Someone to Talk to

When we're in emotional trouble, and our friends and family get to their wits' end with trying to help us, they're likely to say, "Do you think maybe you should, um, well, you know, talk to someone?"

That's a curious phrase, don't you think? After all, we've been talking to the very folks who say it. And they obviously know that. So why the phrase, "Talk to someone"? The word "talk" must have some special meaning in this phrase.

And it does. Mental health professionals do a special kind of talk.

Freud referred to psychoanalysts as "secular pastoral workers" in his little book, "The Question of Lay Analysis." Jerome Frank, in "Persuasion and Healing," pointed out that every society has designated healers to help with personal distress-shamans or witch doctors, for instance, in early cultures. Mental health professionals play that role for us. Thomas Szasz, in "The Myth of Mental Illness," said that psychiatrists are more like ministers than physicians.

Over the decades, many others have likened mental health care to religious work - sometimes as a compliment, sometimes as an insult.

A few major figures in the history of mental health care have happily laid claim to religious tradition in explaining and justifying their work - Carl Rogers, for instance, who started his graduate school work at Union Theological Seminary. A great many of us, in private conversation, will talk about how we sometimes feel that we fill a "priestly" role.

For the most part, though, mental health care professionals see themselves as doing something completely different than anything religion has ever done. Indeed, it's common (especially among psychiatrists), to claim that religious care was a Bad Thing, and mental health care has brought The Wonders of Science to human problems, banishing religion and its ignorant superstition.

I think we could gain a great deal if we embraced the idea of pastoral care as a way to understand and shape mental health care.

In one sense, this has already started. In the last decade or so, mainstream counselors and psychotherapists have embraced Buddhism as a source of insight and healing. "Mindfulness" has become a watchword in psychotherapy, and "mindfulness" derives directly from Buddhism. Paradoxically, very few Buddhists meditate, but American psychotherapists teach Buddhist meditation, along with many Buddhist religious beliefs, to their patients.

Of course, these therapists do lots of studies to show that such practices are "effective," and that lets them claim that what they are doing is scientifically legitimate.

But that's a bit of flim-flam. No one, so far as I know, studies whether Christian, Jewish, or Islamic prayer would work as well, or teaches patients such practices. Common sense suggests, though, that these other religions would work nicely: billions of religious adherents find them effective, and there's no reason to think that psychotherapy patients wouldn't benefit as much from them as from Buddhism. Claiming special scientific legitimacy for Buddhist practices is a fig leaf.

In my next few blog posts, I'll begin exploring the notion of secular pastoral care. I say "secular" to make two points: I'm going to claim that pastoral care - a special kind of talk that every society needs, which I believe mental health professionals can provide - need not be affiliated with any religious organization, and it need not be seen as mediating any special supernatural or cosmic powers.

Mental health care can lay claim, though, to certain elements of human experience that, I believe, promote meaning, reconciliation, and peace, elements of human experience of which religion has most often been steward. That's what makes therapeutic talk special, or can. But more on that later.