September 29, 2009

Should PhDs be Therapists?

There has been a long-standing dictum among many therapists who are classically trained in Wilhelm Reich’s method of treatment that only physicians should practice this therapy. Reich was a medical doctor and felt medical training was a prerequisite, which is why he called his treatment approach “medical orgone therapy.” For most of my career, as a physician and medical orgone therapist, I agreed. However, my thinking has changed.

In the “old days” psychiatrists did mostly verbal therapy. Until the advent of psychotropic drugs in the early 1960s (Valium was marketed in 1963 and Prozac in 1987) medications were reserved for severe psychiatric illness, such as schizophrenia and bi-polar disorder. Psychiatrists treated anxiety and depression with some form of psychotherapy, and they were reimbursed for it. Today, medications are viewed as the “only way to go” for the full range of emotional problems. Today’s psychiatrists are trained almost exclusively in psychopharmacology and they have hardly any training in verbal approaches. And, most significantly, the way that insurance companies reimburse psychiatrists does not allow for multiple extended visits. If some discussion of one’s emotions and situation is deemed appropriate, patients are referred to a clinical social worker other mental health care provider. The bottom line is today’s psychiatrists don’t learn a verbal approach and don’t want to, because there is no money in it.

As a result, it is unreasonable to continue to hold that only medical or osteopathic doctors should be trained to practice orgone therapy. In the best of all possible worlds, this would be the case but in the real world this is an ideal that is unrealistic. The sad truth is that the therapy, as Reich practiced it, is rapidly on its way to extinction. And it will become extinct, unless there is room for other disciplines to train and treat in field. In my view, Ph.d. psychologists are the natural choice when considering who should be trained. They are psychologically oriented and have had many years of training in the methods of psychotherapy. They are actively seeking innovative sub-specialties. I feel many would possess the potential to excel and would be eager to begin training in this field.

Because there is direct body-work involved in the therapy, psychologists who train would have to have knowledge of anatomy. And, of course, they must always refer any physical complaints that might arise during the course of therapy to the patient’s primary care physician.

So I pose the following questions for consideration and debate: Is it best to hold to the strict standard, knowing that the therapy as Reich practiced it will most likely disappear? Could a qualified Ph.d. psychologist be a competent orgone therapist? If not, why not? How best to attract psychologists? Should practitioners in other disciplines be trained as orgone therapists and, if so, which disciplines? I am eager to hear and discuss all views on this topic. Join the discussion and post your comments!

Psychiatric Orgone Therapy

One of Wilhelm Reich’s most important and lasting contributions is a unique treatment for emotional disorders called psychiatric orgone therapy. Reich began as a psychoanalyst and was a member of Freud’s inner circle, but moved away from Freud’s method of free association when he developed a more effective verbal approach he called character analysis. Later he came to recognize the existence of a specific biologic energy in living organisms that he called “orgone,” which was coined from the word “organism.” With this discovery Reich was able to combine his verbal method with a technique that could normalize a person’s energy. The result was an entirely new approach to treating emotional disorders that he named orgone therapy.

Reich’s work with patients convinced him the disturbance in an individual’s energy state is caused by contractions in the body, especially in the musculature. He called these contractions “armor,” and established that they begin to develop in infancy as a way to block out emotionally painful events.

Past traumatic experiences are locked in the body--and they remain throughout life. How this happens is not fully understood, but there is no question that anxiety, anger and sadness, as well as the other upsetting feelings and emotions from childhood are not forgotten. Armor not only holds the disturbing past, causing it to remain alive but out of consciousness awareness, but it also affects how one feels and functions. Because living a natural healthy life depends upon whether a person’s energy flows freely or is blocked, the aim of psychiatric orgone therapy is to free up energy by breaking down armor. As these areas of holding dissolve, patients release their long buried feelings and emotions in the safety of the therapist’s office. They most usually surface spontaneously with the specific method Reich innovated, without the need of urging or any intervention on the part of the treating psychiatrist. However, occasionally, pressure needs to be applied to spastic muscles, or other techniques used to normalize the body. Because this treatment combines a verbal approach with a physical technique, it addresses both the mind and the body to bring about profound changes in how one thinks, feels and functions.

Today almost all people seeking treatment from a psychiatrist are given medications to reduce their symptoms. However, with psychiatric orgone therapy it is usual that patients, over time, find themselves able to wean themselves off medication and function without pharmacologic treatment. Reich’s therapy is unique in that it not only relieves distressing symptoms, but also does much more. It enables individuals to expand and feel pleasure, and better enjoy the many satisfactions life has to offer.

There are people who claim to practice some form of “Reichian” or “orgone” therapy, even though they have had no formal training in medicine or psychology. Often the techniques used by these self-proclaimed therapists have little or nothing to do with the very specific methods Reich developed and taught. The value of such therapies is questionable and may even harm those who get involved in them.

Qualified psychiatric orgone therapists have extensive training. They are physicians who have gone on to specialize in psychiatry and then in the very unique subspecialty of orgone therapy. They practice in much the same way as Reich did more than a half century ago. Ph.D. Psychologists who have had proper training can practice a form of orgone therapy safely and effectively. However, it is crucial they have supervision by a qualified psychiatric orgone therapist.