AAPC: You’re going to be talking about “mortality, individuality, and generativity.” Why do you think those are important themes for therapists to reflect on?”
AAPC interview with
McWilliams: I think it is the job of therapists to help people explore what their cultural surrounding makes it hard for them to talk about or even think about. In Freud’s time, those issues tended to involve sexuality. In our era and culture, the fraught areas are different. They include, among others, vulnerability, dependency, and limitation.
Mortality, and limits in general, tend to be treated in contemporary American culture as realities that are best ignored, or even as obstacles that might be overcome. So the concern with mortality has to do with an argument with the dominant culture about its messages that death is an aberration and that our resources and potentials are unlimited – ideas that I think create a lot of trouble for us all. It also has to do with my having turned 70 this past year and having had a cancer scare. At this phase of life, I am more keenly aware of finitude.
Individuality is important for therapists to think about because all the empirical studies of psychotherapy outcome suggest that individual differences – in therapists as well as patients – have much more impact on therapy outcome than differences in techniques and intervention style. That is not news to most seasoned therapists, who have always known that their clients are most deeply moved and helped when they feel known in all their uniqueness and idiosyncracy, and when they feel their therapist’s authentic selfhood in the consulting room.
Generativity is important to talk about in an age in which being passively entertained is highly valued, and often assumed to be all that people need, and yet we all yearn for ways to feel that we matter, that we can make a difference. A lot of the psychopathologies that are common in this culture at this time involve people’s lack of any sense that they can have a positive impact on their own future, their family, their community, their work environment, their country. The psychotherapy community, like the community in general, is aging, and I think Erikson had it right to frame our mid-to-late-life issues as generativity versus stagnation.
AAPC: This will be your second time speaking at our conference. What is it about talking with pastoral counselors that interests you?
McWilliams: Pastoral counselors deal with complexities that many other therapists can ignore, such as the complicated interfaces between an individual’s problems and those of the family and the religious community. They are informed by the great wisdom traditions and therefore bring a mature holistic sensibility to their work. Many contemporary psychiatrists, psychologists, social workers, and psychiatric nurses have not been at all steeped in the philosophical and theological issues that are the enduring human questions with which our patients, like every generation before them, struggle and suffer.
Pastoral counselors tend to be more widely educated than those who focus narrowly on getting credentialed in psychiatry, psychology, or social work. They ask the bigger questions, and I find I learn a lot from them. I am currently, for the first time, teaching a course called “The Minister and Mental Illness” at the Princeton Theological Seminary, and although my students there know much less about academic psychology than my graduate students at Rutgers, they tend to have rich life experiences and angles of vision on psychological suffering that are new and enriching to me. I have always enjoyed dialogue with people of faith.
Also, I had a great time at Kanuga the last time I was there, and met many people I was more than happy to reconnect with!
AAPC: The field of psychotherapy and mental health care is in such flux. What values guide you and orient you in the midst of all this change?
McWilliams: I would say that my core values as a therapist center around integrity and devotion – not that I think I’m always an exemplar of either of those virtues, but they are certainly a substantial part of my ego-ideal. One has to keep questioning the received wisdom of the powerful, whose interests often involve distorting the truth or treating people as objects to be manipulated rather than subjects to be cherished.
I think my core values were deeply set by my upbringing as a Christian and my identification with the values espoused by Jesus. The Golden Rule remains a pretty good standard. As a child, I was moved by the Beatitudes, by the compassion that infuses them so thoroughly and believably. Trying to extend love toward those who may seem alien or contemptible or different or hostile was a revolutionary idea with which I was greatly impressed. But I think I also was influenced by Jesus’s questioning of authority and insistence on returning to substantive issues when the elders in his faith were emphasizing ritualistic perfectionism at the expense of the larger principles they were designed to embody.