Soothsaying

I am not much for prognosticating. In fact, whenever I am asked to project future developments, I remember a sage comment by Bruno Bettelheim at the first Evolution Conference. He quipped that there were many ways to make a fool of oneself, but the way most secure was to predict the future.

Because you asked, I will try soothsaying. Therapy is changing rapidly in the US because changes in insurance procedures require brief treatment. Therefore, the heyday of psychoanalysis is over. More and more patients seek rapid relief. They use medication more frequently because new nostrums offer great promises. In terms of trends, growth-oriented therapies are on the decline and cognitive therapies are on the rise. Family therapy also is declining. It has not lived up to its promise.

I remember talking to Murray Bowen. He believed that his systems theory would supplant Freudian philosophy because it was a more robust explanatory device. He had a great theory. However, it is not ascendant in today's therapy environment.

Psychotherapy is a field of fads and approaches have a limited life span. This may be due to the fact that oftentimes redundancy is undesirable in psychotherapy. Clinicians repeatedly using an approach will lose effectiveness. Novelty is needed, and therefore, clinicians must use new techniques as old methods lose power.

As far as advice is concerned, I remember a story about Aldous Huxley who, after presenting a rousing lecture on social change, was approached by a student who breathlessly asked, "What should we do now?" expecting advice for mass activism. Huxley replied simply. "Try and be a little kinder."

• Family Therapy Decline: Is the story of its Death exaggerated? by John V. Knapp, 9/1/97