by Mario Molinaro, LMHC, Psychotherapist & Clinical Director, Clinical Consulting Centers
Psychotherapy is one of the professions that in a constant dance between “art” and “science”, both necessary elements for its function. Although some people are misguided or poorly informed, the only “pure science” in the health/medical field is hematology.
The type of dance changes with cultural/societal changes, at times it flows with the music, other times does not, and when the music stops silence fills in the gaps. One of the things in common is that both like aesthetics, while expressed in different ways. They also move with reasoning, although at times it’s not so evident. Sometimes you see it, and other times you don’t, all pending on how the “light is bent”.
Sometimes there is a pause in the dance and appears as silence, but this too is part of the dance. I am aware of the science and the art aspects of psychotherapy, but those are not the only two elements that constitute the process. What is not seen, yet present is what I call “Factor X”. In other words, psychotherapy = science + art + “Factor X” (Now I have to solve for X); the only problem is that Factor X is not yet easily identifiable or measurable with the tools a present, but it can be explored.
What happens “when the music stops”? Good question, indeed, but the music does not stop. Often time the music simply drifts into the background, but the beat continues, and as part of psychotherapy, “Timing” is extremely important. That is the timing of verbal interventions that prompt or clarify insights: Is the patient ready to hear it? The patient’s readiness is an extremely important factor. Timing also involves the timing of certain changes in body language, hand gestures, facial expressions, tone and volume of voice, affect reflected in speech, mood, and often appropriate humor. Timing is not only pertinent and associated with “readiness” of the patient, but the psychotherapist as well. In other words, if the psychotherapist is not ready for an intervention, it’s best not to intervene until he/she explores and understands the “reticent” factors that inhibit timing.
Where is the science? The science is based on the theoretical structure(s) adapted by the therapist which serve as a frame of reference during the therapeutic process. For instance, if I said to you “Sigmund Freud used scientific thought during his sessions”, you would think that I am clueless. Well, here it goes. Sigmund Freud used very scientific structure and frame of reference which he extrapolated from Albert Einstein’s theory on Thermodynamics (Energy cannot be created or destroyed, rather only transformed.) This clearly reminds me of S. Freud’s “Drive Theory”, whereas libido (energy from birth) continues through the person’s life, while it goes through series of transformations and adaptations guided by other forces involved during his development. Now we have Freud the psychotherapist, whose very scientific reasoning goes unnoticed during his practice and in his delivery of psychotherapy. The psychotherapist who draws upon a certain theoretical structure which is invisible in his delivery, in my opinion, becomes the most effective psychotherapist. Let’s bear in mind that the frame of reference is not for the patient, and only for the therapist. So, were Freud’s methods scientific? Absolutely, more scientific than the conventional parameters of science, which typically only sees what is visible (in the light.) Dr. Freud took it one step further, and he searched for the answers that were invisible (in the dark). These were in the subconscious areas of the person. Yes, his psychotherapeutic methods were a combination of Art and Science, plus “Factor X”. Was “Factor X” his ability to connect to a higher level of cosmic awareness? I’d say most likely “yes”, as he tuned into the Cosmos, the common friend of Freud and Einstein.
And the beat goes on……..It has been said; you can follow the dance with your reasoning and imagination….but, rest assured that the beat goes on.