Anaheim, Calif. – The array of giants in the field was impressive at the Dec. 9-13 sixth multi-disciplinary Evolution of Psy-chotherapy conference, despite the toll time has taken since the first conference was held in 1985.
Keynote speakers were Aaron Beck, M.D., who spoke via video due to ill health; Deepak Chopra, M.D.; Salvador Minuchin, M.D.; Robert Sapolsky, Ph.D.; Andrew Weil, M.D.; Irvin Yalom, M.D., and Philip Zimbardo, Ph.D. Martin Seligman, Ph.D. was an invited faculty member.
The meeting, billed as the world’s largest psychotherapy conference, was attended by more than 7,000 therapists, including psychologists, psychiatrists and counselors of various specialties. Sessions were held in the Anaheim Convention Center and two nearby hotels.
The roster of keynote speakers by no means exhausted the list of acclaimed psychotherapists giving presentations. Others included Albert Bandura, Ph.D.; David Barlow, Ph.D.; John Gottman, Ph.D.; his wife, Julie Gottman, Ph.D.; Otto Kernberg, M.D.; Donald Meichenbaum, Ph.D.; Erving Polster, Ph.D., and Jeffrey Zeig, Ph.D.
Zeig is director and founder of the Milton H. Erickson Foundation, which organized the conference co-sponsored by the Department of Counseling at California State University, Fullerton.
Nicholas Cummings, Ph.D., and his daughter, Janet Cummings, Ph.D., were unable to attend because Janet and her daughter were victims of a Dec. 7 auto accident caused by a hit-and-run driver. Their injuries were not considered serious and both were released following an overnight hospital stay for observation.
The conference was dedicated to 24 deceased pioneers of psychotherapy featured at earlier conferences. In a presentation, Meichenbaum alluded to those losses with a bit of grim humor. Meichenbaum said he and other regulars have dubbed the conference: “See them before they die,” adding, “Each time I get invited, I get my cholesterol level checked.”
He specifically referred to the loss of Albert Ellis, Ph.D., who died in 2007. Meichenbaum good-naturedly offered an obscenity-laced quote from Ellis who was known to insiders almost as much for bringing “the F word” to psychological discussions as for developing Rational Emotive Behavior Therapy (REBT).
Topics varied; Expertise unwavering
Meichenbaum and Polster appeared together in a session on how to make psychological interventions work.
“This is a critically important topic and a propitious one, given the state of psychotherapy,” Meichenbaum said. He said he is concerned that some may use evidence-based treatment as a rationale for limiting therapy to “manualized” approaches.
Polster agreed, “Our humanity is our greatest resource.” Polster said new technologies such as downloads for computers, Iphones and Ipods can greatly enhance therapy by providing exercises and “story-telling” examples patients can use between sessions.
“Entertainment is a fantastic addition to therapy,” Polster said. Meichenbaum suggested visiting www.melissainstitute.org for examples of downloads for the treatment and prevention of violence.
Health reform and the mind/body connection
In his keynote address, Weil said if the health reform movement is to produce real results it must do more to stress the mind/body relationship in health care.
“That’s where our problem is,” Weil said, contending that medicine has become too reliant on new drugs, many not well tested for efficacy and safety, and on more and more expensive tests such as MRIs and CT-Scans that may in coming years result in an increase in cancer due to radiation.
He said in simpler times people rarely took prescription drugs and the population overall was healthier. Psychiatry, which by definition means doctoring of the soul, has become a chief transgressor, Weil said. “How sad it is that that branch of medicine has become the most mired in prescription drugs,” he said.
Aaron Beck’s daughter, Judith S. Beck, Ph.D., said work at the non-profit Beck Institute for Cognitive Therapy and Research, which she directs, shows clearly that non-pharmaceutical treatment, such as Cognitive Behavioral Therapy, are effective in treating Axis II disorders, even borderline personality disorder.
She said in Axis II cases the therapist must be prepared to overcome dysfunctional assumptions of patients that cause them to resist treatment. They often foresee danger, fearing that raising negative emotional issues will be upsetting, that exposing problems will require changes that may be painful or that getting better will require taking risks they are afraid to face, such as returning to school or employment.
EFT in couple’s therapy
Susan M. Johnson, Ed.D., a proponent of Emotionally Focused Therapy (EFT), said MRI studies have shown that the attachments subjects make with others can affect how information from experiences is encoded in the brain.
“I’m a couple’s therapist and I’m an attachment theorist,” said Johnson, who is director of Canada’s Ottawa Couple and Family Institute.
She said the effects of emotional attachment were clearly demonstrated in a study where brain patterns were recorded as subjects received minor electrical shocks to their feet.
When the subjects were alone during the tests, she described brain patterns as “berserk” and the shocks were considered very painful. When a stranger held hands with subjects, the patterns were “less berserk” and the pain was lessened.
When a beloved spouse held hands with a subject, the brain patterns were “not berserk” and the shocks were described as minor discomforts.
Johnson said that is clear evidence that romantic love still exists, despite articles to the contrary in the popular press, and that it can be maintained in long-term monogamous relationships.
Ernest Rossi, Ph.D., and Francine Shapiro, Ph.D., gave a presentation on brain plasticity and evidence of the mind/body connection.
Rossi said certain activities, such as therapy hypnosis and psychotherapy can be shown scientifically to turn on genes in the brain affecting mood, and dreams are shown to turn on two genes that foster growth proteins and establish new neuro networks.
He predicted that with more research psychologists in time will be able to chart such brain activity and enlist it to heal psychological problems. Shapiro said true health depends on care of both the mind and the body. “There really is no separation,” she said.
Shapiro said some experiences, such as kidnapping, rape or childhood abuse, can be so disturbing that the brain’s information processing system is overwhelmed.
Her preferred approach for healing in such cases is eye movement desensitization and reprocessing (EMDR) in which the therapist has the patient simulate the back-and-forth rapid eye movement (REM) of dream sleep while assimilating information to reprocess traumatic memories.
Bandura outlined the processes by which good people can be programmed to do cruel things, such as justification through religious or patriotic beliefs that permit soldiers to kill during war.
Other strategies he outlined involve the use of euphemisms, such as describing the accompanying death of civilians in a wartime situation as “collateral damage;” assigning blame, such as branding operators of an abortion clinic as murders deserving punishment or dehumanizing opponents, such as the crusaders depicting Moslems as heathens.
But, Bandura contended, “Human aggression is not an expression of an inborn drive.” He said just as otherwise compassionate people can be manipulated to perform violent acts violent people can be reprogrammed to become peace-loving.
He cited Switzerland as an example. The Swiss Guard for centuries was a feared mercenary force available to the highest bidder to inflict devastation on an enemy, but today the Swiss people are known worldwide as pacifists.
Barlow predicted the DSM-V will not be a radical change from the DSM-IV, but likely will employ a broader view to group disorders with common traits thereby decreasing the use of NOS (not otherwise specified) diagnoses.
Barlow, who served on a DSM-IV task force, said publication of the DSM-V has been delayed until May 2013. He said draft criteria will be posted in January on the website www.dsm5.org.
The American Psychiatric Association issued a press release the next day in which David Kupfer, M.D., chair of the task force in charge of the DSM revision, said there will be a two-month comment period after the draft is released. He said reviews of the comments by DSM-V work groups will be followed with field testing of proposed changes.
Kupfer said the time extension also will permit linking revisions with the federal government’s scheduled adoption Oct. 1, 2013 of the International Classification of Disease (ICD-10-CM) codes for reporting Medicare/Medicaid claims. He said work will continue to harmonize DSM definitions with the international classification system in anticipation of the release of the ICD-11 by the World Health Organization in 2014.
Editor’s note: More information from the psychotherapy conference is available on Twitter, Facebook and YouTube links which are at www.evolutionofpsychotherapy.com.