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This post is Part 1 of a series that will examine the nature of what I refer to as clinical wisdom and provide specific examples of some of these esoteric secrets of psychotherapy.
How much of what we call psychotherapy is about the teaching or transmission of certain esoteric and well-guarded secrets about psychology, life, and how to best live it? What are some of these secrets? Where do they come from? And exactly how would such profound and transformative “clinical wisdom” be conveyed from clinician to client or patient? These are difficult questions. Difficult because there are so many (400 to 500) different types of psychotherapy practiced today with diverse approaches, goals, techniques, and methods.
Most contemporary therapies are strictly symptom-centered, while some are more concerned about treating the whole person (holistic) and promoting personal growth and, perhaps, spiritual development. And there are, of course, various and very different reasons that people seek psychotherapy in the first place, though, for most, it is the painful or debilitating presence of psychiatric signs and symptoms. (See my prior post.)
But if I could distill the primary reason for the continuing existence, and recent resurgence, of psychotherapy as a practice and profession, and what mainly motivates someone to seek it, it would generally come down to this: the universal or archetypal experience of suffering and the perennial problem of evil. We may not be fully conscious of what truly causes us to seek psychotherapy, but rumbling beneath the surface are profound philosophical, existential, and spiritual questions: Why do we suffer? Why is there evil in the world? Does life have meaning? Is there free will? What am I responsible for in life? Why must we die? Is there anything beyond death? Why do I feel so alone? Who am I? Why am I here? What is my purpose or significance? What do I really want, and how can I get it?
We are currently not only in an age of miraculous technological, scientific, and medical advances that enable us to live longer and better, stay more closely linked with others and world events, and enjoy access to modern marvels such as computers, cell phones, television, the internet, GPS, and AI; but, at the same time, we find ourselves in an equally unprecedented period of frustration, rage, hostility, hatred, chaos, alienation, and confusion. Twenty-first-century existence is becoming more complex, stressful, and difficult to manage. Racism, sexism, misogyny, genocide, antisemitism, fascism, terrorism, mass shootings, political animosity, and, more generally, human evil—an archaic concept coming back into use by some psychologists, psychiatrists, sociologists, and the public connoting those pernicious attitudes and actions that promote excessive interpersonal aggression, violence, and disregard for the rights of others—are escalating alarmingly around the world. As C.G. Jung (1961) prophetically observed, “Evil has become a determinant reality. It can no longer be dismissed from the world by a circumlocution. We must learn to handle it, since it is here to stay. How we can live with it without terrible consequences cannot for the present be conceived.”
Consequently, our collective mental health is suffering. These chronically traumatic conditions take a devastating toll on the psyche, spirit, and soul. The incidence of serious psychiatric disorders is on the upswing. Suicide rates in the U.S. over the past two decades rose by 25 percent. According to the National Institutes of Mental Health, more than 44 million Americans suffer from some sort of serious psychiatric symptoms such as depression, panic attacks, generalized anxiety, bipolar disorder, and psychosis. This staggering statistic excludes an additional 20 million who are living with substance use disorders. Indeed, we remain in the unremitting grip of a runaway opioid abuse epidemic, indicative of the futile and dangerous desire to anesthetize (via substance use, alcoholism, workaholism, or problematic behaviors surrounding food or sex or technology) our psychological suffering and escape from stark existential reality at all costs.
People are discouraged, distressed, disoriented, and desperate to make sense of their lives, to find purpose and meaning, peace of mind, self-esteem, security, belonging, power, recognition, and significance, and to discover new and more constructive ways of coping with the perturbing and perilous vicissitudes of post-pandemic existence. But sadly, they seldom possess the necessary skills, means, and knowledge to do so on their own. Yet, there exists, as I contend in my new book, a vast treasure trove of what I call “clinical wisdom,” painstakingly accrued, conserved, curated, and protected by countless psychotherapy practitioners over the past century, that is desperately needed in our day and, therefore, far too precious to stay secret.
Psychotherapy—the therapeutic treatment of mental disorders, existential suffering, and human misery utilizing psychological methods and, perhaps surprisingly to some, more meaningfully defined as healing of the soul or mind—has, in some form or another, been practiced now for more than a century by medical and mental health professionals around the world. Ever since the famed Viennese physician Sigmund Freud, the undisputed father of modern psychotherapy, first introduced the revolutionary “talking cure” and controversial treatment method he called “psychoanalysis,” generations of psychotherapy patients have been privy to a rich and varied collection of clinical wisdom aimed at alleviating, or at least mitigating, their suffering and setting them on the path toward healing and wholeness. Yet, for the most part, it remains enigmatic and shrouded in mystery.
To be sure, the theory and practice of psychotherapy have dramatically evolved since Freud’s day, but all these changes have only added to the diverse wealth, breadth, richness, mystique, and complexity of the potent clinical wisdom it can convey. Over the past decade, and particularly during and since the COVID-19 pandemic, the prevalence and availability of psychotherapy have grown significantly. And as for how psychotherapy is now provided, in 2025, the global use of online video therapy—a relatively recent development in the delivery of psychotherapy services, popularized during the pandemic—will likely exceed $65 billion annually. Psychotherapy has become big business. This is because now, more than ever, we need the encouragement, insight, and inspiration that the cumulative clinical wisdom of psychotherapy can provide. As Jung (1961) himself succinctly said, “Today we need psychology [and psychotherapy] for reasons that involve our very existence.” His words ring doubly true in these deeply unsettling, terrifying, and troubled times.
Indeed, despite dubious trends in recent decades toward a more superficial neurobiological, pharmacological, and cognitive-behavioral approach to the understanding and treatment of psychiatric disorders, and, in effect, a demystifying or mechanization of therapy, there remains a profound, pervasive, and palpable personal and collective hunger for real psychological, philosophical, and spiritual guidance, knowledge, and wisdom. We need to recognize this pervasive psychological, philosophical, and spiritual longing, this intense craving for meaning and purpose, this festering soul-sickness from which we individually and collectively suffer today, and provide in psychotherapy pragmatic clinical wisdom to help restore our soul, strengthen our self, and sustain our sanity in a sometimes seemingly insane world.
