How to Measure Progress in Psychotherapy

Look, we all agree; we have a triune brain--3 brains in one, each with different functions. So one brain can be sick and the other two not so. Or two brains can be sick as a result of compounded early trauma. So isn't it silly to measure progress in therapy and leave out half or two/thirds of the brain? This is what is going on in psychotherapy today. We do followup studies with paper and pencil tests of mood, attitudes, comprehension and other intellectual/cognitive tests. And what do we get? A one third appraisal. So the mind works but the body is a wreck. The engineer functions very well at work while his body is preparing itself for cancer. Or the mind does not work, as in attention deficit disorder, but the body still gets migraine; or the ......you get the idea. Part of us can be more damaged then the rest of us. But all three parts need to work well and in harmony for us not to get seriously ill.

Can you imagine an MRI specialist studying only the cells in the kidney but not the mind? Not a good idea because the sickness starts up there. And we need to cross-reference all parts to see how they interact. We need to get out of the fragmented approach, taking the head and muscle cells to understand migraine, when all we will understand as a result is how those cells work, not how the system works together with other systems., and how that interaction produces symptoms. Again, I am pleading for a unified field theory of illness; illness of all kinds. Yes we need specialists who know more and more about less and less, know how the muscles in the neck work, how they contract and what happens to the blood vessels, but not anything about headaches, their cause and sudden appearance. Yes, they say the vessels contract and this or that happens to them but never why; never the ultimate cause, and certainly never the demise of the symptom and how we can achieve it.

So we treat a drug addict and we measure him afterward. And she feels great; all those great meals, massages and lectures. They work to drown the fish. But we measure the biology and there is a raging cauldron down below; the cortisol level is chronically high and can be life threatening. So much for self-awareness. Or vice versa: we are strict medical scientists and we measure cortisol and the person seems OK but he still feels terrible.You see what I mean? There are parts of us that need to be examined. It may take a combined crew but it will be more accurate. We have been fragmenting the patient, dissecting her because it is easier to study than the whole system as an ensemble. And we get a full blood panel, and we read the numbers and they tell us whether the patient is sick or not. Not much interpreting going on. We become bean counters, so much of this, too little of that and voila, you got diabetes. And of course it is worse in psychology because we do not have enough precise measurements to give us a precise diagnosis. So we ape medicine and imagine we do. We don't.