Psychodynamic Nonsense

The art of ‘being for another’ – following, listening to and making sense of another person’s world – has been practised for millennia. Humans have always discussed their lives, their values and their problems, trying to find meaning, solace and joy. Experts at this sort of discussion have been called wise women, shamans, priests – and now therapists. Then, starting with Sigmund Freud, came a series of attempts to create a science of psychotherapy out of it.

But there is very little science to it.

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I became a psychotherapist and psychologist to maximise the good I could do in the world. It seemed obvious that helping people by engaging with the root of their suffering would be the most helpful thing to do. I also became a child psychotherapist to address the roots of suffering in childhood, where they seemed to stem. I experienced how deepening into a feeling could transform it, and learned about pre-natal trauma; I even wrote a doctorate on trauma. Now, two decades into my career, I practise, lecture, supervise and write about all of these things, but increasingly I reject everything that I learned. Instead, I practise the art of ‘being for another’, an idea that arose in conversation with my colleague Sophie de Vieuxpont. I’m a mentor, a friend in an asymmetrical friendship, and a sounding board and critical ally assisting people as they go through the complexities, absurdities, devastations and joys of life.

Along the way, over years of practise, I lost faith that awareness was always curative, that resolving childhood trauma would liberate us all, that truly feeling the feelings would allow them to dissipate, in a complex feedback loop of theory and practice.

The effect of your family environment matters very little when it comes to your personality

It started with returning to an old interest in evolutionary biology, with the release of Robert Plomin’s book Blueprint (2018). An account of twin studies, the book draws upon decades of twin statistics, from several countries, and the numbers were clear: childhood events and parenting rarely matter that much in terms of how we turn out.

That caused me to re-read Judith Rich Harris’s book No Two Alike (2006), which also examined twin studies along with wide-ranging studies of other species. Harris proposed that the brain was a toolbox honed by evolution to deliver sets of skills, leaving each of us utterly unique.

These books are perhaps summed up best in the second law of behavioural genetics: the influence of genes on human behaviour is greater than the family environment. I noticed my defences popping up, desperately trying to find holes in the science. But at the end of the day, without cherry-picking data conforming to what I learned in my training, the simple fact was this: twin sisters with identical genes raised in totally different families developed very similar personalities, while adopted sisters with no genetic links raised in the same family had very different personalities.

That finding, from the journal Developmental Psychology, undermined years of learning in psychodynamic theory. It means that the effect of your family environment – whether you are raised by caring or distant parents, whether in a low-income or high-income family – matters very little when it comes to your personality. If you’ve ever had any training in therapy, this goes against everything you have been taught.

Yet the tenets of psychotherapy did not reflect my clients’ lived experience, or even my own. Instead, we see what we expect to see, and we make sense of our past based on how we feel now. If I am sad, I will recall deprivation and strife in my childhood, while my happier brother remembers a more positive situation; consider the memoirs Running with Scissors (2002), Be Different (2011) and The Long Journey Home (2011), each a radically different depiction of the same family.

In the few longitudinal studies that have been made, where we track children and their adverse childhood experiences (ACEs) from early years to adulthood, there is no link between ACEs and subsequent adult mental ill health. There is only a link between adult mental ill health and the ‘recollection’ of ACEs. This may seem wildly counterintuitive to a profession steeped in trauma theory. ACEs have not been shown to cause mental ill health; it is rather that, when we suffer as adults, we interpret our childhoods as having been bad. I’m convinced that there are rare exceptions to this, of truly horrendous childhood experiences that do leave a mark, but even that certainty falters when I consider the fact that events that supposedly traumatise one person in a group fail to traumatise the others.

If you are denying what I’ve just written out of hand, you may be doing what religious fundamentalists have been doing for millennia. What I say may feel heartless, cold or politically toxic, but feelings aren’t epistemically valid grounds for rejecting information.

Our treatments could be largely pointless and potentially harmful

Instead, consider this: it is possible to care about suffering while reassessing your analysis of how it is caused and how it can be addressed. Perhaps a vast majority of therapy trainings are wrong about why people suffer. People in other cultures with radically different worldviews about how suffering develops and how best to deal with it also care deeply about helping people – they simply have a different way of doing it.

We need to reconsider why people suffer to help them in a better way. Freud and more recent trauma proponents like Gabor Maté tell us that our personalities and sufferings stem from how we were treated as children. This may resonate with us, but it could actually be wrong. If it is wrong, our treatments could be largely pointless and potentially harmful, and we need to critically examine these theories more carefully before we, as a profession, do more harm.

Historically, in many cultures around the world, from Nigeria to Malaysia, or the West more than 50 years ago, childhood has been seen as just one of the stages we move through, with no sacred status. We learn all the time, but suffering stems from how we now, at this time, relate to the world and what our current circumstances are.

Isn’t it a bit arrogant that so many in the West assume that this new, unevidenced theory – that suffering stems from childhood – should be universally true, or even true for us? How does the psychodynamic therapist, faced with their suffering client, feel resolute that they should dredge up the past, when philosophical traditions from across the world say the answer lies in the here and now? The Buddha, Lao Tzu, Aristotle and Jesus didn’t mention a word about childhood’s irreversible stain on the human condition – they saw us as individuals living through choices in the now.

- After decades of practising psychotherapy, I believe it has little foundation in science and often causes harm