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It's Hard Out There for a Psychotherapist

When this culture celebrates professions that require both dedication and courage, soldiers or athletes are far more likely than psychotherapists to be the focus. After all, isn't a therapist simply that cool, dispassionate listener of New Yorker cartoons?

But as every graduate student discovers and working therapist knows better with every passing year, therapists are on the front lines of raw human need. Their job is a continuing education from which there is no graduation and includes regular exposure to others' grief, failure, rage, and often impaired reasoning. They have chosen a profession in which their goal is to counter the abrasiveness of those daily wounds with openness and compassion rather than turning away or raising a self-protective wall. In consequence, they often pay a high price — burnout, substance abuse, and even suicide rates are high in the profession.

Any research that helps psychotherapists cope with their own needs and responses can be vitally important. This is an area where PsycCRITIQUES can be especially helpful, as professional education and training are a core area covered.

For example, the most recent weekly release included this review:

In "Channeling the Dark Side: Negative Reactions to Psychotherapy Clients," Thomas Schacht reviewed Transforming Negative Reactions to Clients: From Frustration to Compassion (Wolf, Goldfried, & Muran, 2012; DOI:10.1037/a0031778). The reviewer has taught psychotherapy for three decades and knows from personal experience that few people entering the profession realize just how hard it actually is. As Schacht presents the background, people drawn to a "helping" profession such as psychotherapy are typically shaped by the "more spiritual and nurturant poles" of the human motivational spectrum. However, reality brings this:

Like the mythical "Force" in the cinematic Star Wars galaxy, psychotherapy, too, has a "dark side," a dimension of conflict and potential destructiveness originating in the therapist's own passions and expressed in a capacity for reacting to clients with frustration, annoyance, anger, disgust, fear, shame, guilt, withdrawal, disengagement, indifference, and so on…[S]uch negative reactions may evoke experiences of potentially severe dissonance in therapists.

This book provides research on the often-overlooked area of negative reactions to clients. The editor's goal was explicitly to help therapists "understand, accept, and adapt to their negative reactions and to do so in ways that enhance the therapeutic mission. The contributors, all of whom are experts in the field, recount their experiences with and reactions to therapeutic sessions with difficult and noncompliant clients, as well as how they were able to use those experiences in their own lives and work. In addition, case studies presented at the end of each chapter illustrate the theory's practical application relative to the therapeutic module or expertise presented.

Food Fight!

Millions of Americans are making their annual resolution to lose weight on the heels of their also annual holiday bacchanalia. This year's binge and remorse came nearly simultaneously with the Global Burden of Disease Report released in December, by 500 researchers from 50 contributing countries, which found that obesity is now a bigger global health crisis than hunger.

Setting aside some island groups in the Caribbean and Pacific, the United States leads the world in adult obesity and is just edged by Malta in childhood obesity. Outgoing APA president Suzanne Bennett Johnson has made obesity the primary focus of her presidential year, noting that one thing that surprised her during her tenure as president was a persistent belief that psychology is a "mental health" discipline as opposed to a "health discipline."

Thus some questioned whether obesity is psychology's legitimate concern. Yet it would be difficult to find a single issue that affects us as individuals, families, communities, and nations more or that so affects our nation's future.

PsycCRITIQUES has provided reviews of books that cover many aspects of the obesity epidemic and blog discussions on some of its challenges. For example, just in the past 3 years, we have released 11 reviews of books addressing various aspects of obesity. They include the following:

• Jill Salsman (2012) reviewed Fat Shame: Stigma and the Fat Body in American Culture (Farrell, 2011), a work aimed at a popular audience in which the author used media ads to show how the meaning of fatness has changed over time and how "fat denigration has been used as a tool for economic and political power and to disempower individuals of the nondominant culture (e.g., women, immigrants, non-White individuals)."
• Jillon Vander Wal (2012) reviewed Eating Behavior and Obesity: Behavioral Economics Strategies for Health Professionals, a more rigorously academic work in which Heshmat (2011) applied behavioral economics, the application of economic theory and psychological principles to the study of human behavior, to eating and weight management. Heshmat used behavioral economics to explain the "irrational decisions that favor the development of overweight and obesity" and support the proposition that people need a "nudge" to make lifestyle choices consistent with successful weight management.
• Kathryn Henderson and Meghan O'Connell (2010) reviewed The World Is Fat: The Fads, Trends, Policies, and Products That Are Fattening the Human Race (Popkin, 2009).  Popkin has described how the pandemic maps onto global technological advances, food industry growth and proliferation of nutrient-poor foods, and government inaction and government policies that impel, rather than reduce, factors that promote energy imbalance. By using accessible language and a story-like tone, he makes public health policy suggestions aimed at government and corporate audiences, appealing for large-scale changes.

Thank you. And good luck on your January resolutions!