Regarding “life-enhancing anxiety,” for sure it can feel counter-intuitive for some (many?) people, particularly those who experience it as overtly or covertly destructive. It did for me when I was in an acute state of anxiety. However, I use that phrase in part to drive home the point that there is a great deal more to anxiety than being a “nervous wreck” or feeling overwhelmed; it is a complex state that if grappled with, can inspire courage, passion, and new possibilities for living as a whole (View Highlight)
Yes, what I call “life-enhancing anxiety,” which is the capacity to live with and make the best of the depth and mystery of existence, depends largely on what the psychoanalyst D.W. Winnicott called our “holding environment.” A supportive and understanding holding environment is pivotal, not only for the well-being of the neonate, but for our society and indeed world. Support and understanding as distinct from a fear-based orientation is crucial if we are to get along with and indeed become enriched by one another, and become enriched by differences within ourselves. In sum, we need abilities to deal with differences, otherness, and that which is radically unknown. We need skills to manage the helplessness and groundlessness with which we all enter the world, and this means internalizing parental and cultural role models who have made substantial gains in cultivating these skills themselves. Tragically, our society—as with many societies today and in the past—are rather poor at emphasizing these experiential skills. They are much better at stressing external and mechanical skills (like rules and regulations, technical advances) that may temporarily distract people from these larger existential challenges, but don’t sustainably address them. The result is that we’re paying a great price for that negligence, and that price is manifest in such reactionary stances as prejudice, ideological extremes, and disturbed personalities. (View Highlight)
Symbolic anxiety is localized outside of the radius of immediate threat but still arouses many of the same symptoms as signal anxiety, such as sweaty palms, racing heart, narrowing of perception etc. But unlike signal anxiety, symbolic anxiety is reflective and appears to conjure up more than the fear of physical threat, e.g., physical death, but an existential anxiety that I call the “groundlessness” and “helplessness” of the human condition. This groundlessness and helplessness associates with our expulsion into the world and echoes directly what Rank called the “trauma of birth” and Ernest Becker, his foremost expositor, termed the “complex symbol” of death. These conceptions are of course subject to ongoing existential and phenomenological investigation but they have been shown to be quite salient in the realms of Terror Management Theory and the existential-phenomenological depth research that I have assembled in books like The Polarized Mind and Life-Enhancing Anxiety. (View Highlight)
The problem as you well point out is when patterns get turned into doctrines that no longer inform clinical work but predominate it. As May used to say, we need to see the person in the formulation and not the other way around (View Highlight)
I view the basic goal of psychotherapy as helping people to feel more free, alive, and whole. (View Highlight)
So, the long and the short of it is that we have major divisions within clinical psychology largely because practitioners do not want to embrace the whole—it’s too messy and complicated and its very distressing to third party payors such as insurance companies and government agencies, who demand measurable and too often expedient results. Attunements to the long term or in depth, even if they are wiser and more sustainable, are simply in short supply in many quarters of clinical psychology (View Highlight)
This bias has shifted some in recent years with the influence of the relational-contextual factors research by leading investigators such as Bruce Wampold and John Norcross. This research has demonstrated consistently that existential-humanistic factors such as the therapeutic alliance, empathy, genuineness, and the willingness to collaborate are by far more closely associated with therapeutic effectiveness than more technical factors, such as cognitive restructuring or psychodynamic interpretation (View Highlight)
I would say that people are receiving suboptimal care because the major funding sources and the culture as a whole are overlooking the powerful outcome data that privileges emotionally restorative relationships, which often means longer term, life-changing relationships, over the short-term manually-driven relationships. The best way to evaluate the effectiveness of therapeutic relationships is to ask the recipients of those relationships, and don’t just ask them through rating scales and checklists, but through in-depth, qualitative inquiry over substantial periods of time. This is in fact what Seligman did in a Consumer Reports study in the mid-1990s, and the results were strikingly favorable toward the longer term, life-changing relationships (View Highlight)