Just How Important Are Thoughts?
I recently listened to NPR's exciting new podcast, Invisibilia, "a series about the invisible forces that shape human behavior." Their first show covered the history of how psychologists and psychotherapists approach thoughts, exploring the ideas that thoughts have significant meaning, that they can be changed, or that they have little-to-no meaning.
The idea that thoughts have little-to-no meaning has recently become more popular in the practice of psychotherapy, specifically third wave cognitive approaches. People are taught non-judgmental acceptance of thoughts, becoming mindful of them through meditation, and that thoughts and feelings are transitory experiences akin to nuisances that can be tolerated and coped with. Little attention or effort is dedicated to understanding their meanings, origins, or developments (which, admittedly, can be time-consuming and costly). What is important is coping with them in the present. Further, these ideas are not limited to psychotherapy. The increased popularity of yoga, mindfulness meditation, Buddhist ideology, and "living in the moment" suggest that these ideas appeal to a significant number of people.
Despite the popularity (and research-based efficacy) of these ideas, I can't help but wonder: have we gone too far in downplaying the importance of thoughts and emotions? Is teaching people to separate themselves from their experience a fruitful direction to follow? Or have we created the psychotherapeutic equivalent to the psychiatric pill? Something to take the pain away while allowing the underlying issue to continue to effect someone's life on a daily basis.
To be fair, these newer forms of treatment have a good amount of empirical research demonstrating that they are efficacious in reducing symptoms of Major Depressive Disorder, many different forms of anxiety disorders, obsessive-compulsive related disorders, and more. Developing the skills associated with these approaches helps people to become more functional again and to re-engage in their life. People report that their distress and symptoms decrease, which is a major goal of psychotherapy. So why do I have a problem with it?
I worry that we are creating a dis-affected people. Teaching people to separate themselves from their thoughts and emotions as a way to reduce their distress should only be the first step; a psychological skill to be employed as a means to cope. To stop here is to fix the symptom, not the cause (much like psychiatric medication). Until we understand why we hurt and where it comes from, the pain will continue to inexplicably rear its head throughout our lives. Additionally, people seek meaning in their life and their experience. They want to know why they suffer. Few of us would go into the doctor with a persistent medical issue and just be happy that they treated it; we want to know why we are sick.
The idea that thoughts have meaning is particularly psychoanalytic, or Freudian. This long-standing perspective believes that all thoughts, feelings, and behaviors are meaningful and accumulate meaning from the moment one is born. Their meanings can be conscious, but they are mostly unconscious. Given the sheer complexity of human experience and how one integrates this into their thoughts, feelings, and behaviors, you can see how it would be difficult to be conscious of how these phenomenon interact with each other in a coherent way that explains our everyday experience. Psychoanalysis (or it's less intense compatriot, psychodynamic psychotherapy) attempts to make conscious the unconscious source of people's experience, more specifically their distress.
Despite the over-blown controversy over whether or not psychoanalytic ideas are still relevant, the use of psychoanalytic techniques are specifically designed to help people to understand and make meaning of their thoughts, feelings, and behaviors. These are all important psychological experiences of being human that should be understood. The insight that develops from these making these meanings has also been proven to reduce psychological distress and symptoms. Unfortunately, the research isn't as voluminous as the above mentioned approach mostly because scientifically measuring meaning making and unconscious processes proves to be a difficult task. Additionally, examining meanings, origins, and developments take time and money, another drawback from this approach. However, these difficulties are being slowly overcome with each passing day.
Moving forward, third wave cognitive approaches can and should be used as an effective way to help people cope with their experience of distress. However, I feel that we fall short of being helpful when we fail to help people make meaning of their psychological experiences. Yes, thoughts (and feelings) can and should be managed, but that does not make them unimportant.