Tuesday, June 23, 2009

Is Work More Therapeutic Than Therapy?

For several years now Dr. Sally Satel has questioned how much therapy can really help people who have been traumatized by a catastrophic event like 9/11 or Hurricane Katrina. As she put it: "can outsiders bearing therapy provide meaningful help in times of crisis." Link here.

She has concluded that therapy is not really needed: "... mental health advisers acknowledge that local economic and social recovery is a prerequisite for improved psychology, not a consequences of it."

Therapy that tries to help people to process their traumas tends to make them see themselves as victims. Once they enter that mindset they will be less likely to do the work needed to rebuild their lives.

To which she adds a well-known quotation by Harvard psychiatrist Dr. Richard Mollica: "the best antidepressant is a job."

Last Saturday Dr. Peter Kramer addressed the same question in the Wall Street Journal. Link here.

We all know Dr. Kramer as the author of "Listening to Prozac." Clearly, he has been in the forefront of those who have addressed the question of what works for psychiatric patients.

In his Journal article he concludes that work works: "Writing about the antidepressant Prozac I suggested that it can act as a co-therapist, nudging patients out of stale perspectives. Work is a yet more useful colleague; it offers patients particular lessons about how they behave and how others respond."

He adds, in words that resonate with the thinking of Drs. Satel and Mollica: "When I see patients who have been injured in their private lives, by past abuse, say, or by a recent trauma, such as divorce, often I suggest that they invest new energy in their careers. The workplace ... is more neurally instructive than the sphere of intimacy. When it functions well the office teaches us when to stand our ground and when to be strategic."

Dr.Kramer takes it a step further when he shift the nexus of psychological development from the nuclear family to the experience of work: "Who we are in our solitary relationships and in our close relationships is a product of who we are on the job. Increasingly, it's the workplace, as much as the home, that provides lessons about how to face personal challenges."

Kramer's article was occasioned by a reflection that today's college graduates are facing a decidedly unfriendly job market. He expresses his regret that many of them will suffer emotionally because they will not have the opportunity to launch careers.

Ironically, he adds, this same generation has learned in college that work is alienating and dehumanizing, the enemy of love and intimacy.

It is a harsh irony that so many young people are about to learn the hard way that the professors who taught them to devalue work were grievously wrong.

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