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I’ve been thinking hard about the so-called “Dodo Bird Verdict“.
The verdict, based on a character from Lewis Carroll’s “Alice’s Adventures in Wonderland” states that every psychotherapeutic theory is equal, and no one theory reigns supreme. In the words of Carroll’s Dodo (after judging a foot race): ”Everybody has won and all must have prizes.” This verdict asserts that there are common factors among therapists which, if adhered to, will result in successful therapy no matter what model or technique the therapist applies to treatment.
I’ve recently been involved with a group called the International Center for Clinical Excellence (ICCE). Scott D. Miller, it’s founder, used to be one of the most ardent proponent of the Dodo Bird Verdict. In fact, in one of my recent posts entitled “What REALLY Causes Change in Teens“, I outline the common factors of therapy that Miller introduced me to. The common factors are: 1) things that happen outside of the therapy office; 2) the client’s orientation toward hope for change; 3) the strength of the client-therapist relationship; and 4) the therapist’s applied technique.
These four key common factors give us a descriptive sense of what is similar across the vast world of psychotherapy success. However, it is not a model of therapy in and of itself. In other words, if we were to focus our efforts around strictly enhancing the four common factors in our work with clients, we would find that we never improve beyond where we are today. Why?
The “Red Queen Principle” bears the answer. Again taken from a character in Carroll’s book, the Red Queen tells Alice, “It takes all the running you can do, to keep in the same place.” Evolutionary theorists use these words from the Red Queen to elucidate the Red Queen Principle. The Principle explains the necessity of all organisms to adapt or become extinct. In other words, if a predator does not adapt, but its prey does adapt, then eventually the predator will cease to exist. For example, if rabbits become faster and foxes don’t, then foxes will eventually become extinct. The Red Queen Principle states that while groups of organisms must do “all the running [they] can do” just to keep up with other organisms and avoid extinction, individual organisms within those groups often exceed the evolutionary advances of the group. For example, one fox may become exceedingly fast and cunning and it will pass those genes on to its offspring.
So what does this have to do with therapy?
Well, if the common factors are true of every successful treatment outcome, then it doesn’t really matter which model of therapy you use, does it? It would follow that every therapist who focused on those factors would have similar successful outcomes, wouldn’t they? But research shows that this simply isn’t true. Some therapist are vastly more skilled at inching their clients toward health than other therapists. Why? What is different about these “supershrinks“? (Click on the “supershrinks” link. Read the article. You won’t regret it. In fact, it may change your life.)
The difference, according to Miller, lies in the work of K. Anders Ericsson. Internationally renowned as the “expert on expertise”, Ericsson’s research shows that the truly great in any field have things in common – they improve themselves through deliberate practice. And they do much more deliberate practice than other relatively “good” performers – up to as much as 10,000 hours more!
Expert therapists know where they are weak. This means that they are measuring themselves constantly. They are following up with their clients. They are soliciting feedback. They know exactly what they need to improve upon. And then they act to improve it.
In evolutionary terms, supershrinks adhere to the Red Queen Principle. They far exceed the psychotherapeutic advances of their time. They adapt and improve and reach and stretch far more than groupings of their “adequate” peers.
The truly excellent are humble enough to know they are limited, smart enough to seek feedback, passionate enough to act on that feedback, and stubborn enough to engage in deliberate practice over and over and over again.
Looks like I have some work to do. How about you?
Photo by jurvetson
It’s not only identity which suffers when girls are in pain. The pain threatens the very idea of their self-worth. At her core, a young woman begins to lose hope in the value she brings to the world and her family and friends. She loses touch with the infinite part of herself – the part which cannot be measured and which is invaluable.
Many months ago I led a group therapy session and brought a strand of my mother’s pearls with me. I pulled the milky-white chain out of my pocket and held it up to the ten young women seated in a circle near me. I explained that I had inherited the pearls after my mother died. My father had purchased them for her in Thailand while he was stationed there during the Vietnam War. Furthermore, I said, I was going to give the pearls to my daughter when she turns 16. I added that I thought it interesting that my daughter’s birthstone happens to be “pearl”.
After allowing them each to hold the strand, I asked them what they thought the pearls were worth. “Are they real?” one asked.
“Yes. What do you imagine they are worth?”
“Do you mean how much they’re worth in dollars?”
“No, in value to me.”
“You can’t put a price on that!” one said. “You have to consider what they were worth to your father, too,” another said. “And to your daughter,” a third added. They all seemed to agree.
Having established the high value of the pearls, I tossed the strand on the wet and muddy floor. The girls were stunned. One stared at me as if I had gone out of my mind.
“What are they worth now?” I asked. “Have they lost any value?”
“No,” was the quick reply.
I stepped on the pearls and used the sole of my shoe to rub the strand around on the dirty floor. I even stood up, my foot firmly planted on the pearls. This time the girls were angry. “What’s wrong with you?” one said. Her voice was loud. “Why are you doing that?” another yelled, and others echoed her question.
I ignored them. “Have the pearls lost any value now? They’re dirtier. And certainly you would agree that stepping on them has made them worth less. Treating pearls like this cheapens them, right?”
“You’re crazy!” one said.
“You don’t deserve those pearls!” said another. “What would your mother think? Your daughter’s going to kill you!”
Ignoring their outrage for the moment, I pressed them to answer my question about the value of the pearls. All agreed that the pearls had not lost their value. We discussed the similarity between the pearls and their own lives. Many felt downtrodden, dirty, and abused, like my mother’s pearls. Many, if not all, had lost sight of their intrinsic value.Understanding spread across their faces as they applied the object lesson to their own lives.Similarly, treating young women requires us to see beyond the surface. As we submerge ourselves deeper beneath the cold reality of the presenting behavior, what appears at first to be a significant outcropping of jagged, icy moodiness above the surface reveals itself to be a vast, confused form of frigid misunderstanding, confusion, and despair. We can never help a young woman heal if we don’t acknowledge the true nature of the problem, as well as its scope. That said, it is important to remember that the problem may appear bigger than she is, but it is critical that we communicate to her that, with help, nothing is impossible to overcome.
What influence do men hold over you, and why?
I ran a group therapy session yesterday. One young woman began the conversation by speaking eloquently about her obsession with five college-age men who had sexually assaulted her. ”Why can’t I let it go?” she asked. ”What is it about me that clings to them, even when I know they are bad for me?”
Another girl chimed in: ”I feel ashamed that I sexualize all males. Even the staff here. I objectify everyone, and I can’t stop.”
I had the girls and the staff (18 in all) place themselves in the room based upon how much influence they allow males to have over them. We established a range; one wall and its couch became “100% influence” and the opposite wall was “0% influence”. I was not surprised to see most people place themselves between 50% and 100%. One girl said, “I’m sitting at 105%!”
We talked at length about the power that males have over us: fathers, brothers, boyfriends, men we don’t even know. The girls and adult staff identified their reasons for granting this kind of powerful influence to the men in their lives. ”I like to feel protected,” one said. ”I wanted to be accepted – that’s all I cared about,” another said. ”Love is the bottom line for me,” one of our staff members added.
None of these desires/needs is bad in and of itself. We discussed taking the shame out of wanting to be protected, accepted, or loved, and decided to more productively focus on what we do with the overpowering need for acceptance, protection, and love – especially from males.
The Lead Supervisor of our staff spoke up quietly and said that after she lost her sister in a car accident, her teenage brothers and her father all became very protective. She described a healthy relationship with them as a leading influence for good in her life. A young woman who just arrived at New Haven piped up and said that her father is someone she wants to please, and she knows he loves her very much.
We all decided that even though we are influenced to varying degrees by men, we should acknowledge how much we are influenced, discover what need it fills for us, and then seek a more healthy and productive way of obtaining that need. Being influenced by males does not need to be a bad thing. Shaming ourselves doesn’t work – we need to recognize that they underlying need for male connection or approval is not always bad.
By the end of the group, the young woman who said she “objectifies” the men in her life committed to practicing healthier relationships with the male staff we employ. The one who started the conversation decided to end a flirtatious relationship she began on a recent trip home, since she was “using” the young man and not really interested in him.
I imagine we’ll continue this discussion in group next week.