Freaking brilliant, John. This resonates deeply for me both as a client — what I am always “feeling” for with a potential therapists (and wow, I have definitely met some who do not have this capacity at all) — and as a Spiritual Counselor (where organizing contact is also the point) — I can see that where it works, this is actually what I provide. Now I want to share this with so many people. Thank you (and thanks to Andrew for bringing it to my attention).
Thanks so much for taking the time to write, Traci!
A bit of shameless self-promotion: This period in my life seems to be all about writing, and my first book (“Staying Close”) is currently available on Amazon, published late last year. The second book (“Staying with Strain”) should be available within the next week or two. They’re both short, readable in a single sitting. If you’re inclined, I hope you’ll take a look.
I read several of your stacked articles last night. Thanks for doing that — it seems that our interests overlap quite a lot. No need to reply to this, just saying “hello” and glad to meet you.
I love your openness to change and focus on what really matters in our profession, but you may be underestimating the capacity of AI to provide organizing contact. How else can you account for people falling in love with their chat bots? If my Teddy Bear could do it for me when I was a child, then certainly Claude can.
I love this. You're right: teddy bears are infinitely accommodating, and people *do* fall in love with their chatbots. We can’t ignore this.
It gets me thinking about “transitional objects” (Winnicott's term). The teddy bear regulates, but it's inert; the child brings everything to it. AI is the opposite: responsive, precise, actively shaping the interaction. And when people fall in love with their AIs, what is that? Is it Narcissus and a sophisticated Echo, falling in love with a perfect reflection of the self? An infinitely accommodating mirror?
What kind of object is AI, exactly? Not transitional, not a person, not inert. Something new.
Lovely post, thank you for writing. A couple of thoughts:
1. Totally agree with your basic premise that AI will force us psychotherapists, more than even the Wampold research did, to specify the value we provide. That's a good thing.
2. I have found it hard myself, when specifying what the "therapeutic alliance" really is, or what the "common factors" really are, to avoid creating another therapeutic orientation. That's basically what your hypothesis about the "organizing contact" is. You could mint an approach called "organizing contact therapy" and it'd go up on Psychology Today along with all the others. The fact that you and I agree with it, and perhaps think it cuts to the heart of the matter more than other approaches, makes it no different than the other approaches. At the end of the day, we have no means of discriminating between approaches because, as you note, none of this is specifiable, quantifiable, measurable. So maybe that is why, even though the field may want - and now desperately needs - to clarify its value, it still won't - because the mind isn't a broken bone.
3. On your point about the infant under the adult, I really enjoyed Our Babies, Ourselves by Meredith Small. Someone recommended it to me a few months ago and I found it revelatory. That said, I really found myself seeing the infant in my clients, and in myself, when I had my first child about a year ago. I couldn't seem to do anything OTHER than see the adults around me as babies :)
Thanks for the note! Your point #2 made me smile, and you're right that I *could*. But minting "Organizing Contact Therapy" would be precisely what the essay argues against. The orthopedic equivalent would be calling it "Move Your Body Orthopedics" — a new brand for something that was always just... well, how bodies heal. Stating the obvious isn't a methodology. And my ego doesn't need the food! 😊
Thank you for this beautiful articulation of the “relationship.” As I recently heard someone say, less elegantly, only if you’re a “worksheet therapist” should you be worried about AI coming for your job. I think my concern is less about AI replacing us - it can’t - and more about real therapy no longer being deemed medically necessary and/or not funded/covered. Regardless, this was really lovely to read.
And thank you, Tara, for taking the time to write. As I’ve written in response to a few other comments here — Word-of-mouth is the entirety of my marketing strategy for these ideas. And so: You might want to take a look at a small book that represents the core of my thinking (“Staying Close”, available on Amazon). My second book (“Staying with Strain”, which should be available within the next week or two) takes the ideas an applies them to several real-world domains. Thanks again.
This is indeed the heart of our work, John, just as you've so beautifully captured it--primordial and irreplaceable. Sometimes I think about Tom Hanks' character in the movie Castaway, his reliance for survival on Wilson, on all that he projected onto this non-human object and how successful his efforts were in this regard. As you suggest, other-than-human supports play their part in healing but when it comes to being in the presence of a deeply present, steady, containing, caring person, there is no substitute. Thank you for articulating this so comprehensively. I'll be sharing too and did see this earlier on PsiAN's list serve. I'm glad to have found your work.
Thanks so much, Mary Ellen, for your comment and for re-stacking the article.
I’ve been thinking about these issues for my whole career. Trained in psychoanalytic theory & practice, and coming-of-age at a time when microanalytical studies of parent-infant interaction were just getting started, I’ve always seen my work with clients through the lens of early relationships and how those early relationships touch something deep and difficult-to-name in us. The advent of polyvagal theory gave me a new vocabulary, and the rise of AI (and my advanced age!) have added a feeling of urgency to get these ideas across.
This (I mean, this message to you) is my only marketing strategy: Word-of-mouth. You might want to take a look at a small book that represents the core of my thinking (“Staying Close”, available on Amazon). My second book (“Staying with Strain”, which should be available within the next week or two) takes the ideas an applies them to several real-world domains.
In any case, thanks for taking the time to write. I appreciate your engagement.
I hope you are right. However pessimistically, I suspect that we lack political will to make it work . Most likely it will mean that only people from well off family can afford to become a therapist and only wealthy client can afford to have human care . We have been in the "Society of diminishing expectations" as Christopher Lasch has put it in the 70s and we haven’t seen it getting any better in any rate , with the arrival of AI it would only intensity everything has been going wrong . As a new joiner to this field , I envy the older generation and their sense of optimism .
I didn't address the structural pressures you're describing (insurance companies, tech lobbies, the economics of training) in this essay. I'm definitely not suggesting I think that capitalism will sort this out — I've watched it fail to do that for decades, in my own practice and everywhere else. What I'm arguing is that the profession has been unable to make its case clearly because it hasn't named what it actually does. That's a problem we can actually do something about, regardless of the political and economic forces arrayed against us.
And you're right that younger practitioners face pressures I didn't. The economics of entering this field are harder than they were, and that's a serious problem. But I'd still rather we fight that battle knowing what we're fighting for.
Freaking brilliant, John. This resonates deeply for me both as a client — what I am always “feeling” for with a potential therapists (and wow, I have definitely met some who do not have this capacity at all) — and as a Spiritual Counselor (where organizing contact is also the point) — I can see that where it works, this is actually what I provide. Now I want to share this with so many people. Thank you (and thanks to Andrew for bringing it to my attention).
Thanks Seth. Endorsements like this are the entirety of my marketing strategy, both for the essays and for the books... so, much appreciate. ❤️
Holy Moly John,
I haven't been moved to tears by writing about what we do in a long time.
With Gratitude,
Traci
Thanks so much for taking the time to write, Traci!
A bit of shameless self-promotion: This period in my life seems to be all about writing, and my first book (“Staying Close”) is currently available on Amazon, published late last year. The second book (“Staying with Strain”) should be available within the next week or two. They’re both short, readable in a single sitting. If you’re inclined, I hope you’ll take a look.
Thanks again,
John
I will. Happy to help get the word out. I shared this article to PSIAN - a 15k network of psychoanalysts.
I read several of your stacked articles last night. Thanks for doing that — it seems that our interests overlap quite a lot. No need to reply to this, just saying “hello” and glad to meet you.
Thanks John. Andrew Law is a close friend so he gets the cred. I just got both of your books. Thank YOU.
Andrew is a wonderful human being, and a good friend... it seems you and I have a *lot* in common. :)
I love your openness to change and focus on what really matters in our profession, but you may be underestimating the capacity of AI to provide organizing contact. How else can you account for people falling in love with their chat bots? If my Teddy Bear could do it for me when I was a child, then certainly Claude can.
I love this. You're right: teddy bears are infinitely accommodating, and people *do* fall in love with their chatbots. We can’t ignore this.
It gets me thinking about “transitional objects” (Winnicott's term). The teddy bear regulates, but it's inert; the child brings everything to it. AI is the opposite: responsive, precise, actively shaping the interaction. And when people fall in love with their AIs, what is that? Is it Narcissus and a sophisticated Echo, falling in love with a perfect reflection of the self? An infinitely accommodating mirror?
What kind of object is AI, exactly? Not transitional, not a person, not inert. Something new.
Time will tell!
Lovely post, thank you for writing. A couple of thoughts:
1. Totally agree with your basic premise that AI will force us psychotherapists, more than even the Wampold research did, to specify the value we provide. That's a good thing.
2. I have found it hard myself, when specifying what the "therapeutic alliance" really is, or what the "common factors" really are, to avoid creating another therapeutic orientation. That's basically what your hypothesis about the "organizing contact" is. You could mint an approach called "organizing contact therapy" and it'd go up on Psychology Today along with all the others. The fact that you and I agree with it, and perhaps think it cuts to the heart of the matter more than other approaches, makes it no different than the other approaches. At the end of the day, we have no means of discriminating between approaches because, as you note, none of this is specifiable, quantifiable, measurable. So maybe that is why, even though the field may want - and now desperately needs - to clarify its value, it still won't - because the mind isn't a broken bone.
3. On your point about the infant under the adult, I really enjoyed Our Babies, Ourselves by Meredith Small. Someone recommended it to me a few months ago and I found it revelatory. That said, I really found myself seeing the infant in my clients, and in myself, when I had my first child about a year ago. I couldn't seem to do anything OTHER than see the adults around me as babies :)
Again, thanks for writing.
Thanks for the note! Your point #2 made me smile, and you're right that I *could*. But minting "Organizing Contact Therapy" would be precisely what the essay argues against. The orthopedic equivalent would be calling it "Move Your Body Orthopedics" — a new brand for something that was always just... well, how bodies heal. Stating the obvious isn't a methodology. And my ego doesn't need the food! 😊
Fair enough - we'll leave it for a starving ego :)
I'm so in favor of your granular, organic approach to marketing, John, looking forward to your posts.
Thank you for this beautiful articulation of the “relationship.” As I recently heard someone say, less elegantly, only if you’re a “worksheet therapist” should you be worried about AI coming for your job. I think my concern is less about AI replacing us - it can’t - and more about real therapy no longer being deemed medically necessary and/or not funded/covered. Regardless, this was really lovely to read.
And thank you, Tara, for taking the time to write. As I’ve written in response to a few other comments here — Word-of-mouth is the entirety of my marketing strategy for these ideas. And so: You might want to take a look at a small book that represents the core of my thinking (“Staying Close”, available on Amazon). My second book (“Staying with Strain”, which should be available within the next week or two) takes the ideas an applies them to several real-world domains. Thanks again.
This is indeed the heart of our work, John, just as you've so beautifully captured it--primordial and irreplaceable. Sometimes I think about Tom Hanks' character in the movie Castaway, his reliance for survival on Wilson, on all that he projected onto this non-human object and how successful his efforts were in this regard. As you suggest, other-than-human supports play their part in healing but when it comes to being in the presence of a deeply present, steady, containing, caring person, there is no substitute. Thank you for articulating this so comprehensively. I'll be sharing too and did see this earlier on PsiAN's list serve. I'm glad to have found your work.
Thanks so much, Mary Ellen, for your comment and for re-stacking the article.
I’ve been thinking about these issues for my whole career. Trained in psychoanalytic theory & practice, and coming-of-age at a time when microanalytical studies of parent-infant interaction were just getting started, I’ve always seen my work with clients through the lens of early relationships and how those early relationships touch something deep and difficult-to-name in us. The advent of polyvagal theory gave me a new vocabulary, and the rise of AI (and my advanced age!) have added a feeling of urgency to get these ideas across.
This (I mean, this message to you) is my only marketing strategy: Word-of-mouth. You might want to take a look at a small book that represents the core of my thinking (“Staying Close”, available on Amazon). My second book (“Staying with Strain”, which should be available within the next week or two) takes the ideas an applies them to several real-world domains.
In any case, thanks for taking the time to write. I appreciate your engagement.
I hope you are right. However pessimistically, I suspect that we lack political will to make it work . Most likely it will mean that only people from well off family can afford to become a therapist and only wealthy client can afford to have human care . We have been in the "Society of diminishing expectations" as Christopher Lasch has put it in the 70s and we haven’t seen it getting any better in any rate , with the arrival of AI it would only intensity everything has been going wrong . As a new joiner to this field , I envy the older generation and their sense of optimism .
Thanks for your thoughtful comments.
I didn't address the structural pressures you're describing (insurance companies, tech lobbies, the economics of training) in this essay. I'm definitely not suggesting I think that capitalism will sort this out — I've watched it fail to do that for decades, in my own practice and everywhere else. What I'm arguing is that the profession has been unable to make its case clearly because it hasn't named what it actually does. That's a problem we can actually do something about, regardless of the political and economic forces arrayed against us.
And you're right that younger practitioners face pressures I didn't. The economics of entering this field are harder than they were, and that's a serious problem. But I'd still rather we fight that battle knowing what we're fighting for.
The robots are good at talking about why they are so useful
Apparently, robots can have big egos! :)
It's more like they're really good at mimicking the people who use them.
Yes. And therefore, for too many users: garbage in, garbage out.