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Dr. Jerome Frank is professor emeritus in the Department of Psychiatry at Johns Hopkins University and has the unique distinction of having two degrees, one an MD with a specialization in psychiatry and a second a PhD in psychology. As counselors, we are faced with many contemporary issues in a changing world. Dr. Frank is a master at bridging the past and the present and helping those of us who work in the field of mental health better understand and prepare for our future. This film enables us to hear Dr. Frank discuss vital issues related to the field of counseling. On a more personal note, Dr. Frank is a warm and wonderful human being, who has touched many people's lives.
Dr. Jerome FrankAnd… so I'd say psychotherapy is an effort to change people's meanings from negative to positive through this relationship with the therapist. Now, let me say a word about that. If you take that positive about psychotherapy then psychotherapy is not so much a form of science as a form of rhetoric. Now rhetoric has a bad name in our country, but it's very old discipline and a very good discipline. And it has... when you've been... begin to look into rhetoric or what was it (inaudible ) said about rhetoric, what Aristotle said about it, it turns out to be very much like the principles of psychotherapy. So if you think of psychotherapy as a form of rhetoric, there are three aspects to rhetoric.
Rhetoric and Psychotherapy The Ethos of the Rhetorician The Arousal of Emotion The Argument
Jerome Frank One is the ethos of the rhetorician. The ethos is whatever makes him incredible, because you make authority over the (inaudible ). The other will be arousal of emotion, which happens in all psychotherapy. And the third is we used to call the argument. And the argument is everything else. Now therapies differ in the argument, and all the different forms we have are different forms of therapy, are different arguments, but that they all have in common, the relationship and the emotional arousal. Psychotherapy depends on the fact that that human beings react not to the facts or experiences perse, but as to the meanings of these facts as they interpret them. And the tiny example comes to mind from my daughter when she was learning to speak. This is not the daughter who collaborated in persuasion and healing. This is (inaudible ) it's another daughter. But anyway, she was quite a frightened little girl. And she was lying in bed one evening, when a lawn mower went by the window, very loud old-fashioned, hand-driven lawn mower and she panicked. And I remember picking her up and holding and explaining, that's just a lawn mower, it's not going to harm and so forth, and that was that. She quieted down and the next evening the lawn mower went by again and she started to tighten up, because your faced determines to tight. And she was about to cry. And then she suddenly said, lawn mower and relaxed. Well, she… she did given a meaning to this, it's a, it's a very good example of the way that a better need to who mastered events depends on believing on in some way. And here she given... She didn’t know what this was very fighting noise. She gave an innocuous label and then she was okay. And it has a very good paradigm of all the psychotherapy as well as rhetoric was the same thing. So the aim of Psychotherapy is to transform the meanings the patients attribute to events, from fright... from negative ones to positive ones. As this happened, as my daughter did with the lawn mower.
Dr. Clemmont VontressAnd then some of your works you have said demoralization is a chief problem that people have today. What exactly do you mean by that?
Dr. Jerome FrankWell demoralization, I guess is we all know what it means somehow.
Dr. Jerome FrankIf you feel frightened or sad, un... un... uncertain about the future, you lack self-confidence, you lack your sense of mastery, you feel you are the victim of events. And that brings whether the emotions that we all treat in psychotherapy. These emotions are things like anxiety and depression particularly, that that all, all our patients complain of those two. And I think many also complain of… also part of demoralization is resentment. And because of world isn't treating me well, and I don’t have to deal about it, I feel helpless. So you feel anxiety and depression or resentment are all part of demoralization, I'd say. All patients, I would say by definition, I demoralize so they wouldn’t come to see us in first place. We're the, we're the ticket of admission?
Dr. Clemmont VontressWhat are some of the special features of our society that cause people to have, to have psychological problems? That is do you think our society is driving people crazy?
Dr. Jerome FrankIt's a terrific problem. And I would refer you to a man named John Silber for that for loss of... more recently the President of Boston University. He would... he gave a series of talks and what he call The Pollution of Time.
Dr. Jerome FrankAnd it was like a light bulb going off in my head, because what he was saying, as I got it was that that real problem of the world today is the things that are going too fast.
Dr. Clemmont VontressYou have said that the speeding up of time in our society leads to the erosion of social order. What do you mean by this?
Dr. Jerome FrankThe social order against us is kind of continuity, as although we were urging value system and traditional ways of doing things so that you.... we... we can predict how you're we're going to behave, how we're gonna think and feel. You can pick up other people who are gonna do it. And that predictability is absolutely essential for a peace of mind, it seems to me. Even if it is negative, even if... if it is less to... to anticipate a tragedy then not have, do not to be able to anticipate anything. And it's a hardest thing to stand. You just... believe me, as such... there is a phase of mental illness. I remember we had Schizophrenia for example can be thought, being that kind of a problem, and for these people live in an unpredictable world, and that’s the... that's the real source of their distress. Because they can't read other people's behavior and they can't predict their own behavior that was gonna happen. And they also they're have to be confused, because of their illness. And that’s I think was such a terrible time. It's not a cause of Schizophrenia. I don’t know what the causes of Schizophrenia is, but it's a phenomenon that's user friendly. To be able to organize one’s life has to be sense of continuity. But when things change too fast, the continuity breaks down. As a philosopher, Alfred North Whitehead said, I thought it was very interesting, he said to this to me when I was a fresher, sophomore art(ph) college, about 60 years ago, long time ago, he said you are the first generation in history, that cannot be guided by the precepts of (inaudible ) grandfathers. See, because it was going so fast, you can’t rely on what our grandfathers thought of and since and that, we can't predict the future, because we had need up with there's no continuity there. So for example, while when one think of the what's going on now with Microsoft, new programs come up so fast, before the old ones are absorbed. And therefore new program comes out, and the same thing happens in the arms race, (inaudible ) impressed me especially, when in the old days, it took first generations for, for new weapons have developed, you know going from spheres, from clubs to spears and spears to bows and arrows, might take centuries, and now it got faster and faster and today atomic weapons are obsolete, before they are deployed, before that we can’t use them, that’s what I mean, by speeding up of time and that breaks down the continuity of life, and I invests… I think when we read in paper about how in spite of economic conditions improving and so on, no one is comfortable, people are so uneasy, and it has why, no one knows what to do next, because we had to go from the… we can't predict from the past to the future.
Dr. Clemmont VontressThat suggest an another question I like to pose that is how can parents help children live more effectively in… in a rapidly changing society?
Contemporary Issues How can parents help children to cope?
Dr. Jerome FrankI think it has comes down to helping the child to feel secure and valued whatever happens in the world, and that means of course of one thing, that certainly the love of the child appreciation… appreciation of child for himself, I got to guess the main thing. I think the other thing is and this is much harder to achieve these days, consistency ah… I think, if you, if you to be equally healthy if you are brought up in a very strict religion, not religion with family, or very loose and comfortable one, but there has to be some consistency, and the essence, I think of Schizophrenia, for example is unpredictability again. And you can't that you have to, you have to feel your parents and siblings are have a feeling that predictably interested in your welfare and that has a wide range, as I say you may quite brutal or quite kind, but that’s this important feature it seems to me, that doesn’t get us very far, I had made but it got my temperament has a lot to do work how it is I've never (inaudible ) in a world like ours today.
Dr. Clemmont VontressI find your response very interesting. What aspect of human nature lead... has has lead to the creation of the atomic bomb. Do you think the people are by nature suicidal?
Contemporary Issues Are Human Beings Suicidal?
Dr. Jerome FrankI think there are two things. I will suggest once the power drive, we all want all the power we can get as part of our survival technique really can control and power of the environment and to the extent that it is now a problem for mankind, and the other is something, I don't know, we call blood thirsting us(ph) we're, we're still carnivores in some way, and in certain circumstances, certain people, especially had a great kick out of killing other people and torturing them. And I think that’s been something, we none of the peace moves and I've really got know to deal with, I guess we can't deal with it. When a person is in that frame of mind like well Sarlene (ph) for example indicating that it is greater satisfaction in life, was to successfully wreck revenge on somebody that’s what you live for. But we used to talking about peace and those things to people like that, because they don’t, they don’t want peace. So as there are two things that seems to that, bloodthirstiness and then this power drive. And then that it goes out of hand entirely.
Dr. Clemmont VontressAre you saying that we by our nature are suicidal?
Dr. Jerome FrankThat’s a great question ah… we may be we may be... we may... we may be suicidal, in the sense that we can't control our own instrumental intelligence, we are wonderful tool building the big builders. But our ethics is... are not, are not equal to our tool building ability. So, but if you would put that and that makes too it's ominous. I really think it is, you see it as the first time, and it is the first time in human history, that we devised the weapons that sort of destructive enough to wipe out all life. We, we can do it now, we never could do it before, we kept on trying to, believing we were very far from it, and suddenly with the atom bomb and new, new tailor made pistols and sort of things that destroyed, we made... we... we may have released things that can wipe us all out. And when people going in war, they always, always as fast they... a... oh... to the limit you know, they finding to use the most terrible weapon they have, oh.. those... the most terrible weapon we found nuclear weapon, wasn’t was really awful, but never threatened mankind, this new one does, right now both directly and to the environment. The environment, so that’s why I am rather pessimistic, with the law but you have might you hear that was the best we can you know.
Dr. Clemmont VontressAnd that could that suggest a... a... another question. Are people inherently good or bad?
Human Nature… Good or Evil?
Dr. Jerome FrankThat’s the question of philosophers(ph) would have to answer, I can't… I think we are obviously both, and that's the same way the, the problem of evil. We can never really answer there it is, we call out the devil or what we like, but it remains inside of a problem for humans, it seems to me. I can't please it a way… inherited good, unfortunately I wish I could, But I can't.
Dr. Clemmont VontressDo you think that Sigmund Freud was correct in… in, in his idea that sex is a driving force of human nature, that is ah… does sexual frustration actually drive people crazy as he suggests?
Dr. Jerome FrankThere are two separate questions, it seems to me. I understand that Freud had a brave interpretation of sex. He didn’t mean it's only sex enticer(ph) organisms. He was showing about the life, the life force, or a greater force, or the fiddler(ph) force as a very important aspect of mankind, and I think he has been pushed into the wrong, people interpret him wrongly about that. So I would say that had been in any case sex is certainly not the only drive for humans and I think you have to agree with that, I guess when he talks about the ability to love and to work, has been the essence of mental health, than he is talking about more than sex, of course. You know, he was a moralist himself, I think he was badly maligned.
Dr. Clemmont VontressIn terms of love when many… many people are riding about love these days. Is love basic to good mental health. Or just can we live without love?
Is Love Basic to Mental Health?
Jerome FrankWell, you think... I think... How we interpret that? As this in the sense we're root features, we can’t live in isolation, even a hermit has a group behind them, where the people being proved and do worship, and maintain a distance and so forth. We can’t live in isolation, in that sense you can say that, love is part of a distance being a good creature, but our assumption is a sexual frustration, anymore than the other kind of frustration, it may be… eh... that one is a creator of mental illness, health as an independent variable, it seems to me. Some people suffer great deal from frustrations, and sexual other frustrations, some don’t suffer for those things, they know that they all they feel bad about it, there may be so... sort... suffer from it, but is not doesn’t dominate their lives and I think we… at the end there is a we mean sort of thing I think we exaggerate them, the idea that happiness is mere there's what love, like it was absence of frustration or pain.
Dr. Clemmont VontressCan you, can you explain that a bit?
Dr. Jerome FrankEveryone has own ideas about what is good mental health is? I think, probably it's having a positive attitude toward life, a sense of mastery or potential mastery was going on rather means helpless victim of circumstances, and I guess it's a big factor for I thought about the ability to love and to work as he put his fingers on…
What is Mental Health? Love and Work Happiness and Struggle Belonging
Dr. Jerome Frank…perhaps the main human traits, while there is affiliation and creativity is not just sex as you misinterpret for it to say, and work has request your ability to move the world along, with your neighbors and friends to make things get better, so I think those are parts of mental health too. I don’t think mental health is necessarily happiness, it's nice to have it, but I think I guess we have add certain... mental health is the ability to withstand suffering and stress, not happiness, and it's certainly not a plain equanimity. People who physically not... people who criticize psychoanalysts we're saying as try to rule over anxiety, and everybody happy, and so forth, and if you have to prove it, if you have no anxiety, and those problems will be dead. It is not valued… valued. It is not a... not a workable way of living, as it seems to be entirely. And so I think that those are some of the things I would think about, about mean by mental health.
Dr. Clemmont VontressWhat is your view about the effect of a positive mental attitude on physical well-being of people how that attitude might in fact affect the immune system of individuals.
Dr. Jerome FrankThere’s lot of evidence, so that on the negative side that depression or negative attitudes can weaken the immune system, I haven’t followed closely, whether you can also strengthen the immune system, without the positive attitude to strengthen it. I think, I've... But we suspect it's true, that I should have… have a positive attitude your immune system is functioning better, which is causing recess effect, I don’t know, but I think it's there. The other thing is about emotional and that depressed people on more prone to ordeal in various ways, but the positive side I haven’t followed closely, I suspect you will find that too, it will be true that a positive attitude goes with better health, but it get brings, you see that you are again, that I'm knowing it wondering into the American culture, because we find it hard to believe, that mental stage is gonna affect the body, it is easy enough to take a Bowley(ph) states affecting the mind, but if you have this, dicartesian(ph) notion, with the physical world and the mental world is separate, and the physical world is self-contained and every now and then the mental world dips into it, then you get the questions, that then you are puzzled by questions which people know that, for all the cosmologies you take for granted, there is no question for Hindu, for example the mind and body are so called mind and body are closely inter-related, all the thing in the universe is, is matter, while I guess, we (inaudible ) Whitehead comes to mind. He talks about the fallacy or misplaced concreteness. We think of matter is something concrete, and mind is something vague. But matter is high level concept, no one has ever seen matter, we see chairs and tables and molecules and oceans, but to talk about matters really abstracting from a whole a lot of host of different things and just one way slicing the universe and it is a very-very effective way, but it's I think we, that this say this early his own Whitehead's points, that they can’t by… separating mind and matter, make research possible, because god knows it is all concerned with matters, so you can really want to it, then it has extended nor concerned with animals, so you do if you want animals, only man or only the mind is sacred and that and that let to this tremendous spirit and knowledge and then of course, we be if we have fastened on us, he talked about that we, we do not examine the sources of our believes and here is a very good example, we take it for granted that our mind and matter are given by god, you know, and the only... only (inaudible ) finally, only now recent years, it has been realized as, they, Caucasians believe(ph) over the world there is only one view.
Dr. Clemmont VontressDo you believe that there is a real difference between what traditional healers do, and third world societies and what our psychotherapists here do?
Dr. Jerome FrankNo, I think the same principles hold and probably hold more effectively in the third world, because as you can tell me better than I can you know better than I really the tradi... tradi... traditional healer is part of a unified society, with a unified set of values and ways of doing things and therefore his power over the individual, he can heal because he can bring people back into the group, because it was just one group, and it all part of it and he is been a leader in it, it was very different from our western therapist, who is buffered by any number of troops at the moment and any number of value systems, so I think traditional healer has a real advantage, for many over the western psychotherapist. If you, if you brief us like us we go through that mental, that's that what and demoralization includes the concept of isolation and loss of connection with other people and the most healing rituals in other societies, mentally powerful and bring people back into the group than ours are.(ph)
Dr. Clemmont VontressWhy are those rituals so much more powerful in other societies than what our therapists do?
Dr. Jerome FrankI think, I think is because that maybe a misjudging the other societies, but my impression is they are more unified, they… and they are more structured, so that you can mobilize the family for example, in a way you can't had to do in the west, when they are all fragmented into single and parents, families and so on, that’s why I think it's so this (inaudible ) more powerful.
Dr. Clemmont VontressWe know that we have individual psychotherapy and group psychotherapy do you have a preference for one over the other if so why?
Individual or Group Psychotherapy?
Dr. Jerome FrankBy and large very much so I think the whole emphasis on individual therapy sprang up from the medical model in which the doctor and the patient, had a confidential relationship, so she lives in a another rest of the world, when there is a proper model again, proper model for therapy again, it seems to be as rhetoric, and the rhetoricians spoke to groups and that read at least to the emotional arousal aspect, because people are much more aroused in groups and then they odd, more usually individually, so often patients benefit more from, what they say to each other and then do from what the therapists says, I remember striking little example of a catholic young man, adolescent who is absolutely no… guilt, frenzy of a masturbation, and know I talked to him of that of some lengths and he didn’t know bit of good really. He was same (inaudible ) is all I was all done and then I put him in a group, and it was group with older men, many of them catholic like himself, and you know, I immediately understood what his problem was and that the turn over a bull(ph) session, I could have left the run he was really sure of these all things vanished and I want to ask him what did it? What helped him? And he said well the doctor lives in his own little world, he said usually it better from a bunch of guys, he said and that was it, and he immediately identified with any members of the group, he couldn't identify with me as a doctor, that's just one of the many examples of group therapy.
Dr. Clemmont VontressWhat about self help group such as AA Alcoholic Anonymous?
Dr. Jerome FrankLike I said the same thing applies, they are young as they... they... this fells step notion, which... which… which rigidifies many groups, with that story so maybe we can't (inaudible ) from them, therefore people who can't follow from that kind of thing, is very helpful indeed, and I am all for it.
Dr. Clemmont VontressThat’s very interesting, and it, it leads to another question, I would like pose, and that is can we scientifically measure the outcomes of psychotherapy?
Is Psychotherapy a Science?
Dr. Jerome FrankI guess you asked the people. Let's get back to the question, is this Psychotherapy a Science you know, I am not surely can but, I will see what makes me to pose, is I am a... (inaudible ) I'm computer illiterate. I really have no concept of what computers can do, and it may well be that all these a lot of the programs, and and prove this can eventually, hopeless meaning problem, which has a meaning to write, individuals static, and change from time to time and so on, but that’s so I'll keep their hope to open for this, but I think conventional thought as a science is very as we all know hasn't yielded a very important results, despite of the brilliance of the people who were in it, into it. Well they, they can (inaudible ) I think it has been demonstrated as well as anything it can be. The psychotherapy is better than no psychotherapy it works by the, any psychotherapy because the issues are helping us push on psychotherapy is different and that are effecting us again, and I guess a wrong question, because all depends on the particular patient therapist relationship and particular illnesses he is suffering from.
Dr. Clemmont VontressSome people believe that the best way to help people with problems is to help them to understand their childhood. How do you feel about this, this idea?
Dr. Jerome FrankWell, that's Freud's idea again, is one of the many rituals of etho psychotherapy, and it has a rationale and it's for some patients it may be true, that trauma, traumas in childhood affect our later lives, I guess it is true in some people, but to say that's everybody is clearly wrong it seems to me.
Dr. Clemmont VontressWe also find often in the newspapers today, articles pertaining to psychotherapists trying to get the individuals to recall their early childhood sexual experiences and sometimes using these in court cases but not to. What do you think about the validity of… of these kinds of activities in psychotherapy?
Dr. Jerome FrankThat's still not settled I mean the whole thing is up to... but the first thing you have to say is that, be patient who respond, report this kind of experience turn out to be very suggestible, and in general, it's a highly suggest for bunch of patient and as we know the patient enormously influenced by the pre-conceptions with their therapists, and the whole of, the whole approach is not as one which would assume the thing as true, you see assume is the memories happened, and then justify, and the patient doesn’t confess on that, because the patient is repressing or something, so the set of the interviewer is to get the information, it is there, but he knows is there, and that means the whole thing has contaminated, by always there may be something in it. I must saying there isn’t, but it's only… you don’t take why through or why do we, we never through all this stuff on top, which is the tremendous to just the ability of the patients and the conviction of the therapist, so they have the right hand, what, they... they know the right thing to do, so that’s I tend to put a reserve judgment, expect as in the world in general, I'm fond of putting Horatio and Hamlet, many says that there are more things in heaven and earth Horatio then I have dreamt having your philosophy and I think we should keep that in mind all the time we, we just have a small window on the world and knowledge, and we think that all goes through it. We don’t know things like telepathy for example, or peak admission or on the whole courses, not respectable phenomenon or even a very good psychiatrist a very respectable one, has written lot about young children’s memory of previous lives, and he is very convincing, very good evidence, I mean it's if people for example he have these children produce memories that seems where they have never been, and their parents have never been. And I then, I might have told all wrong, into or that here, of course, a sex is very far feel, that is a reminder that audible cosmology of the world, is just one cosmology and there are many… many others that are quite possible.
Dr. Clemmont VontressToday we... we read often in the press about the use of psychotherapy with... in a criminal justice system, and I suppose we could call that Coercive Psychotherapy. What do think about Coercive Psychotherapy being used in our criminal justice system?
Dr. Fred Bemak That... that whole question seems to be, is based on a misunderstanding, or misapprehension that criminology is as same as mental illness, and that basically they are very different. The mentally ill patient is suffering and wanted help, the criminals trapped in a system, it has a different set of values as his, and he is not really guilty necessarily, and he is going through the emotions of psychotherapy, he is may be trying to... he is really trying to calm(ph) these therapist to get something out of it, and that was I mean the therapy, therapy can't be useful for some criminals, for some criminals, but it, it does involve changing their value system, it doesn't involve, so… soon they have the same value system as the therapy says, so I've... I don't think that it has to re-formulated, there is successful work with criminals, but involves good punishment... punishment may be a part of it, and not... not... not inside may not be importance on, some pers... some, I remember, I was at the member of the protection institutionary in Maryland when they tried to give psychotherapy on, on people who were assigned to protect with, but because being criminal, that although, criminals, they also had some mental problem, and let me... let me notice so often, that criminals aim was to try how to flaw... how flux the therapists, and get something from him, not really had help for himself, so but if you knew that and work in that framework, and then there are some. I don't have them in mind, but were a couple very promisingly, rehabilitation programs, we should don't include discipline and punishment sometimes, and from working toward change the certain changes, the criminals value system, so it doesn't seem so as enemy of the society anymore, and the society sees the enemy, I should say.
Dr. Clemmont VontressAnd other thing that's very much in the news these days is the effect that, on insurance companies have on Psychotherapy, um... would you... What do you think about the implications of managed health care on psychotherapy today?
Contemporary Issues Managed Healthcare
Dr. Jerome FrankFirst of all again, I have to say, I've never go into this, it is what happened, since my time, so I don't have any real first hand information, but the... is psychotherapy is individualized, this whole effort had managed care, takes you away from the individual, patients have to come co... co... cohorts, and we would add on it, measured on various indices, and I used to, I used to ask for all who talked to some and believe people, and... in... in people, perhaps they have missed this, fits Johns Hopkins and they... they were there accusations more, there is a list of numbers, US force on the check list and scores on inventories, and scores on symptoms, as I said on symptoms and we look at the persons, the persons vanished, and then and all these numbers, anyway, and no hope at all, should try to do psychotherapy, a very little help. So that's my... that's my, that's how it looks to me now it has a very important that, it's important for another purpose that of psychotherapy of course, but for making it possible for knowledge accumulate, it will trouble with the feel, it's from research standpoint has been, that with two people working, using the same terms, we can know that there are trying up the same thing or not. Maybe one doctor one of the researcher produces the paper and tends to use FedEx or someone else chose on hundred depressions(ph), we don't know whether are those people are the same people others, starting about the same thing on their own. The one thing, that all this was down, I guess its DSM-III, the diagnostics theme has increased the probability that when two say accurately like 10 schizophrenics, they are talking about the same thing that's a tremendous step from the standpoint of research, but it's not, there is no real help from the standpoint of, this is stating with this patient's problems on his way looking at life.
Dr. Clemmont VontressThat's very interesting and that it leads to another question like to pose and that is ah... the... the use of Prozac and other anti-depressants in helping people with problems. Do you believe, for example that Prozac can replace psychotherapy as we know it today?
Contemporary Issues Drugs and Psychotherapy
Dr. Jerome FrankI think, Mr. Alford worked all of the things, relationships with drugs and psychotherapy. A drug like Prozac can and... and... has moved and increase enterprising us, and increase self-confidence, which makes the patient then, May usually solve his problems, or if it doesn't he is more accessible to psychotherapy, and knew psychotherapy better, by... because he will be proactive, as it were. He thinks by learning some psychotherapy and applies it. So I think it is a real, very important, the negative of course is that, if you just concentrate on the drugs then as the drug is stopped, and the patient relapses, feels where he was, but I don't see any basic contradiction between using this two brutalities in certain patients.
Dr. Clemmont VontressToday, as you know many people lose their jobs um... doesn't... does that fact contribute to psychological problems?
Dr. Jerome FrankOh yes, yes, but even this some people will stand this very well and some break down under it, and it have to the vulnerability of the person involved to, and the greater the stress is, I suppose the greater percentage of people will began to show mild health symptoms, but it's not the same as environmental stress is the, is added to their total life, which is basically a problem.
Dr. Clemmont VontressIs one a... type of psychotherapist better than another? What do... what... What do you've... What are your views on... on this?
Is one type of psychotherapy better than others?
Dr. Jerome FrankYes, but not in terms of one therapy lining up all the therapy orientations and saying which is good, and which is bad, you switch one tricks with the patient, for example, if theory of physicists might be able to respond better to say, cognitive therapy, which makes it all rigid... restrict... rigid and lined-up, but a, a religious person might respond much better to existential therapy, which fetches the values of life and so on... that's the reason you can't judge... that's why they all have a value, they all have a place, it is individualized, you can't breakout, its generalization. Some therapists as people had the ability to be more persuasive, there are more people on others of course, and that makes it harmful at different schools, and why there is a (inaudible ) I might say Freud is a massive powerful man, I respect, he was a great mythmaker in our time, and a mythmaker in a good sense, if he has wonderful structure very dramatic and appealing to people, and a method that the therapy that it goes on forever, because, it is always more past history to dig up, and all fascinating things to find out, so it appears for both the patient and the therapist, so I see their lives... everyone one of these therapists has an appeal. But it's not in terms of their objective, relatively objective, but little bit... in fact literally, and I become anonymous I can, I say you can't line up therapies and say this is better than that one. You can't say this will no appeal to that kind of person, and this will not appeal to that kind of person. And this therapy is going to attract a great many people and this therapy of course can only attract a few, isn't that realm that you can talk about differences in theory.
Dr. Clemmont VontressDr. Frank you have studied and worked with some of the most significant figures in psychotherapy, who influenced your career most?
Influential Thinkers Kurt Lewin Carl Rogers Sigmund Freud Albert Ellis Abraham Maslow Viktor Frankl Irvin Yalom
Dr. Jerome FrankFirst of all, I wanted to make sure that, you know, people know that I, never met Freud I then accused to be here, the cycle of, had a memories of Freud I never had met him, and there is only one figure, really I had a big influence on me, and that's Kurt Lewin , he is not a psychotherapist, he is psychologist, and he is a kind of a role model for me, that I would like to to aspire to but had begin to, and from the theoretical stand point, his notion that, behavior as a function of person and environmental always. It's not the one and another alone, you can't just study the person, as you get into with fore(ph) very often just, it is more than over the environment, to the person. Only that... You can't get this hung up, on the in a very environment like the behavior therapists, where everything is both of these, and he was a brilliant man at bringing down to the researchable level, real problems, in the, in the human nature, which most psychologists have not been able to do. For example he studied anger, and he studied the difference in memory over unfinished memories under unfinished tasks and finished tasks, this kind of thing. So even though excited and may be you could and.... that his conceptualizations, he was like a pinwheel as always new ideas coming up, always he just sits up there, he just sits there and just listen for hours, So he is... and... a is a real role model for, and of course that one side of him. He had enormous energy, he has three full time careers that killed him in his 50's so I guess it's really is a reason I think, as a surgeon now with more knowledge of (inaudible ) but, he, he first was a academic psychologist, used to be mentalist and then he believes in industry, he did like industry should know every people in industrial psychology, and then he was an art designist(ph) any one of these things, could have take... taken his full-time. He was always into… he never call up at life, always rushing, and then the... and that's personally he was very accessible. The German professors after he was very formal he was just I mean, he called by his first name, and all those kind of thing, so he was a real inspiration for me in those ways. I don't know, but I can't really say any other influenced me too much, I mean, I was in... I was far away from the environment. People like Carl Rogers , he who was very sympathetic to me. But, what... what… what struck in mainly is mainly in some of these healers, I was around, Rogers would be one and (inaudible ) a lot of people whose behaviors and other. He says they have it and only call as therapeutic personality as envelope you, and make you feel, I mean the patient, I guess and it isn't matter what their theory was, you know, they had that quality and you can't bottle that of course but and that struck me, I don't think any others that would be influence on me on my thinking, the way Lewin did and of course, that would be, that will be true, and no one else in a personal level, and you know certain... certain theories appeared to me as oddlers(ph) particularly and Freud for a while, but that's on the personal way.
Dr. Clemmont VontressWhat about Albert Ellis ?
Dr. Jerome FrankHe is the example, I would use to a person, who doesn't look therapeutic, but who is, and he is therapeutic, because he convince Zanodona(ph) I know didn't change, and I will make you change and so forth, and he used for (inaudible ) reinforce it, it was just not the model of a usual therapists. He also extremely perceptive and brave. You know we as a concerned(ph) patients say very pers... very convincing so but, his method is just that would have to be depressed like. I couldn't use this method, it's not part of me well, I couldn't despite where I would call Rogers' way of doing things for example. Then, there was a very small room, but only one person they cannot, you can learn from this other people, Ellis is really, I think we mentioned before is behind all cognitive therapies severely, you can learn from this (inaudible ) and reading them, but I can't say… interests me personally, but because it is language in, and it desire to shock people not to make and make it more appealing to some people, but you can take that all away, and still very good stuff I think. I think it's a weakness on me, but I never warmed up to Maslow , I don't look why, I just didn’t read nothing, I mean his idea that of the stressing creativity and, and pro-activeness. I think he was right, but somehow I never regarded nothing to this will be able to say, I could that I was influenced by him, and there were two people and three people, I didn't kept with… Viktor Frankl as, I've found myself very sympathetic to his view point. He, has people out of the same and some of them to do... that bad, I have wishes and so on, but by radically(ph) then, I think that's a very appealing idea to as you can't shifting meanings of same event. You know, for a sense, I remember his example of a person who as modified with the stress, we stress too much and then in fact, paradoxical that's the word, paradoxical intention, he... he was, he says okay sweat, sweat both in that so you can't… sweat (inaudible ) and so on, and of course he makes the thing ridiculous, and that's would rate us, but that works very well with some people, if you have the... if you have the ability of Frankl to do this to people. I think it also as a little book on some just (inaudible ), it essentially as a sense of perfect statement of "you can't control the environment, but you can control your allergy toward the environment" and that book with a beautiful as you can (inaudible ) by our sense that was it's a sort of... sort of... sort of persons who are dying all around him, and all over hungry and so on... I think it is a very inspiring notion that is for anybody including psychotherapists.
Clemmont Vontress Dr. Frank , One of your most famous students was Irvin Yalom . What do you think about his approach to group psychotherapy?
Dr. Jerome FrankI think it's absolutely excellent, he is really blanket of the field, who uses Borchardt(ph) youth therapy, this is a better (inaudible ) except beyond that too, he seems... I think his book on existential psychotherapy is very important in pointing out that (inaudible ) patient, mental patients that had exactly the same problems as other people have, it is essential problems, I think he has talked about the loneliness particularly, and that we all have a fear, problem about death we have to do with one way or another and isolation by... by approaching you know patients as individuals who, who suffer from the same human predicaments that Irvin Yalom's does rather than as riding in a something special, it makes them much, and again means that much closer to other people and that's one of the ingredients of all successful therapy to, overcoming that isolation.
Dr. Clemmont VontressIn connection with that question, what is your own theoretical approach to psychotherapy?
Dr. Jerome FrankI guess, I'm here with people (inaudible ) or constructionists, and that I think, we, we don't specifically experience the environment, you can construct the environment out of our... out of the input from the environment plus all the things we bring into from our own lives. And again the effort in psychotherapy seems to me to change some of those constructs, so that advance that as that are perceived by the patient as frightening or depressing, and is shifted to another set of reference, I remember a story of John Gardner , who was at first secretary of health and education, and welfare and was a new department which was just a mess, he was just starting the department, and he said I am surrounded by exciting opportunities, skillfully disguised as insoluble problems. I think that sums up the whole thing, we are patients, bring those insoluble problems and we try to shift you exciting opportunities which is into it. And people like Frankl talk about research for meaning, I find very sympathetic, but... I... I will say is not just the social meaning but changing meanings we had them, I think, I have said somewhere in this tape earlier, that we... we have experiences little bit daunted, it really mean to out away, so it was not the search for meanings, the meaning were due to that extent that I would say that as an I mean is essentialist or constructionist or whatever they call these days.
Clemmont Vontress What did Norman Cousins say about the Power of the Mind in healing?www.psychspace.com心理学空间网
TRANSCRIPT OF VIDEO FILE :
BEGIN TRANSCRIPT:
A Presentation of American Counseling Association ACA Great Minds in Counseling Dr. Jerome FrankPersuasion and Healing
Dr. Fred Bemak Hello, my name is Fred Bemak and I am pleased to welcome you today to the first film in a series sponsored by the American Counseling Association entitled Great Minds in Counseling. I along with my colleague Clemmont Vontress , I'm honored to bring to you a world renowned scholar, teacher and researcherDr. Jerome Frank. Dr. Frank is Professor in Ameritas in the Department of Psychiatry at Johns Hopkins University and has the unique distinction of having two degrees, one an MD with a specialization in psychiatry and a second a PhD in psychology. As counselors we are faced with many contemporary issues in a changing world. Dr. Frank is a master at bridging the past and the present in helping those of us who work in the field of mental health, better understand and prepare for our future. This film enables us to hear Dr. Frank discuss vital issues related to the field of counseling. On a more personal note, Dr. Frank is a warm and wonderful human being, who has touched many people's lives. I hope that this inspiring film with Dr. Frank will stimulate new ideas and perspectives about counseling for you as it did for me. And now, may I present to youDr. Jerome Frankinterviewed by Dr. Clemmont Vontress
Evergreen House Johns Hopkins University
Dr. Clemmont VontressDr. Frank what is psychotherapy?
Dr. Jerome FrankPsychotherapy is effort by a healer to make a... sufferer(ph) feel... feel more comfortable, the sufferer(ph) feel more comfortable or more efficient, through the use of words and symbols. Ah… there are several features about psychotherapy. I'd like to say something about to start with. This is a… most of you listeners will be psychologists I imagine, and they would like to think of psychotherapy is a kind of applied behavioral science. I think that’s the wrong model, because all science is based on facts, and facts are invariant over time, they are replicable and so on, but the world vary and in Psychotherapy is the world of meanings. And meanings that differ very much from facts.
Psychotherapy… The World of Meanings
Dr. Jerome FrankAnd… so I'd say psychotherapy is an effort to change people's meanings from negative to positive through this relationship with the therapist. Now, let me say a word about that. If you take that positive about psychotherapy then psychotherapy is not so much a form of science as a form of rhetoric. Now rhetoric has a bad name in our country, but it's very old discipline and a very good discipline. And it has... when you've been... begin to look into rhetoric or what was it (inaudible ) said about rhetoric, what Aristotle said about it, it turns out to be very much like the principles of psychotherapy. So if you think of psychotherapy as a form of rhetoric, there are three aspects to rhetoric.
Rhetoric and Psychotherapy The Ethos of the Rhetorician The Arousal of Emotion The Argument
Jerome Frank One is the ethos of the rhetorician. The ethos is whatever makes him incredible, because you make authority over the (inaudible ). The other will be arousal of emotion, which happens in all psychotherapy. And the third is we used to call the argument. And the argument is everything else. Now therapies differ in the argument, and all the different forms we have are different forms of therapy, are different arguments, but that they all have in common, the relationship and the emotional arousal. Psychotherapy depends on the fact that that human beings react not to the facts or experiences perse, but as to the meanings of these facts as they interpret them. And the tiny example comes to mind from my daughter when she was learning to speak. This is not the daughter who collaborated in persuasion and healing. This is (inaudible ) it's another daughter. But anyway, she was quite a frightened little girl. And she was lying in bed one evening, when a lawn mower went by the window, very loud old-fashioned, hand-driven lawn mower and she panicked. And I remember picking her up and holding and explaining, that's just a lawn mower, it's not going to harm and so forth, and that was that. She quieted down and the next evening the lawn mower went by again and she started to tighten up, because your faced determines to tight. And she was about to cry. And then she suddenly said, lawn mower and relaxed. Well, she… she did given a meaning to this, it's a, it's a very good example of the way that a better need to who mastered events depends on believing on in some way. And here she given... She didn’t know what this was very fighting noise. She gave an innocuous label and then she was okay. And it has a very good paradigm of all the psychotherapy as well as rhetoric was the same thing. So the aim of Psychotherapy is to transform the meanings the patients attribute to events, from fright... from negative ones to positive ones. As this happened, as my daughter did with the lawn mower.
Dr. Clemmont VontressAnd then some of your works you have said demoralization is a chief problem that people have today. What exactly do you mean by that?
Dr. Jerome FrankWell demoralization, I guess is we all know what it means somehow.
Demoralization
Dr. Jerome FrankIf you feel frightened or sad, un... un... uncertain about the future, you lack self-confidence, you lack your sense of mastery, you feel you are the victim of events. And that brings whether the emotions that we all treat in psychotherapy. These emotions are things like anxiety and depression particularly, that that all, all our patients complain of those two. And I think many also complain of… also part of demoralization is resentment. And because of world isn't treating me well, and I don’t have to deal about it, I feel helpless. So you feel anxiety and depression or resentment are all part of demoralization, I'd say. All patients, I would say by definition, I demoralize so they wouldn’t come to see us in first place. We're the, we're the ticket of admission?
Dr. Clemmont VontressWhat are some of the special features of our society that cause people to have, to have psychological problems? That is do you think our society is driving people crazy?
Dr. Jerome FrankIt's a terrific problem. And I would refer you to a man named John Silber for that for loss of... more recently the President of Boston University. He would... he gave a series of talks and what he call The Pollution of Time.
Contemporary Issues The Pollution of Time
Dr. Jerome FrankAnd it was like a light bulb going off in my head, because what he was saying, as I got it was that that real problem of the world today is the things that are going too fast.
Dr. Clemmont VontressYou have said that the speeding up of time in our society leads to the erosion of social order. What do you mean by this?
Dr. Jerome FrankThe social order against us is kind of continuity, as although we were urging value system and traditional ways of doing things so that you.... we... we can predict how you're we're going to behave, how we're gonna think and feel. You can pick up other people who are gonna do it. And that predictability is absolutely essential for a peace of mind, it seems to me. Even if it is negative, even if... if it is less to... to anticipate a tragedy then not have, do not to be able to anticipate anything. And it's a hardest thing to stand. You just... believe me, as such... there is a phase of mental illness. I remember we had Schizophrenia for example can be thought, being that kind of a problem, and for these people live in an unpredictable world, and that’s the... that's the real source of their distress. Because they can't read other people's behavior and they can't predict their own behavior that was gonna happen. And they also they're have to be confused, because of their illness. And that’s I think was such a terrible time. It's not a cause of Schizophrenia. I don’t know what the causes of Schizophrenia is, but it's a phenomenon that's user friendly. To be able to organize one’s life has to be sense of continuity. But when things change too fast, the continuity breaks down. As a philosopher, Alfred North Whitehead said, I thought it was very interesting, he said to this to me when I was a fresher, sophomore art(ph) college, about 60 years ago, long time ago, he said you are the first generation in history, that cannot be guided by the precepts of (inaudible ) grandfathers. See, because it was going so fast, you can’t rely on what our grandfathers thought of and since and that, we can't predict the future, because we had need up with there's no continuity there. So for example, while when one think of the what's going on now with Microsoft, new programs come up so fast, before the old ones are absorbed. And therefore new program comes out, and the same thing happens in the arms race, (inaudible ) impressed me especially, when in the old days, it took first generations for, for new weapons have developed, you know going from spheres, from clubs to spears and spears to bows and arrows, might take centuries, and now it got faster and faster and today atomic weapons are obsolete, before they are deployed, before that we can’t use them, that’s what I mean, by speeding up of time and that breaks down the continuity of life, and I invests… I think when we read in paper about how in spite of economic conditions improving and so on, no one is comfortable, people are so uneasy, and it has why, no one knows what to do next, because we had to go from the… we can't predict from the past to the future.
Dr. Clemmont VontressThat suggest an another question I like to pose that is how can parents help children live more effectively in… in a rapidly changing society?
Contemporary Issues How can parents help children to cope?
Dr. Jerome FrankI think it has comes down to helping the child to feel secure and valued whatever happens in the world, and that means of course of one thing, that certainly the love of the child appreciation… appreciation of child for himself, I got to guess the main thing. I think the other thing is and this is much harder to achieve these days, consistency ah… I think, if you, if you to be equally healthy if you are brought up in a very strict religion, not religion with family, or very loose and comfortable one, but there has to be some consistency, and the essence, I think of Schizophrenia, for example is unpredictability again. And you can't that you have to, you have to feel your parents and siblings are have a feeling that predictably interested in your welfare and that has a wide range, as I say you may quite brutal or quite kind, but that’s this important feature it seems to me, that doesn’t get us very far, I had made but it got my temperament has a lot to do work how it is I've never (inaudible ) in a world like ours today.
Dr. Clemmont VontressI find your response very interesting. What aspect of human nature lead... has has lead to the creation of the atomic bomb. Do you think the people are by nature suicidal?
Contemporary Issues Are Human Beings Suicidal?
Dr. Jerome FrankI think there are two things. I will suggest once the power drive, we all want all the power we can get as part of our survival technique really can control and power of the environment and to the extent that it is now a problem for mankind, and the other is something, I don't know, we call blood thirsting us(ph) we're, we're still carnivores in some way, and in certain circumstances, certain people, especially had a great kick out of killing other people and torturing them. And I think that’s been something, we none of the peace moves and I've really got know to deal with, I guess we can't deal with it. When a person is in that frame of mind like well Sarlene (ph) for example indicating that it is greater satisfaction in life, was to successfully wreck revenge on somebody that’s what you live for. But we used to talking about peace and those things to people like that, because they don’t, they don’t want peace. So as there are two things that seems to that, bloodthirstiness and then this power drive. And then that it goes out of hand entirely.
Dr. Clemmont VontressAre you saying that we by our nature are suicidal?
Dr. Jerome FrankThat’s a great question ah… we may be we may be... we may... we may be suicidal, in the sense that we can't control our own instrumental intelligence, we are wonderful tool building the big builders. But our ethics is... are not, are not equal to our tool building ability. So, but if you would put that and that makes too it's ominous. I really think it is, you see it as the first time, and it is the first time in human history, that we devised the weapons that sort of destructive enough to wipe out all life. We, we can do it now, we never could do it before, we kept on trying to, believing we were very far from it, and suddenly with the atom bomb and new, new tailor made pistols and sort of things that destroyed, we made... we... we may have released things that can wipe us all out. And when people going in war, they always, always as fast they... a... oh... to the limit you know, they finding to use the most terrible weapon they have, oh.. those... the most terrible weapon we found nuclear weapon, wasn’t was really awful, but never threatened mankind, this new one does, right now both directly and to the environment. The environment, so that’s why I am rather pessimistic, with the law but you have might you hear that was the best we can you know.
Dr. Clemmont VontressAnd that could that suggest a... a... another question. Are people inherently good or bad?
Human Nature… Good or Evil?
Dr. Jerome FrankThat’s the question of philosophers(ph) would have to answer, I can't… I think we are obviously both, and that's the same way the, the problem of evil. We can never really answer there it is, we call out the devil or what we like, but it remains inside of a problem for humans, it seems to me. I can't please it a way… inherited good, unfortunately I wish I could, But I can't.
Dr. Clemmont VontressDo you think that Sigmund Freud was correct in… in, in his idea that sex is a driving force of human nature, that is ah… does sexual frustration actually drive people crazy as he suggests?
Dr. Jerome FrankThere are two separate questions, it seems to me. I understand that Freud had a brave interpretation of sex. He didn’t mean it's only sex enticer(ph) organisms. He was showing about the life, the life force, or a greater force, or the fiddler(ph) force as a very important aspect of mankind, and I think he has been pushed into the wrong, people interpret him wrongly about that. So I would say that had been in any case sex is certainly not the only drive for humans and I think you have to agree with that, I guess when he talks about the ability to love and to work, has been the essence of mental health, than he is talking about more than sex, of course. You know, he was a moralist himself, I think he was badly maligned.
Dr. Clemmont VontressIn terms of love when many… many people are riding about love these days. Is love basic to good mental health. Or just can we live without love?
Is Love Basic to Mental Health?
Jerome FrankWell, you think... I think... How we interpret that? As this in the sense we're root features, we can’t live in isolation, even a hermit has a group behind them, where the people being proved and do worship, and maintain a distance and so forth. We can’t live in isolation, in that sense you can say that, love is part of a distance being a good creature, but our assumption is a sexual frustration, anymore than the other kind of frustration, it may be… eh... that one is a creator of mental illness, health as an independent variable, it seems to me. Some people suffer great deal from frustrations, and sexual other frustrations, some don’t suffer for those things, they know that they all they feel bad about it, there may be so... sort... suffer from it, but is not doesn’t dominate their lives and I think we… at the end there is a we mean sort of thing I think we exaggerate them, the idea that happiness is mere there's what love, like it was absence of frustration or pain.
Dr. Clemmont VontressCan you, can you explain that a bit?
Dr. Jerome FrankEveryone has own ideas about what is good mental health is? I think, probably it's having a positive attitude toward life, a sense of mastery or potential mastery was going on rather means helpless victim of circumstances, and I guess it's a big factor for I thought about the ability to love and to work as he put his fingers on…
What is Mental Health? Love and Work Happiness and Struggle Belonging
Dr. Jerome Frank…perhaps the main human traits, while there is affiliation and creativity is not just sex as you misinterpret for it to say, and work has request your ability to move the world along, with your neighbors and friends to make things get better, so I think those are parts of mental health too. I don’t think mental health is necessarily happiness, it's nice to have it, but I think I guess we have add certain... mental health is the ability to withstand suffering and stress, not happiness, and it's certainly not a plain equanimity. People who physically not... people who criticize psychoanalysts we're saying as try to rule over anxiety, and everybody happy, and so forth, and if you have to prove it, if you have no anxiety, and those problems will be dead. It is not valued… valued. It is not a... not a workable way of living, as it seems to be entirely. And so I think that those are some of the things I would think about, about mean by mental health.
Dr. Clemmont VontressWhat is your view about the effect of a positive mental attitude on physical well-being of people how that attitude might in fact affect the immune system of individuals.
Mental health and the Immune System
Dr. Jerome FrankThere’s lot of evidence, so that on the negative side that depression or negative attitudes can weaken the immune system, I haven’t followed closely, whether you can also strengthen the immune system, without the positive attitude to strengthen it. I think, I've... But we suspect it's true, that I should have… have a positive attitude your immune system is functioning better, which is causing recess effect, I don’t know, but I think it's there. The other thing is about emotional and that depressed people on more prone to ordeal in various ways, but the positive side I haven’t followed closely, I suspect you will find that too, it will be true that a positive attitude goes with better health, but it get brings, you see that you are again, that I'm knowing it wondering into the American culture, because we find it hard to believe, that mental stage is gonna affect the body, it is easy enough to take a Bowley(ph) states affecting the mind, but if you have this, dicartesian(ph) notion, with the physical world and the mental world is separate, and the physical world is self-contained and every now and then the mental world dips into it, then you get the questions, that then you are puzzled by questions which people know that, for all the cosmologies you take for granted, there is no question for Hindu, for example the mind and body are so called mind and body are closely inter-related, all the thing in the universe is, is matter, while I guess, we (inaudible ) Whitehead comes to mind. He talks about the fallacy or misplaced concreteness. We think of matter is something concrete, and mind is something vague. But matter is high level concept, no one has ever seen matter, we see chairs and tables and molecules and oceans, but to talk about matters really abstracting from a whole a lot of host of different things and just one way slicing the universe and it is a very-very effective way, but it's I think we, that this say this early his own Whitehead's points, that they can’t by… separating mind and matter, make research possible, because god knows it is all concerned with matters, so you can really want to it, then it has extended nor concerned with animals, so you do if you want animals, only man or only the mind is sacred and that and that let to this tremendous spirit and knowledge and then of course, we be if we have fastened on us, he talked about that we, we do not examine the sources of our believes and here is a very good example, we take it for granted that our mind and matter are given by god, you know, and the only... only (inaudible ) finally, only now recent years, it has been realized as, they, Caucasians believe(ph) over the world there is only one view.
Dr. Clemmont VontressDo you believe that there is a real difference between what traditional healers do, and third world societies and what our psychotherapists here do?
Traditional Healers
Dr. Jerome FrankNo, I think the same principles hold and probably hold more effectively in the third world, because as you can tell me better than I can you know better than I really the tradi... tradi... traditional healer is part of a unified society, with a unified set of values and ways of doing things and therefore his power over the individual, he can heal because he can bring people back into the group, because it was just one group, and it all part of it and he is been a leader in it, it was very different from our western therapist, who is buffered by any number of troops at the moment and any number of value systems, so I think traditional healer has a real advantage, for many over the western psychotherapist. If you, if you brief us like us we go through that mental, that's that what and demoralization includes the concept of isolation and loss of connection with other people and the most healing rituals in other societies, mentally powerful and bring people back into the group than ours are.(ph)
Dr. Clemmont VontressWhy are those rituals so much more powerful in other societies than what our therapists do?
Dr. Jerome FrankI think, I think is because that maybe a misjudging the other societies, but my impression is they are more unified, they… and they are more structured, so that you can mobilize the family for example, in a way you can't had to do in the west, when they are all fragmented into single and parents, families and so on, that’s why I think it's so this (inaudible ) more powerful.
Dr. Clemmont VontressWe know that we have individual psychotherapy and group psychotherapy do you have a preference for one over the other if so why?
Individual or Group Psychotherapy?
Dr. Jerome FrankBy and large very much so I think the whole emphasis on individual therapy sprang up from the medical model in which the doctor and the patient, had a confidential relationship, so she lives in a another rest of the world, when there is a proper model again, proper model for therapy again, it seems to be as rhetoric, and the rhetoricians spoke to groups and that read at least to the emotional arousal aspect, because people are much more aroused in groups and then they odd, more usually individually, so often patients benefit more from, what they say to each other and then do from what the therapists says, I remember striking little example of a catholic young man, adolescent who is absolutely no… guilt, frenzy of a masturbation, and know I talked to him of that of some lengths and he didn’t know bit of good really. He was same (inaudible ) is all I was all done and then I put him in a group, and it was group with older men, many of them catholic like himself, and you know, I immediately understood what his problem was and that the turn over a bull(ph) session, I could have left the run he was really sure of these all things vanished and I want to ask him what did it? What helped him? And he said well the doctor lives in his own little world, he said usually it better from a bunch of guys, he said and that was it, and he immediately identified with any members of the group, he couldn't identify with me as a doctor, that's just one of the many examples of group therapy.
Dr. Clemmont VontressWhat about self help group such as AA Alcoholic Anonymous?
Dr. Jerome FrankLike I said the same thing applies, they are young as they... they... this fells step notion, which... which… which rigidifies many groups, with that story so maybe we can't (inaudible ) from them, therefore people who can't follow from that kind of thing, is very helpful indeed, and I am all for it.
Dr. Clemmont VontressThat’s very interesting, and it, it leads to another question, I would like pose, and that is can we scientifically measure the outcomes of psychotherapy?
Is Psychotherapy a Science?
Dr. Jerome FrankI guess you asked the people. Let's get back to the question, is this Psychotherapy a Science you know, I am not surely can but, I will see what makes me to pose, is I am a... (inaudible ) I'm computer illiterate. I really have no concept of what computers can do, and it may well be that all these a lot of the programs, and and prove this can eventually, hopeless meaning problem, which has a meaning to write, individuals static, and change from time to time and so on, but that’s so I'll keep their hope to open for this, but I think conventional thought as a science is very as we all know hasn't yielded a very important results, despite of the brilliance of the people who were in it, into it. Well they, they can (inaudible ) I think it has been demonstrated as well as anything it can be. The psychotherapy is better than no psychotherapy it works by the, any psychotherapy because the issues are helping us push on psychotherapy is different and that are effecting us again, and I guess a wrong question, because all depends on the particular patient therapist relationship and particular illnesses he is suffering from.
Dr. Clemmont VontressSome people believe that the best way to help people with problems is to help them to understand their childhood. How do you feel about this, this idea?
Dr. Jerome FrankWell, that's Freud's idea again, is one of the many rituals of etho psychotherapy, and it has a rationale and it's for some patients it may be true, that trauma, traumas in childhood affect our later lives, I guess it is true in some people, but to say that's everybody is clearly wrong it seems to me.
Dr. Clemmont VontressWe also find often in the newspapers today, articles pertaining to psychotherapists trying to get the individuals to recall their early childhood sexual experiences and sometimes using these in court cases but not to. What do you think about the validity of… of these kinds of activities in psychotherapy?
Contemporary Issues Recovered Memory of Childhood Sexual Experience
Dr. Jerome FrankThat's still not settled I mean the whole thing is up to... but the first thing you have to say is that, be patient who respond, report this kind of experience turn out to be very suggestible, and in general, it's a highly suggest for bunch of patient and as we know the patient enormously influenced by the pre-conceptions with their therapists, and the whole of, the whole approach is not as one which would assume the thing as true, you see assume is the memories happened, and then justify, and the patient doesn’t confess on that, because the patient is repressing or something, so the set of the interviewer is to get the information, it is there, but he knows is there, and that means the whole thing has contaminated, by always there may be something in it. I must saying there isn’t, but it's only… you don’t take why through or why do we, we never through all this stuff on top, which is the tremendous to just the ability of the patients and the conviction of the therapist, so they have the right hand, what, they... they know the right thing to do, so that’s I tend to put a reserve judgment, expect as in the world in general, I'm fond of putting Horatio and Hamlet, many says that there are more things in heaven and earth Horatio then I have dreamt having your philosophy and I think we should keep that in mind all the time we, we just have a small window on the world and knowledge, and we think that all goes through it. We don’t know things like telepathy for example, or peak admission or on the whole courses, not respectable phenomenon or even a very good psychiatrist a very respectable one, has written lot about young children’s memory of previous lives, and he is very convincing, very good evidence, I mean it's if people for example he have these children produce memories that seems where they have never been, and their parents have never been. And I then, I might have told all wrong, into or that here, of course, a sex is very far feel, that is a reminder that audible cosmology of the world, is just one cosmology and there are many… many others that are quite possible.
Dr. Clemmont VontressToday we... we read often in the press about the use of psychotherapy with... in a criminal justice system, and I suppose we could call that Coercive Psychotherapy. What do think about Coercive Psychotherapy being used in our criminal justice system?
Contemporary Issues Coercive Psychotherapy
Dr. Fred Bemak That... that whole question seems to be, is based on a misunderstanding, or misapprehension that criminology is as same as mental illness, and that basically they are very different. The mentally ill patient is suffering and wanted help, the criminals trapped in a system, it has a different set of values as his, and he is not really guilty necessarily, and he is going through the emotions of psychotherapy, he is may be trying to... he is really trying to calm(ph) these therapist to get something out of it, and that was I mean the therapy, therapy can't be useful for some criminals, for some criminals, but it, it does involve changing their value system, it doesn't involve, so… soon they have the same value system as the therapy says, so I've... I don't think that it has to re-formulated, there is successful work with criminals, but involves good punishment... punishment may be a part of it, and not... not... not inside may not be importance on, some pers... some, I remember, I was at the member of the protection institutionary in Maryland when they tried to give psychotherapy on, on people who were assigned to protect with, but because being criminal, that although, criminals, they also had some mental problem, and let me... let me notice so often, that criminals aim was to try how to flaw... how flux the therapists, and get something from him, not really had help for himself, so but if you knew that and work in that framework, and then there are some. I don't have them in mind, but were a couple very promisingly, rehabilitation programs, we should don't include discipline and punishment sometimes, and from working toward change the certain changes, the criminals value system, so it doesn't seem so as enemy of the society anymore, and the society sees the enemy, I should say.
Dr. Clemmont VontressAnd other thing that's very much in the news these days is the effect that, on insurance companies have on Psychotherapy, um... would you... What do you think about the implications of managed health care on psychotherapy today?
Contemporary Issues Managed Healthcare
Dr. Jerome FrankFirst of all again, I have to say, I've never go into this, it is what happened, since my time, so I don't have any real first hand information, but the... is psychotherapy is individualized, this whole effort had managed care, takes you away from the individual, patients have to come co... co... cohorts, and we would add on it, measured on various indices, and I used to, I used to ask for all who talked to some and believe people, and... in... in people, perhaps they have missed this, fits Johns Hopkins and they... they were there accusations more, there is a list of numbers, US force on the check list and scores on inventories, and scores on symptoms, as I said on symptoms and we look at the persons, the persons vanished, and then and all these numbers, anyway, and no hope at all, should try to do psychotherapy, a very little help. So that's my... that's my, that's how it looks to me now it has a very important that, it's important for another purpose that of psychotherapy of course, but for making it possible for knowledge accumulate, it will trouble with the feel, it's from research standpoint has been, that with two people working, using the same terms, we can know that there are trying up the same thing or not. Maybe one doctor one of the researcher produces the paper and tends to use FedEx or someone else chose on hundred depressions(ph), we don't know whether are those people are the same people others, starting about the same thing on their own. The one thing, that all this was down, I guess its DSM-III, the diagnostics theme has increased the probability that when two say accurately like 10 schizophrenics, they are talking about the same thing that's a tremendous step from the standpoint of research, but it's not, there is no real help from the standpoint of, this is stating with this patient's problems on his way looking at life.
Dr. Clemmont VontressThat's very interesting and that it leads to another question like to pose and that is ah... the... the use of Prozac and other anti-depressants in helping people with problems. Do you believe, for example that Prozac can replace psychotherapy as we know it today?
Contemporary Issues Drugs and Psychotherapy
Dr. Jerome FrankI think, Mr. Alford worked all of the things, relationships with drugs and psychotherapy. A drug like Prozac can and... and... has moved and increase enterprising us, and increase self-confidence, which makes the patient then, May usually solve his problems, or if it doesn't he is more accessible to psychotherapy, and knew psychotherapy better, by... because he will be proactive, as it were. He thinks by learning some psychotherapy and applies it. So I think it is a real, very important, the negative of course is that, if you just concentrate on the drugs then as the drug is stopped, and the patient relapses, feels where he was, but I don't see any basic contradiction between using this two brutalities in certain patients.
Contemporary Issues The Impact of Job Loss
Dr. Clemmont VontressToday, as you know many people lose their jobs um... doesn't... does that fact contribute to psychological problems?
Dr. Jerome FrankOh yes, yes, but even this some people will stand this very well and some break down under it, and it have to the vulnerability of the person involved to, and the greater the stress is, I suppose the greater percentage of people will began to show mild health symptoms, but it's not the same as environmental stress is the, is added to their total life, which is basically a problem.
Dr. Clemmont VontressIs one a... type of psychotherapist better than another? What do... what... What do you've... What are your views on... on this?
Is one type of psychotherapy better than others?
Dr. Jerome FrankYes, but not in terms of one therapy lining up all the therapy orientations and saying which is good, and which is bad, you switch one tricks with the patient, for example, if theory of physicists might be able to respond better to say, cognitive therapy, which makes it all rigid... restrict... rigid and lined-up, but a, a religious person might respond much better to existential therapy, which fetches the values of life and so on... that's the reason you can't judge... that's why they all have a value, they all have a place, it is individualized, you can't breakout, its generalization. Some therapists as people had the ability to be more persuasive, there are more people on others of course, and that makes it harmful at different schools, and why there is a (inaudible ) I might say Freud is a massive powerful man, I respect, he was a great mythmaker in our time, and a mythmaker in a good sense, if he has wonderful structure very dramatic and appealing to people, and a method that the therapy that it goes on forever, because, it is always more past history to dig up, and all fascinating things to find out, so it appears for both the patient and the therapist, so I see their lives... everyone one of these therapists has an appeal. But it's not in terms of their objective, relatively objective, but little bit... in fact literally, and I become anonymous I can, I say you can't line up therapies and say this is better than that one. You can't say this will no appeal to that kind of person, and this will not appeal to that kind of person. And this therapy is going to attract a great many people and this therapy of course can only attract a few, isn't that realm that you can talk about differences in theory.
Dr. Clemmont VontressDr. Frank you have studied and worked with some of the most significant figures in psychotherapy, who influenced your career most?
Influential Thinkers Kurt Lewin Carl Rogers Sigmund Freud Albert Ellis Abraham Maslow Viktor Frankl Irvin Yalom
Dr. Jerome FrankFirst of all, I wanted to make sure that, you know, people know that I, never met Freud I then accused to be here, the cycle of, had a memories of Freud I never had met him, and there is only one figure, really I had a big influence on me, and that's Kurt Lewin , he is not a psychotherapist, he is psychologist, and he is a kind of a role model for me, that I would like to to aspire to but had begin to, and from the theoretical stand point, his notion that, behavior as a function of person and environmental always. It's not the one and another alone, you can't just study the person, as you get into with fore(ph) very often just, it is more than over the environment, to the person. Only that... You can't get this hung up, on the in a very environment like the behavior therapists, where everything is both of these, and he was a brilliant man at bringing down to the researchable level, real problems, in the, in the human nature, which most psychologists have not been able to do. For example he studied anger, and he studied the difference in memory over unfinished memories under unfinished tasks and finished tasks, this kind of thing. So even though excited and may be you could and.... that his conceptualizations, he was like a pinwheel as always new ideas coming up, always he just sits up there, he just sits there and just listen for hours, So he is... and... a is a real role model for, and of course that one side of him. He had enormous energy, he has three full time careers that killed him in his 50's so I guess it's really is a reason I think, as a surgeon now with more knowledge of (inaudible ) but, he, he first was a academic psychologist, used to be mentalist and then he believes in industry, he did like industry should know every people in industrial psychology, and then he was an art designist(ph) any one of these things, could have take... taken his full-time. He was always into… he never call up at life, always rushing, and then the... and that's personally he was very accessible. The German professors after he was very formal he was just I mean, he called by his first name, and all those kind of thing, so he was a real inspiration for me in those ways. I don't know, but I can't really say any other influenced me too much, I mean, I was in... I was far away from the environment. People like Carl Rogers , he who was very sympathetic to me. But, what... what… what struck in mainly is mainly in some of these healers, I was around, Rogers would be one and (inaudible ) a lot of people whose behaviors and other. He says they have it and only call as therapeutic personality as envelope you, and make you feel, I mean the patient, I guess and it isn't matter what their theory was, you know, they had that quality and you can't bottle that of course but and that struck me, I don't think any others that would be influence on me on my thinking, the way Lewin did and of course, that would be, that will be true, and no one else in a personal level, and you know certain... certain theories appeared to me as oddlers(ph) particularly and Freud for a while, but that's on the personal way.
Dr. Clemmont VontressWhat about Albert Ellis ?
Dr. Jerome FrankHe is the example, I would use to a person, who doesn't look therapeutic, but who is, and he is therapeutic, because he convince Zanodona(ph) I know didn't change, and I will make you change and so forth, and he used for (inaudible ) reinforce it, it was just not the model of a usual therapists. He also extremely perceptive and brave. You know we as a concerned(ph) patients say very pers... very convincing so but, his method is just that would have to be depressed like. I couldn't use this method, it's not part of me well, I couldn't despite where I would call Rogers' way of doing things for example. Then, there was a very small room, but only one person they cannot, you can learn from this other people, Ellis is really, I think we mentioned before is behind all cognitive therapies severely, you can learn from this (inaudible ) and reading them, but I can't say… interests me personally, but because it is language in, and it desire to shock people not to make and make it more appealing to some people, but you can take that all away, and still very good stuff I think. I think it's a weakness on me, but I never warmed up to Maslow , I don't look why, I just didn’t read nothing, I mean his idea that of the stressing creativity and, and pro-activeness. I think he was right, but somehow I never regarded nothing to this will be able to say, I could that I was influenced by him, and there were two people and three people, I didn't kept with… Viktor Frankl as, I've found myself very sympathetic to his view point. He, has people out of the same and some of them to do... that bad, I have wishes and so on, but by radically(ph) then, I think that's a very appealing idea to as you can't shifting meanings of same event. You know, for a sense, I remember his example of a person who as modified with the stress, we stress too much and then in fact, paradoxical that's the word, paradoxical intention, he... he was, he says okay sweat, sweat both in that so you can't… sweat (inaudible ) and so on, and of course he makes the thing ridiculous, and that's would rate us, but that works very well with some people, if you have the... if you have the ability of Frankl to do this to people. I think it also as a little book on some just (inaudible ), it essentially as a sense of perfect statement of "you can't control the environment, but you can control your allergy toward the environment" and that book with a beautiful as you can (inaudible ) by our sense that was it's a sort of... sort of... sort of persons who are dying all around him, and all over hungry and so on... I think it is a very inspiring notion that is for anybody including psychotherapists.
Clemmont Vontress Dr. Frank , One of your most famous students was Irvin Yalom . What do you think about his approach to group psychotherapy?
Dr. Jerome FrankI think it's absolutely excellent, he is really blanket of the field, who uses Borchardt(ph) youth therapy, this is a better (inaudible ) except beyond that too, he seems... I think his book on existential psychotherapy is very important in pointing out that (inaudible ) patient, mental patients that had exactly the same problems as other people have, it is essential problems, I think he has talked about the loneliness particularly, and that we all have a fear, problem about death we have to do with one way or another and isolation by... by approaching you know patients as individuals who, who suffer from the same human predicaments that Irvin Yalom's does rather than as riding in a something special, it makes them much, and again means that much closer to other people and that's one of the ingredients of all successful therapy to, overcoming that isolation.
Dr. Clemmont VontressIn connection with that question, what is your own theoretical approach to psychotherapy?
Dr. Jerome FrankI guess, I'm here with people (inaudible ) or constructionists, and that I think, we, we don't specifically experience the environment, you can construct the environment out of our... out of the input from the environment plus all the things we bring into from our own lives. And again the effort in psychotherapy seems to me to change some of those constructs, so that advance that as that are perceived by the patient as frightening or depressing, and is shifted to another set of reference, I remember a story of John Gardner , who was at first secretary of health and education, and welfare and was a new department which was just a mess, he was just starting the department, and he said I am surrounded by exciting opportunities, skillfully disguised as insoluble problems. I think that sums up the whole thing, we are patients, bring those insoluble problems and we try to shift you exciting opportunities which is into it. And people like Frankl talk about research for meaning, I find very sympathetic, but... I... I will say is not just the social meaning but changing meanings we had them, I think, I have said somewhere in this tape earlier, that we... we have experiences little bit daunted, it really mean to out away, so it was not the search for meanings, the meaning were due to that extent that I would say that as an I mean is essentialist or constructionist or whatever they call these days.
Clemmont Vontress What did Norman Cousins say about the Power of the Mind in healing?www.psychspace.com心理学空间网
