Thom Harrison on Getting By, but Not Getting Better
Recently I had a chance to spend half an hour with Thom Harrison talking about his career and the need for the EternalCore Conference coming up in March this year. In the interview, I asked him about aspects of his practice and his life, teaching at the university, about the change from therapy to medications in psychiatry, and what brought him to ask us all to reconnect our hearts, souls, and spirit to our brains. This was his response:
“I remember feeling a real let down in my educational experience because so much of it was based on theoretical constructs. Initially, I was trained in the seventies and late sixties in a more Freudian psychoanalytic orientation. I liked the underpinning this training created in my life because it gave me a sense of how families and environmental circumstances effect our mental health and neuronal development.”
“However, it always felt a bit hollow and missing important elements of healing. The spiritual aspects of the individuals were never considered. Initially, I learned a great deal from this psychoanalytic approach to mental illness. I then moved into a very behavioral Skinnerian approach to treatment. That involved observing negative behaviors and extinguishing them through behavioral reinforcement. The entire focus was based on looking at people like rats in a maze. This was not very humanistic or rewarding for this therapist.”
“What we did with this approach was reinforce good behavior and extinguish bad behavior. You extinguished a bad behavior by not reinforcing it and ignoring it over and over again. Over time the behaviors were extinguished. The premise, Skinner believed, was that we are just all part of the animal race and respond to what get’s reinforced in our homes and society. What was reinforced continued, and what was not reinforced diminished and ended up being extinguished.”
“This works if you can constantly keep people in a rat maze. But we are talking about people in real life, where the variables are far more complicated. You can believe that you can control them, but the reality is, people can’t always be controlled this way, unless you’re constantly with them. The constant of the reinforcement must be maintained. (whatever it is that is a reinforcement for them.) You know, shoving the Oreo cookies down their throat and saying, ‘good boy, you did that very well. Now here’s another Oreo cookie.’
” I felt very confused, and not so happy with doing this kind of treatment for the entire length of my career. I saw no hope of truly helping patients in getting better. I wondered, ‘No, this can’t be right. There must be something profoundly missing.’ What was missing for me was the relationship, the spiritual and cognitive side of the brain equation. Proper brain development seemed to be misunderstood. Advancements in understanding brain function have gone a long way in helping me understand what was previously missing.
He said that patients have to know, “That you’re a real human being and that their brain is capable of changing and getting better. See, the doctor-patient structure of relationship is very important. Up to this stage of development it had been very rigid in its format. The doctor often sat away from, or behind the patient’s chair.”
“You really didn’t have much eye contact with them either because they were behind you or were distant from you. You just allowed their mind to flow with their subconscious thoughts, rehearsing the subconscious thinking that was emerging and coming to the surface. This was a process of waiting for the patient to come to their own conclusions and insights for their aberrant thoughts and behaviors. That was the psychoanalytic process in a very small nutshell.”
“What we’d do was nudge them in the appropriate direction by questioning or by giving verbal cues in the ‘right’ places. The focus was on whatever moved the patient to, ‘Yes, keep moving forward, keep going with this.’ But, it took a very long time and was very expensive. It seemed that only the very rich could afford this kind of treatment.’
“You can be in psychoanalysis for years, for your entire life. I thought there had to be a better way which was more time effective and less costly.”
‘I then began hearing about Skinner’s behavioral approach because people were getting better really quickly. But you always had to be there reinforcing them, or teaching someone else to reinforce them.” He said that, ‘that is what I mean about treating people like the rats in a maze, and I didn’t like that approach to life or therapy.’
“So then I became very reality and cognitive based in my treatment approach. These types of therapy allowed me to see patients as people, as human beings. People learn negative things from their family, as they may learn negative traits from their culture and personal experience. Therapy and treatment are often needed to recognize when to let go of these traumas. New skill sets are often needed in dealing with the complexities of life in more functional wasy.
“A lot of our parenting is a knee jerk action or reaction to what we learned from our parents or what they did to us. You know, ‘spare the rod-spoil the child,’ kinds of approaches to parenting.
“I went with this relationship and cognitive approach to treatment and to helping people change their thinking. Outcome-based questions gave them insights into their behavior and allowed them to come up with different ways of acting. I saw a lot of profound changes as people learned that they could change their behaviors and thinking. They could start to see themselves differently than how parents, siblings, medical professionals and others had described or labeled them. In seeing themselves anew, their lives started to change also.
“As you create a relationship of trust and interaction, belief and change also flourishes. As people play together, share, observe and interact in a positive open, truthful way, brain structures and neuronal patterns open to change. A new awarenesses of self becomes available to them. Once you have the trust and start seeing changes, people can move forward. I found that understanding and relationship really helps in the healing process when they are based on trust, safety, choice, and new thinking.
Then he went on to explain that in 1983 and 84 there were marijuana studies. ” Scientist were seeing how and when using therapeutic doses of marijuana could be helpful for depression, pain management, and anxiety. When these researchers were looking at marijuana, they knew that ‘pharmacologically’, they couldn’t control marijuana use in the United States. They realized they could not make a monopoly out of this plant and make millions of dollars off of its distribution.”
It was said that if anyone could grow it for self treatment, or recreational use, that Big Pharma could not control outcomes. So something had to be done about marijuana. ‘Their solution was to make it illegal. All research related to its use for mental health issues was discontinued. They treated it as evil, bad, terrible and awful. This totally changed the structure of the ability to do further research regarding its use. No longer could anyone even have it in their offices or labs, because then they were accused of having controlled substance. Please don’t get me wrong. There are many negative effects to this substance, which I won’t enumerate at this time..
‘A lot of the studies looked really promising before this happened, however because it showed promise in helping people with depression, with pain management, and with anxiety it was now not available for further study. And they [Big Pharma] realized that they could control Benzodiazepines, antidepressants, and other psychotropic medications. Most of these are manufactured from the poppy seed, which are heroin derivatives.
“They could also control this new stuff, known as serotonin reuptake inhibitors—which are the Prozac, Luvox, Zoloft and all of the myriad of new names and formulations of antidepressant medications. Out of these, a monopoly could be made. (Now again don’t kill the messenger.) Medications like these have their place in the treatment of manic depressive disorders, psychosis, anxiety, and other severe depressive states. My concern is what appears to be the overuse and
‘When the profession went in that direction. we made people more and more dependent on the pharmacological piece of the mental health spectrum. The relationship and therapy component of treatment was moved to the back burner. The reality of, ‘I am your physician, (if you’re a psychiatrist or an MD) and I’m going to manage your medications and this is going to be your savior in your battle with mental health issues became dominant. We kept hearing, “Medications alone are what’s going to help you.” Current medical training has now moved almost totally away from psychiatrists even learning how to do psychotherapy treatment. They focus on how to manage and prescribe psychotropic medication.”
Thom explained that he liked the mix of medication with skilled treatment, “helping people have the trust in the relationship and not have it all directed towards pharmacology or the psychopharmacology markets. The psychopharmacological drugs can assist patients out of the difficult early stages of depression, anxiety and overwhelming symptoms. When we keep pushing medications and new configurations of psychotropic meds, patients believe they are forever doomed to adjusting meds and to an attitude of ‘what is my new cocktail of drugs for this year verses last year’s’, mentality. Our goal is to help them move out of that dependency, and when possible, help them wean away from a life-long dependency on medications. There are some diagnostic criteria that does not allow this to occur.
“One foundational principle for establishing EternalCore was to help patients and providers remember the importance of the relationship and finding a supportive community. Relationship therapies seem to be down played and have almost become discarded by some professionals. When this happens the relationship component moves from learning and cognitively changing our mind sets and behaviors, to an exclusive focus on medication that is touted to be all that can and will be needed for the sufferer improvement. He explained that would mean we no longer needed ‘the relationship, therapy experience. I’ve found that people were getting better, but there was no healing taking place. There was just keeping them dependent on the psychopharmacology side of treatment and treating symptoms. “
This interview with Thom Harrison continues in our Podcast listed below.
You can also hear Thom speak at the EnternalCore Conference, March 29–30. 2019 at Salt Lake City’s Little America.