Problems with Insurance

Not all problems are behavioral or developmental.

Insurance companies have assumed that problems are behavioral in nature. Not all that long ago, the behaviorists were in disrepute as being "shallow," merely relieving symptoms and not getting at the "root cause" of problems. But as third parties began to worry about the bottom line, the tide shifted and now measuring all problems in behavioral terms is "in."

The reasoning goes thus: If you are depressed, I will see the depression in your behavior and when you are better, your bright and perky smile will tell me so.

This is fundamentally silly and illogical. I can think of three reasons why.

First of all, a person can learn to act appropriately and still feel awful. How many news stories tell of the person who shot himself while no one had an inkling of a problem? Depressed people and addicts often fake it.

Second, behavioral care companies require clients to agree in advance to specific, concrete goals for therapy. That allows no room for for the power of subtle suggestion. Research shows that people heal best when a general idea is offered so that they can shape that idea to their personal needs, often unconsciously. Behavioral changes dictated by the therapist in the first few sessions destroy this powerful source of healing.

Finally, not all problems have anything to do with behavior. This is the most important one. I had a client once who believed she was unlovable. No matter what concrete behavior I focused on, I failed. No behavioral approach addressed what was basically a matter of self esteem.

For example, when you forget your wife's birthday, it is too late for your therapist to suggest the flowers. It was the thought, not the behavior, that counted. Another example is that parents don't just want their kids' homework done. That would be too easy. They want junior to want to do it. We're in the world of meaning here, meaning and purpose in life, not just behavior.

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