I was scheduled to spend time as a visiting scholar in Israel in the spring of 2020. Postponed and rescheduled a few times due to global and personal circumstances, I finally arrived in Tel Aviv last week to collaborate with Israeli colleagues on several mental health initiatives over the coming months. Kaplan Street is a short walk from my apartment. It is also the epicenter for recent rallies in Tel Aviv, where tens of thousands have repeatedly demonstrated against proposed judicial overhauls.
Last weekend, I was exiting the Tel Aviv Museum of Art and walked right into Saturday evening’s protest. In less than an hour, Kaplan Street was a sea of flags held by impassioned citizens standing shoulder to shoulder as far as the eye could see. We have no shortage of experts providing political analysis and historical explication of what we are witnessing, so I will offer a different perspective. Standing among the crowd, I couldn’t help but see parallels between what was unfolding on Kaplan Street and what unfolds in the process of therapy – from crisis to healing.
1. Why now? This is the first question a beloved supervisor taught me to ask when someone presents for treatment. It has become a cornerstone question for me as a therapist and whenever I am trying to understand our complex and messy world. When someone sits down in my office for the first time, their story is new to me but not to them. First sessions are also last straws. “Enough is enough,” my client is saying. The same is true with community protests. Whether it is the individual seeking therapy or a collective demonstration, we have hit bottom, and the status quo can no longer be tolerated or ignored. But this is also a moment of optimism and possibility. The individual in therapy or the thousands of people on Kaplan Street are hopeful that change is possible. That the situation can improve. Therein lies the paradox that rock bottom is also a high point.
2. The Headlines. Headlines sound an alarm. Headlines simplify complex issues. Headlines represent single perspectives. Taking to the streets in public protest and walking into your therapist’s office for the first time are likewise headline events. They are watershed moments in collective and individual histories that capture and focus attention. When a group of people perceives an existential threat sufficient to catalyze a groundswell of response, they hope that their protests will garner sufficient attention to drive change. When individuals embark on therapy, they too, start with a headline issue that they hope will lead to lasting change. But headlines are just headlines. Most protests fizzle. The modal number of psychotherapy sessions is one. Headlines don’t get the work done.
3. From Attention to Intention. The mantra “if it bleeds, it leads” is deeply ingrained in journalism. The news is rife with gore, drama, and hype. We criticize the media for sensational headlines, but they continue to use them because we reliably read them. And we read them because our brains are primed to protect us from threats in the environment and so are always scanning for risk. We focus our attention on real, imagined, or potential harms to ensure our survival. Solving complex problems – whether it is citizenship and democracy in Israel or individual mental health struggles such as addiction, depression, anxiety, or eating disorders – requires moving from attention to intention. Attention without intention is wasted energy. Intention harnesses one’s attention and entails developing a course of action for the future. This is when the real work begins. This is when change is possible.
4. Root Cause Analysis. We have many political scientists and historians providing thoughtful analyses of the underlying causes of the crisis in the Israeli Knesset today. We do the same in healthcare when we have a bad outcome. Root cause analysis is a method of problem-solving that entails careful examination of the root causes of systems failures and bad outcomes. The strategy is designed to get to the bottom of things so that we can move beyond superficial, ad hoc, and reactive remedies to effective and sustained solutions by preventing and solving underlying problems. Sigmund Freud, the father of psychoanalysis, never used the term root cause analysis, but the core tenet of psychoanalysis is that careful examination of a person’s history reveals the underlying causes of mental disorders and thereby provides the foundation upon which to achieve sustained health and healing. But there’s more.
5. Healing Doesn’t Happen in the Past. Headlines are necessary to garner our attention. What we learn when we pay attention informs our intentions for change. Similarly, root cause analysis illuminates foundational faults and problems that sit at the base of a problem. We need to understand our history to prevent repeating our mistakes. That said, we also recognize that understanding how we got into a predicament is powerful but not sufficient to effect the changes we want to see in the future. This is true for the demonstrations on Kaplan Street. It is true for my patients and me in therapy. Understanding not only historical and etiological factors of our situation but also present-day factors that maintain the status quo and future conditions that complicate the path forward, all need to be part of the journey. Healing can only happen with forward motion.
While protests erupted all over Israel, Nashville’s Convent School lost three students and three staff to another mass shooting, more than thirty-eight migrants died in a fire that started in protest at the Ciudad Juárez Retention Center, and a tornado killed at least 26 people as it ripped through southern US states. Every week, social and political polarization, gun violence, immigration, climate change, and escalating mental health concerns around the globe vie for headlines that capture our attention. Across the board, healing depends on moving from headlines and attention to sustained intention and forward motion.