Author Topic: Talk therapy marches toward extinction  (Read 9637 times)

Matt Koeske

  • Management
  • *
  • Posts: 1173
  • Gender: Male
    • Useless Science
Talk therapy marches toward extinction
« on: March 06, 2011, 07:29:38 PM »
Here's a less than heartening article about the state of psychiatry (and by extension, psychotherapy) today:
Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.
You can always come back, but you can’t come back all the way.

   [Bob Dylan,"Mississippi]

Keri

  • Dream Work Vessel
  • *
  • Posts: 407
  • Gender: Female
  • Sedna
Re: Talk therapy marches toward extinction
« Reply #1 on: March 08, 2011, 02:35:32 AM »
It is distressing.  I don't know very many people in medicine, psychiatry or otherwise, who are actually happy and feel a good deal of job satisfaction.  It just seems to be spiraling more and more out of control (of the providers and of the patients).  I wonder whether, if we had a system that allowed more people to become providers (whether physicians, psychologists, etc), that might lessen the burden.  I'm imagining a situation where medical school training is less expensive or one in which the payment involved being required to do a certain amount of "community service" or public health or taking care of the underserved after graduation.  I think they do this in Mexico.  If you had less debt starting out, you might feel more empowered to make your own decisions about how to run your practice - eg, maybe some would be willing to see fewer patients and on a cash-only basis (maybe a sliding scale that more people could afford) if they didn't have massive debt to repay.  Of course, it would help to not be too greedy.  And it would help if patients were willing (when able) to pay what such a service is actually worth.
O gather up the brokenness
And bring it to me now . . .

Behold the gates of mercy
In arbitrary space
And none of us deserving
The cruelty or the grace

O solitude of longing
Where love has been confined
Come healing of the body
Come healing of the mind
  - Leonard Cohen, "Come Healing"

Let me be in the service of my Magic, and let my Magic be Good Medicine.  -- Dominique Christina

Matt Koeske

  • Management
  • *
  • Posts: 1173
  • Gender: Male
    • Useless Science
Re: Talk therapy marches toward extinction
« Reply #2 on: March 08, 2011, 04:25:35 PM »
It is distressing indeed, but I wonder if some positive changes could eventually come out of this.  The drive (of psychotherapists and their patrons) has been to seek for the return of psychotherapies to the medical status they once had (at least in the eyes of insurance companies).  But not only are the insurance companies in possession of the power needed to lay down almost any law they desire (profit trumps health), I'm not really sure that psychotherapy is or should seek to be considered "medical".  Psychotherapies will always have a very difficult time trying to establish their "curative" benefits empirically.  And much of the time, we have no clear idea what "heals" the mind or is best used to treat it.  This seems to differ radically from one person to the next.  Also, it remains undetermined (scientifically speaking) that any particular psychotherapeutic method is more effective than another.  Data often suggest that the personal relationship between the patient and therapist is a better predictor of success in treatment.

We could look at what is happening with health care and psychotherapy as a very bad sign that health care (especially of the "soul") is stumbling into a new dark age where mental disease will run rampant.  And maybe that will happen, but I also think the opposite could be true.  For decades now, psychotherapies have been trapped in a state of bad faith, desperately wanting to be and pretending to be medical (diagnosing "real" pathologies) in order to appease a broken health management system.  In essence, psychotherapy was taking dictation from insurance companies on what and how to diagnoses and treat.

If psychotherapies are eventually "disowned" by both medicine and insurance companies, they would lose their "provident breast", but they would also be freed to evolve for the first time since the early days of psychoanalysis.  I wouldn't wish that kind of strife upon the profession, but I also think that a little bit of environmental pressure could help them adapt and evolve.  Of course some (as mentioned in the article above) could simply charge full price (or more) to rich clients . . . and this would return psychotherapy to its beginnings.  It could be like art used one was . . . dependent upon wealthy patrons.  It seems like such an ineffective system for "growing art" or psychotherapy, and yet a lot of great (and not commodified) art (and psychotherapy) came out of this system.

Still, that doesn't interest me, much.  Wealthy people already have Scientology today, after all.  Do we really need a psychotherapy more like Scientology or some other kind of New Age guru-for-hire pseudo-spiritualism?  What I am actually (although very distantly) a bit excited about is the idea of "e-psychotherapy".  I wonder if such a thing could grow to become viable (not just as an industry, but as actual treatment of mental disease and dysfunction.  Like most psychotherapists today, I very much believe in the value of a face-to-face therapy.  There are just so many more cues to read and a much greater chance for intimacy and responsible behavior from both therapist and patient (but also, of course, a number of distractions).

Obviously such psychotherapy would have its limitations.  It wouldn't make a very good suicide watch and it wouldn't work very well with people with psychopathic tendencies or "pathological liars".  Perhaps one variant could involve video conferencing psychotherapy.  That might help a bit, and it could enable therapists to see patients that were not local or capable of travel.

But I'm more curious about a kind of "therapy-light" where the expectation of old-school, on the couch psychoanalysis is disposed of.  It wouldn't be something to do for people who were more severely ill.  It wouldn't be curative.  Rather it could work for people who just need a bit of feedback and supportive guidance.  Of course something like this could only evolve if psychotherapies changed quite a bit and moved away from their psychoanalytic roots (and medical pretenses).

My experience with online communities like Useless Science makes me think that there must be some way of harnessing social media technology to the benefit of the treatment of the soul.  I see this in our dream work forums.  Therapeutic benefits often emerge from doing dream work, and this might require more of an ethic of sympathetic cooperation among members than any actual expertise.  Dream work also has the advantage of working within a group rather than requiring a one-on-one format.

I think I've seen dream groups (possibly online ones) that charge a membership fee.  Usually the idea of such groups is that they will teach people how to interpret dreams.  I am pretty skeptical about that, even when actual psychotherapists are running the "workshops".  Of course, I'm skeptical about "dream interpretation" in general.  I would never personally want to cater to people's desires to "interpret" dreams rather than work with them in a more self-therapeutic manner (see my current conversation with Enjolras . . . another long post is on the way).  To my mind, "dream interpretation" is an act of bad faith because it misuses dreams and fails to understand what they are.

But I've occasionally wondered what Useless Science would be like if we had a large, thriving dream forum.  Perhaps one in which I wasn't doing extensive analysis on almost every dream, but was instead mostly "tending the vessel".  A kind of custodial role.  I could envision a format for that community that was compatible with a forum . . . a stable of "moderators" and such.  But it would have to be people who were very committed and who I could trust to care about others and not merely be ideological.  If such a community could develop, I don't think it would be unreasonable to charge a membership fee (paying whatever there was to the moderator staff).  After all, many people pay to belong to clubs, professional societies, and gyms.  I see dream work as similar to the "body work" one might do at a gym.  And it does often require a good "facility" . . . where the facility would be something like access to the resources of reliable and skillful dream workers and a supportive, like-minded community in general.

And really, conventional psychotherapy may not be any more effective than exercise (for problems like depression, especially).  There is no reason that, for certain people, "dream work exercise" could not be every bit as beneficial as psychotherapy.

Well, even if something like that could evolve, it's a long way off.  And there would be a problem with charlatans and figuring out how to find a decent "dream dojo".  But all the tools of communication are readily available.  It certainly would be an amazing development if the collapse of psychotherapy led to a popularization of dream work.
You can always come back, but you can’t come back all the way.

   [Bob Dylan,"Mississippi]

Keri

  • Dream Work Vessel
  • *
  • Posts: 407
  • Gender: Female
  • Sedna
Re: Talk therapy marches toward extinction
« Reply #3 on: March 21, 2011, 08:28:30 AM »
The thing I like most about what you've written here is that it's "outside the box."  I really believe that most of the solutions we are going to require in attempting to find a sustainable way to live as a species are going to involve completely new ideas rather than tinkerings with old ones. 

And maybe we won't ever "attempt to find a sustainable way to live as a species."  That might be asking too much (both of our species and of our solutions?).  Maybe the better question is how each of us can live in a more tolerable way, and that might mean or lead to better sustainability for us as a group overall.  But at least in what you write there's a shift in responsibility back to a group of concerned others and to an individual who is actively involved in their own process. 
« Last Edit: March 21, 2011, 08:39:05 AM by Keri »
O gather up the brokenness
And bring it to me now . . .

Behold the gates of mercy
In arbitrary space
And none of us deserving
The cruelty or the grace

O solitude of longing
Where love has been confined
Come healing of the body
Come healing of the mind
  - Leonard Cohen, "Come Healing"

Let me be in the service of my Magic, and let my Magic be Good Medicine.  -- Dominique Christina

The Old Spirit

  • Known Members
  • *
  • Posts: 26
    • rajivmudgal
Re: Talk therapy marches toward extinction
« Reply #4 on: March 26, 2011, 01:51:20 PM »
Actually I see it this way.
The success of modern medicine to communicate in body's own native language, or to put it crudely 'chemical language' or physical, or low level language by passing speech or higher level language has resulted in trust. And Therapy is all about trust.

Nicholas Humphrey Interview by- Richard Dawkins
http://youtu.be/e1AQPue7FEM
http://youtu.be/FQcwbnshxWk
http://youtu.be/WpkLfs43FxE
http://youtu.be/RO_ayj_BtC0

and
Eric Mead: The magic of the placebo
http://www.ted.com/talks/eric_mead_the_magic_of_the_placebo.html

Interestingly placebo has an evil twin, necebo.Just like placebo, Its effects are real, It can make you sick and even kill the person depending on the subject's pessimistic belief and expectation that the inert drug would produce harmful, injurious, unpleasant, or undesirable consequences.

Talk therapy may go out of fashion but Urban Shamanism is growing in leaps and bounds.
I had this terrible cervical spondylitis. After a month of Physiotherapy and pain killers, I moved to Yoga and homeopathy, and I feel better. A minor change in life style, a little slowing down, a little Yoga and regular visits to my homeopathist, is doing wonders for me.
Interestingly my cervical spondylitis gave me the same symptoms for example depression, bad sleep, stomach upsets and chilling dreams and these would have been interpreted differently by any of the oral therapy's.

On the side note, my homeopathist does talk and work like some "New Age guru- with his pseudo-spiritualism?" He has weird theories as to why homeopathy works. I don't take him seriously, but still there is no doubt that I have benefited by his alchemical cocktail. It works.
The change in lifestyle has seriously resulted in some time honoured transformation.

So Psychotherapy has to seriously think why some "New Age guru- with his pseudo-spiritualism?" works where Psychotherapy doesn't.

 



Matt Koeske

  • Management
  • *
  • Posts: 1173
  • Gender: Male
    • Useless Science
Re: Talk therapy marches toward extinction
« Reply #5 on: March 27, 2011, 09:04:46 PM »
Hi Rajiv,

I don't have any problem with "alternative medicines" in general.  Perhaps many have "faith-based" cures, and if and when these are effective, who am I to object?  I do object to pseudo-scientific claims (i.e., should some faith based approach fallaciously claim to work by science rather than faith).

I agree with many Jungian analysts that what works therapeutically is worth utilizing in psychotherapy.  But I do have an objection to some of the approaches Jungians (and psychoanalysts and other psychotherapists) take that appear to have healing results but only from specific (and often faith-based) perspectives.  One example I've written about previously is the confusion in many psychotherapies between indoctrination and healing or between indoctrination and initiation/individuation.

Indoctrination as therapy would be more like what we see in the stereotypical 12 step program.  There is a specif dialect and perhaps some rules and signature ideas (more like mantras), but primarily, "healing" is about finding an identity within a supportive group.  Far beyond a mere placebo effect (more on that later), indoctrination into a tribe can have substantial mental and physical health benefits for the individual who embraces that indoctrination.  This should be studied far more scientifically and thoroughly than it has been.

I don't mean to criticize this tribal indoctrination as healing either.  My suspicion is that it is something everyone needs, this ability to belong and be "seen" and participate within a group.  I don't criticize psychotherapies that indoctrinate more heavily or are composed of more overtly tribal bodies because "indoctrination is wrong or bad".  It isn't.  My critique is more subtle.  I think that these psychotherapies become unnecessarily and dangerously unscientific when they use a form of "indoctrination therapy" but claim that some kind of scientific, objective medicine or method of treatment is being used.

Jungianism and psychoanalysis are substantially tribal micro-cultures that rely very heavily on indoctrination therapies.  But they both believe that their methods of treatment are more or less scientifically sound and essentially universal.  Like, say, antibiotics . . . which have a scientifically proven effect.  Jungians and especially psychoanalysts are true believers in their methods and theories, but these remain to be proven.  Statistically, although hard to measure accurately, there does seem to be some effectiveness to their treatments, but this effectiveness is not itself analyzed.  How much of it ("healing" or functional identity construction) might come as a benefit of indoctrination is not factored.  That is, how much of the method of treatment is effective because it universally "works" and how much is healing merely a matter of finding a group or mindset in which the patient's identity is allowed to be more "whole" and visible (so long as the patient conforms to the conventions of tribal indoctrination, i.e., "believes" in the validity of the psychotherapeutic methodology as "true"?

Although psychoanalysis seems to be considerably more "indoctrinating" and overtly tribal than Jungianism, Jungianism runs into the problem of promoting as a facet of its methodology "individuation" . . . which cannot be the same thing as indoctrination.  individuation is a differentiation from group affiliations, not a mystical participation in them and in the tribe's identity construction.  So my concern is that there is a degree of bad faith in this method and in Jungian ideology.  Individuation is in many cases a sham.

With psychoanalysis, there is perhaps a different kind of sham.  Something more along the lines of claimed scientific credibility.  I don't know what expression of bad faith is worse.  My concern (as a Jungian, however "outside") is that maintaining this expression of bad faith is harmful to the Jungian tribe and its capacity to think and treat patients with any scientific validity.  Also, If Jungian analysts are indoctrinating some of their patients, then I would like to see what they are being indoctrinated into as viable, healthy, functional, sustainable, adaptable, and survivable.  That is, if we are organizing as a tribe, then the "tribal soul" needs to be tended to.

I also have no objection to shamanism (although I remain suspicious of and unconvinced by "urban shamanism").  Real shamanism only superficially treats individuals.  More accurately, I think it treats the "tribal soul".  Individuals who suffer a "soul sickness" are like organs in a body that become diseased.  They need to be healed so that they do not contribute to the destruction of the entire body (i.e., the tribe).  The shaman treats the individual within the context of the tribe's mythos, values, identity constructions, and stories of selfhood.

My suspicion of urban shamans is largely a matter of recognizing that they do not really treat the "tribal soul".  They operate (sometimes knowingly and cynically) on the individual soul as if soul treatment of this sort could restore the health of the individual in a sick world/community.  In other words, the problem with this kind of urban and "plastic" shamanism is that it sees the soul as "ego-like".  It envisions suffering and disease as personal matters and has a dangerously ignorant or irresponsible vision of the relationship between individual and tribe.

I don't, for instance, believe that a modern, urban person can go seek out a native, tribal healer, undergo a tribal healing ritual, and return to modern urban life "completely cured".  Perhaps a placebo effect can dispel a symptom or two if the patient really believes in the ritual on some level, but the disease is still there.  A shaman can only heal individuals within his or her tribe.


Regarding the placebo effect.  I think it itself is part urban legend.  The actual measured effect of placebos where the number of tests over a longer duration of time is quite extensive is not at all miraculous.  And I believe that the long term effectiveness of placebos is much lower than the short term.  I don't have references for this right now, but I do recall reading about this in various places in the past.  I will try to find some data or studies to link to or cite when I get a bit of time.

I don't know much about homeopathy, but I am not sure that your health improvements, if they resulted from this treatment, were actually based in placebo effects.  Diet, lifestyle/exercise, and limiting exposure to various forms of toxicity could certainly (and perhaps scientifically) have immense benefits to health.  My mother, before she died of cancer, tried a strict macrobiotic diet.  I suspect that most of the foods she was prescribed were prescribed for hokey reasons, and they may not have had any effect on the growth rate of her cancer.  But the diet totally "cured" her diabetes.  Did the diet have to be specifically "macrobiotic" to achieve this?  I seriously doubt it.  But eating healthy foods, no meat, and strictly controlling portions . . . a "lifestyle" change . . . did have a profound positive effect on her health.

Equally with psychotherapies, where strategies can be developed and employed for reducing anxiety, increasing coping abilities, and finding more access to fulfillment in relational or identity roles, I think that resultant health benefits would be entirely "real" and even within the gaze and grasp of science.


Although I do admire aspects of rationalism and consider myself a kind of atheist and naturalist, I am not the kind of materialist ideologue that believes all non-rational thoughts are foolish and wrong (a la Richard Dawkins).  Science is not a religion to me, merely an excellent tool.  And not when it is invoked by name alone, but when its methods are practiced with real integrity.  Where I might grumble and say slightly flippant things like "Do we really need a psychotherapy more like Scientology or some other kind of New Age guru-for-hire pseudo-spiritualism" (which is the accurate quote you seem to be appropriating), my meaning is not "arch-rationalist".  Scientology and alternative and natural medicines are not in the same league.  And my gripe in the above had more to do with exploitation of people for selfish gains and wasn't a sweeping condemnation of the non-rational or not-yet-scientifically-understood.

I'm not quite sure how to interpret your first paragraph about modern medicine communicating in the body's own native language, and what you say about therapy being "all about trust" is a bit vague and overly general.  I don't see exactly how you are connecting that up with the rest of the statements in your post.

Best,
Matt
« Last Edit: March 28, 2011, 09:30:37 AM by Matt Koeske »
You can always come back, but you can’t come back all the way.

   [Bob Dylan,"Mississippi]

Matt Koeske

  • Management
  • *
  • Posts: 1173
  • Gender: Male
    • Useless Science
Re: Talk therapy marches toward extinction
« Reply #6 on: March 28, 2011, 11:02:28 AM »
This Wikipedia article on placebos has a lot of information.

Quote
Clinical significance

Hróbjartsson and Peter Gøtzsche published a study in 2001[8] and a follow-up study in 2004[94] questioning the nature of the placebo effect. The studies were performed as two meta-analyses. They found that in studies with a binary outcome, meaning patients were classified as improved or not improved, the placebo group had no statistically significant improvement over the no-treatment group. Similarly, there was no significant placebo effect in studies in which objective outcomes (such as blood pressure) were measured by an independent observer. The placebo effect could only be documented in studies in which the outcomes (improvement or failure to improve) were reported by the subjects themselves. The authors concluded that the placebo effect does not have "powerful clinical effects," (objective effects) and that patient-reported improvements (subjective effects) in pain were small and could not be clearly distinguished from reporting bias. Other researchers (Wampold et al) re-analysed the same data from the 2001 meta-analysis and concluded that the placebo effects for objective symptom measures are comparable to placebo effects for subjective ones and that the placebo effect can exceed the effect of the active treatment by 20% for disorders amenable to the placebo effect,[95][96] a conclusion which Hróbjartsson & Gøtzsche described as "powerful spin".[97] Another group of researchers noted the dramatically different conclusions between these two sets of authors despite nearly identical meta-analytic results, and suggested that placebo effects are indeed significant but small in magnitude.[98]

Hróbjartsson and Gøtzsche's conclusion has been criticised on several grounds. Their meta-analysis covered studies into a highly mixed group of conditions: the placebo effect does occur with peripheral disease processes (such as hypertension, asthma, prostatic hyperplasia, anal fissure, bronchitis) though not for processes reflecting physical disease (such as venous leg ulcers, Crohn’s disease, urinary tract infection, and chronic heart failure).[99] Placebos also do not work as strongly in clinical trials because the subjects do not know whether they might be getting a real treatment or a sham one. Where studies are made of placebos in which people think they are receiving actual treatment (rather than merely its possibility) the placebo effect has been observed.[100] Other writers have argued that the placebo effect can be reliably demonstrated under appropriate conditions.[101]

In another update by Hróbjartsson & Gøtzsche, published as a 2010 Cochrane systematic review which confirms and modifies their previous work, over 200 trials investigating 60 clinical conditions were included. Placebo interventions were again not found to have important clinical effects in general but may influence patient-reported outcomes in some situations, especially pain and nausea, although it was "difficult to distinguish patient-reported effects of placebo from response bias". The pooled relative risk they calculated for placebo was 0.93 (effect of only 7%) but significant. Effects were also found for phobia and asthma but were uncertain due to high risk of bias. In other conditions involving three or more trials, there was no statistically significant effect for smoking, dementia, depression, obesity, hypertension, insomnia and anxiety, although confidence intervals were wide. Several clinical (physical placebos, patient-involved outcomes, falsely informing patients there was no placebo) and methodological (small sample size, explicit aim of studying the placebo effect) factors were associated with higher effects of placebo. Despite low effects in general and the risk of bias, the authors acknowledged that large effects of placebo interventions may occur in certain situations.[102]


5.) Hróbjartsson A, Norup M (June 2003). "The use of placebo interventions in medical practice--a national questionnaire survey of Danish clinicians". Evaluation & the Health Professions 26  (2): 153–65. doi:10.1177/0163278703026002002. PMID 12789709. http://ehp.sagepub.com/cgi/pmidlookup?view=long&pmid=12789709.
8.) Hróbjartsson A, Gøtzsche PC (2001). "Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment". New England Journal of Medicine 344 (21): 1594–1602. doi:10.1056/NEJM200105243442106. PMID 11372012. http://content.nejm.org/cgi/content/short/344/21/1594.
94.) Hróbjartsson A, Gøtzsche PC (2004). "Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment". J. Intern. Med. 256 (2): 91–100. doi:10.1111/j.1365-2796.2004.01355.x. PMID 15257721. http://www3.interscience.wiley.com/journal/118792130/abstract.
95.) Wampold BE, Minami T, Tierney SC, Baskin TW, Bhati KS (2005). "The placebo is powerful: estimating placebo effects in medicine and psychotherapy from randomized clinical trials". J Clin Psychol 61 (7): 835–54. doi:10.1002/jclp.20129. PMID 15827993.
96.) Wampold BE, Imel ZE, Minami T (2007). "The placebo effect: "relatively large" and "robust" enough to survive another assault". J Clin Psychol 63 (4): 401–3. doi:10.1002/jclp.20350. PMID 17279522.
97.) Hróbjartsson A, Gøtzsche PC (2007). "Powerful spin in the conclusion of Wampold et al.'s re-analysis of placebo versus no-treatment trials despite similar results as in original review". J Clin Psychol 63 (4): 373–7. doi:10.1002/jclp.20357. PMID 17279532.
98.) Hunsley J, Westmacott R (2007). "Interpreting the magnitude of the placebo effect: mountain or Molehill?". J Clin Psychol 63 (4): 391–9. doi:10.1002/jclp.20352. PMID 17279525.
99.) Meissner K, Distel H, Mitzdorf U (2007). "Evidence for placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials". BMC Med 5: 3. doi:10.1186/1741-7015-5-3. PMC 1847831. PMID 17371590. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1847831.
100.) Vase L, Riley JL 3rd, Price DD (2003). "A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia". Pain 104 (3): 714–5. PMID 12406519.
101.) Barfod TS (2005). "Placebos in medicine: placebo use is well known, placebo effect is not". BMJ 330 (7481): 45. doi:10.1136/bmj.330.7481.45. PMC 539859. PMID 15626818. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=539859.
102.) Hróbjartsson A, Gøtzsche PC (January 2010). "Placebo interventions for all clinical conditions". Cochrane Database Syst Revl (1): CD003974. doi:10.1002/14651858.CD003974.pub3. PMID 20091554.


A more thorough discussion of this research can be found in The Skeptic's Dictionary entry for Placebo.
You can always come back, but you can’t come back all the way.

   [Bob Dylan,"Mississippi]

The Old Spirit

  • Known Members
  • *
  • Posts: 26
    • rajivmudgal
Re: Talk therapy marches toward extinction
« Reply #7 on: March 31, 2011, 04:46:23 AM »
By modern medicine communicating in the body's own native language I meant enhancing, or simulating the host's own defense mechanism by talking to it in its own language. Antibiotics is an good example, so is vaccination; I am not very sure, but I think that Placebos or homeopathy probably works on similar principals, with the attractive advantage of letting the body produce the necessary medicine rather than supplementing it from outside. They are also proven stress busters.

You are right that Scientology and that alternative or natural medicines are not in the same league.

By "all about trust", I meant the referential wholes.which equates exactly to community soul you spoke about and that the Individual soul is everywhere and always found colored. That is, there are no particulars outside of their referential wholes. This may sound a bit Taoistic, but if it is so, then Depth Psychology does in its present form appears more like an aberration than something natural. The particular soul might not be there outside of its referential whole. and the nature of wholes themselves could be Pantheistic than monotheistic.

Also it puts the Aristotelian universals "more or less scientifically sound and essentially universal" you spoke about into a large question mark.
Psychotherapy's rapid success and eventual collapse could be related to its modelling of itself on universals like Natural medicine.