learned something, and that he would like to come back to see me. I had previously told his mother and him that I would not see him a second time unless he wanted to come back. We finished our time together, and I shook his hand as adolescents do, and brought him to the waiting room where mother sat wondering if I had done a miracle. She seemed to think that I had, because Jeff was willing to come back to see me. Jeff left happy. His mother left pleased and a bit stunned. Had I done some kind of miracle to turn this kid around from an unhappy, whiny, demanding child into someone who was seemingly interested in understanding himself, and maybe ultimately finding happiness? Or had God done some kind of miracle? Mother seemed to think so. Time will tell. But it did seem like a miracle to me that through known and unknown forces Jeff appeared happy for what seemed like the first time in a long time.

No miracle with John despite the better part of 25 years of work! An apparent miracle with Jeff within 45 minutes! It is a general understanding among therapists that some patients get better and find happiness within a short period of time, while others seem to be unable to ever improve their lots in life, despite the same therapist, the same treatment approach, the same diagnosis, and the same God.

In my practice I have few Johns, meaning 25-year patients, and even fewer Jeffs, kids who seem to turn around within a few minutes. These are but the extremes of psychotherapy patients. Most people lie somewhere in between chronic dissatisfaction with life and instantaneous cure. A larger question, however, is the actual nature of psychotherapy, namely, whether there are miracles occurring in the therapist’s office. Furthermore, might there be miracles that are unknown to the psychotherapist, or even more curiously, unknown to the psychotherapy patient?

Miracles In Psychotherapy

It certainly seems that miracles do occur in psychotherapy: a woman freed of the results of chronic sexual abuse in her childhood; a man freed of chronic alcoholism; a teenager finding some happiness in life despite a history of great dissatisfaction; a man finding his life’s passion can also be his life’s work; a child who learns to be introverted without shame; an avid sportsman who finds a way to engage in sports without destroying his family; a returning veteran who can grieve the sorrows of war without the symptoms of flashbacks and anxiety. There is no doubt that miracles of this sort do happen. Granted, they do not often happen, but is that not the nature of a miracle: an infrequent occurrence of a positive experience in life for which there is no known cause?

I believe that miracles happen in the offices of psychotherapists, as I also believe they have happened in my office. In my maturing years in this profession I realize that I know more about my field and am certainly better at my profession than I was even a few years ago. I am more efficient. I am more honest. I just told a patient who presented with panic disorder that I didn’t know whether I could help him, but that I was willing to give all that I have to give to him, and that I might help him. I love this work; but I am also humbled in it because more people do not find lives of genuine happiness, permanent satisfaction, sustained harmony, and character-changing altruism.

I am humbled by the people who do find these things in life, seemingly miraculously, almost as if I were just a bystander and a brief compatriot in their life journeys. I remain committed and content in this miracle-based profession, knowing that even with the best of effort, skills, and technique, some patients will not find real joy in their lives. Yet when one does, when one person truly finds joy and satisfaction, I rejoice with him or her, knowing that I have been in the presence of God’s work, of God’s handiwork, of God’s miraculous influence.