Fewer years ago than I’d like to admit, I was royally schooled by a client in a therapy group that I was running. Having recently been dazzled by a week-long training in Internal Family Systems (my preferred therapeutic approach), I felt it appropriate to suggest to the group members that some therapeutic approaches might have more to offer than others. While I don’t recall exactly what I said, it included some psycho-ed about IFS and CBT, with a very clear bias towards the superiority of IFS. Basically, I threw CBT under the bus.
Many members of the group nodded enthusiastically at my proclamation, having worked with me for some time and developed a kind of loyalty to my integrated, CBT-light methods. However, after the group ended, one of the group members approached me to gently challenge me and my big mouth. As it turns out, CBT had been life-changing for her. After years of therapeutic work, she routinely used CBT skills she’d learned from a previous therapist to get through every day, and found them essential to her growth. She felt that my statement in group devalued her self-work. And, let’s be fair… she wasn’t wrong.
Needless to say, I was horrified.
As in all moments of complete personal embarrassment and flagrant mistake-making, a learning opportunity bloomed up in front of me (over-rated, those learning opportunities). Why was it necessary that I to dismiss one approach in order to lift up another? Does my preferring a particular treatment modality mean that others need to be lesser? Is it possible that both modalities, frankly, that ALL modalities, have something unique and important to offer to the individuals for whom they resonate? Don’t CBT practitioners have something vital and valuable to offer their clients, too?
Isn’t there room for all of us in this expansive, murky interplay of art and science that we call therapy?
Practitioners, at our best, make room for every thought and every body. Our work, by its very definition, demands inclusivity, acceptance, and validation. We stand in solidarity with the “other;” we make it our business to fight for the underdog. It stands to reason that a wide array of approaches are necessary in order to pursue wellness and wholeness for everybody. While the practice next door might do it differently, it’s correct to guess that their approach to healing is exactly what somebody out there is looking for.
At our worst, as illustrated by my smug announcement in group therapy, we judge one another. Maybe we criticize other clinicians for not accepting insurance, or for being “too woo-woo”, or for practicing by the book, or for thinking too far outside the box. We think of dozens of reasons why we are more effective than our counterparts. I see this effect in Facebook group threads for therapists all the time – arguments over the right way to approach something, shaming language, expressions of superiority. When the moderators sort it out and the argument is resolved (or not), I’m left wondering – must we be so competitive with one another?
I submit the notion that, in the field of mental health, there is room enough for all of us. Truly, there is a need for all of us! There is space enough for as many different treatment modalities and clinicians as there are unique people seeking support for their individual needs and circumstances. This is not a black and white field, to be sure. As clinicians, we have the privilege and the responsibility to support one another, because doing so means that we are meeting the needs of as many individuals as possible, and goodness knows that’s what brought us all here in the first place.
So, my deepest apologies to my client from that group, who had to remind me that therapy is not a one-size-fits-all affair. And my apologies to CBT practitioners, who are out there changing lives and supporting their clients with their skill and knowledge every day. I’m on your team. We’re all in this together.