The specific psychotherapeutic strategy that Rosmarin identifies is what is often called a symptom-relief mode of psychological treatment (which eliminates some of the pain):
This is consistent with recent evidence suggesting that brief psychosocial interventions are highly effective for people with adjustment disorders. Therefore, I envision a broader model for psychotherapy: People should be able to seek guidance from mental health professionals before they need a diagnosis. It should be the norm for all Americans to have an annual 50-minute psychotherapy well visit.
It is at this point that I diverge a bit from Rosmarin. He still seems to be trapped in the highly seductive assumptive world of mental health. His clients/patients still need to change and require his expert assistance. His client is not going “crazy” after having the panic attack – and Rosmarin reassures her of this. I would push Rosmarin in a new direction at this point, suggesting that the world in which his client/patient lives might be “crazy” even if she is not. She should not just recognize her misconception. This woman should spend some time with Rosmarin considering how to alter the potentially “crazy world” in which she is living.
I am enough of an organizational psychologist and executive coach to know that change often needs to occur not just in the head and heart of my clients, but also in the world where they reside—otherwise they can become victims and we as therapists, consultants and coaches can become “enablers” of this victimhood. An assumptive world of Aspirations requires that we look at external as well as internal pathologies. We are not independent beings but are instead intimately interwoven with our environment: we live in our world and our world lives within us.
As Resmaa Menakem (2017) has noted, we all live with pain in our life and are surrounded with a world that all too often inflicts this pain. However, as I have already noted, the pain can be clean. It is a pain from which we learn and grow. By contrast there is pain that is dirty. It derives from traumatizing life experiences that are never processed. I come back in alignment with Rosmarin when he opens the therapy door, so that dirty pain can be confronted. Furthermore, I agree with Rosmarin when he identifies the need for prevention along with treatment. While pain in life can’t be prevented, it can be minimalized and addressed before it becomes entrenched as dirty pain. It seems that the existence of trauma in our life can itself be traumatizing. We are anxious about our anxiety. We are fearful that fear will reside in all the corners of our life.
