Written By, Michael Rudy, LMSW, CFP©, EA
Power is an essential, if not the essential element in managing and transcending depression and anxiety. This article explores the history of power in the evolution of psychotherapy and offers some original ideas on how best to help clients become effective in understanding the ways and using means of power. This blog aims to make the concept of agency an operational set of skills useful in managing anxiety and depression.
Psychological conversations about power, per se, are almost taboo. There is no question that right from the beginning of the creation of the theory and practice of psychotherapy, power was front and center and, like now, completely hidden. Peter Kramer, in his book, Freud: Inventor of the Human Mind, unabashedly asserted that Freud was something of the embodiment of Nietzsche’s “will to power.” I take this to mean, that he sought to control every element in the creation and practice of psychoanalysis. At every turn in its evolution, Freud maintained an autocratic control over the orthodoxy of psychoanalytic theory and practice. The repudiation and expulsion of Otto Rank from the ranks of acceptable theorists, even after years of faithful service to Freud, is a glaring example of this will to power. And even if Carl Jung and Alfred Adler – early supporters of Freud – had a voice and choice in leaving the fold, most historians say they two were ousted. At every turn, Freud’s capacity to say what “is” is, underscores the centrality of the power dynamic in the birth and evolution of psychoanalysis.
Power is important and holds a central place in human existence. Most modern psychotherapists understand that there is a power differential between patient and therapist. Even more importantly, helping our patients learn and use agency – power may well be the aim and goal of psychotherapy work. Creel Froman, in his book series, all entitled Language and Power¸ believed that power is always in play in all human interactions. In our day-to-day work, are we adequately addressing this question of power head-on? Or do we merely speak of agency without helping our patients grasp and use it as a tool?
Miriam-Webster’s definition of power is threefold: the ability to act to produce an effect; possession of control, authority, or influence over others; physical might. My definition, which aligns with Miriam-Webster, has proved more useful to me in my work with patients: Power is the ability to get what you want or need. Expressed this way, we are better to speak of the ways and means of getting and using agency.
The Importance of Power in Psychological Life
Sometime in the early ’90s, after having traversed a career that went from a green-behind theears clinic therapist to a failed private practice one, to a stockbroker and then back to clinic therapist, I had become a serious student of the work of Rollo May, the now renowned father of the American existential psychoanalysis. At the clinic where I was working, the agency director asked me if I would take over the domestic violence treatment program. I agreed, with only requesting authority to use my theoretical orientation. She accepted on the condition that the length of the program is 10 weeks. I argued for my particular orientation because I of a singular idea from May’s 1972 book, Power and Innocence: A Search for the Roots of Violence. In that volume, he argued that violence was an expression of powerlessness. What a simple and radical idea. My thought in contemplating the setup and structure of my aggression management program was that if I could empower these convicted domestic violence offenders, they would have less destructive ways of getting what they wanted or needed. They would have far less need to resort to force. The program was unique in the idea of empowerment and came to the attention of the Washtenaw County court system. More than the fact that it was a relatively short program – 2 and a half months vs. the yearlong programs in vogue then –
my idea of empowerment was intriguing. Instead of the then-current punitive approach to shaming the perpetrators into compliance, I worked to teach them how to get what they wanted and needed in totally non-violent ways.
The first question I asked in designing the program was, “How many ways are there to get what you want or need from another person?” My mentor, May, was no help here. We didn’t have Google in those days, but if you did your search now, you’d find numbers all over the place. Why is this question so important? The answer came out of my putting the question to my court-sent clients. Like Google today, their answers were all over the place, from “I don’t know” to “millions.” If it’s millions, there’s nothing I would be able to offer. But if the answer was a finite number, then we would have practices we could teach.
My analysis and answer came by degrees. Force was the first obvious answer: you take it. This is what my clients had been doing that got them into the criminal justice system. But what else? You can ask for it. That seemed obvious as well. So, two so far. What else? Oh, I know: working as a stockbroker, I had to negotiate and then make a deal. So that makes three. What else? What else? It took a while and thought of Dale Carnegie’s How to Win Friends and Influence People. And the more I thought about it, the more I began to think of influence as a form of manipulation. The first dictionary definition of manipulation was telling: to handle! The way it showed up for me was that you work on the other person’s mind, to advance your own interest, but you don’t hurt the other person. That being said, I also imagined that you could work on another person’s mind to advance your own interests and end up hurting the other person: lying, cheating, intimidating, shaming, or creating guilt. There were lots of ways to affirm a person (good manipulation) and lots of ways to hurt another (negative manipulation). In the conversation of “influence,” clearly the idea is to not injure the other; to authentically acknowledge and respect the other person. But it must, by definition, be an authentic care and respect. It can’t ever be intentionally used to “manipulate”, in the sense of “playing the dude.” Things like real praise, genuine appreciation, true feelings of love and affection; all these ways of being with another impact their mind, but don’t leave them hurt or disrespected. In fact, if anything, when your expressions of acknowledgment, affirmation, acceptance, and care are authentic, the other person experiences you being supportive and caring and, over time, as the person comes to know that there wasn’t an aim or goal in mind when these affirmations were offered, that person naturally becomes more open to your request and more willing to consider deals you might propose. But, again, you can’t just do these affirmations just to set up a deal. It’s a shaping of relationship but authentically heartfelt
So there it was: request, deal, positive and negative manipulation, and force. Notice right away: requests, deals, and positive manipulation have no domination quality about them, but negative manipulation and force are all about domination. And as I learned in those days from my work and association with Werner Erhard’s est training / Landmark Forum, domination will always negatively impact or destroy relationships! So, in the design of my course, it was essential to introduce, develop and anchor these distinctions with my clients. When a Washtenaw County judge said that he would commit to sending his first-time offenders to my program if I set up my office locally, I set up my office in Ypsilanti, Michigan. I created a brochure, reached out to the local probation departments, visited the judges in the various other courts, created and began offering The Wolakota Aggression Management Course. Wolakota is a Lakota word for peace and harmony as was part of the name that was given to me years earlier when I worked as a public welfare social worker on the Pine Ridge Reservation in South Dakota. The program was well-received, ran for over 10 years, treated hundreds of individuals – men and women – and had a very low rate of recidivism.
Power and Therapy
But now, where are we? What about power and therapy? The odd thing about my becoming a therapist has been the sense that I had to do therapy using only the ideas of the published authors. It even seemed a bit arrogant to assert my own unique ideas, even after having used my original ideas in a successful treatment program. Our field is just full of great originators. But about two years ago, I found myself wondering what my therapies might look like if I practiced with my ideas. And which ones? No surprise: my ideas on the role of power in mental health.
Think of it: when you are unable to get what you desire strongly, whatever it might be if it’s truly important to you and all the avenues for your getting it are blocked, you experience depression. On the other side: if there’s something in the future that you strongly desire or need, or some heartbreaking situation you fear you won’t be able to handle or make come out in a particular way so you don’t get hurt, is this not what the experience of anxiety is? Is this not a failure of power; of not being able to get what you want or need? Knowing there are only four ways to get what you want and need from another person provides a solid place to begin exploring how to work with depression and anxiety. And trauma. Isn’t trauma always about having been powerless at the hands of someone or some situation?
There is another book by Rollo May that is relevant here. His 1975 book, The Courage to Create points to the requirement to make things up as part of any serious problem solving, adaptation, and growth process. There are a million ways to ask, a thousand deals that can be put together, and hundreds of ways of saying “You’re special.” May’s title was, for the insiders like me who know so much of his history, a nod to his lifelong friend and mentor, the great philosopher/theologian, Paul Tillich. Tillich wrote his highly influential and hugely useful (to psychotherapists) book, The Courage to Be, as
his particular response to The Meaning of Anxiety, May’s Ph.D. thesis that he completed with Tillich, as his dissertation chairman. The importance of helping our patients find a path to having the “courage to accept acceptance”, as Tillich wrote, is so essential to our work. So, courage and creativity in venturing an exercise of power is also an essential ingredient, to my mind, in healing and growth.
Then, there’s one last element that has to be included in any discussion of power as a key to mental well-being and that is grieving. As the Rolling Stones once pithily observed, “You can’t always get what you want.” And this is true no matter what your station in life might be. Therapists are required to look at mortality as an essential act of courage they must exercise every day. Ernest Becker’s Pulitzer Prize-winning book, The Denial of Death says it quite succinctly: none of us humans like looking into the face of utter and complete powerlessness. And yet, for the sake of our own and our patient’s mental health, we must acknowledge that we can’t always get what we want and grieving is inevitable and necessary. So that’s it then. In my view, power and the non-dominating exercise of power are essential to healing and growth. Power is the proper name for an agency. There are only four ways to get what you want, and only two and a half if you want to preserve and cultivate enduring relationships. Creativity can be cultivated and it is an essential ingredient in the effective exercise of power. And coming to grip with your own and helping your patients come to grips with their finiteness is a very difficult and equally essential step in healing and growth. Are there infinite other matters that psychotherapists must learn and do well? Of course; without question. But seeing the operational side of agency as the exercise of power – may be a useful and I daresay, an essential tool to have in your therapeutic practice.
A graduate of the University of Iowa’s Master’s program in 1971, Michael Rudy has been a
clinical social worker for 50 years both in clinics and in private practice. During the ’90s, he ran a domestic violence rehabilitation program designed around the ideas taken from his mentor, Rollo May’s book, Power and Innocence. This work led him to become curious about the role power plays in the etiology and treatment of depression and anxiety. Michael continues his work both as a clinician with Heron Ridge Associates, as well as his private practice as a Certified Financial Planner and an Enrolled Agent – IRS’ select advisor program – offering individual tax preparation and planning.
1 Kramer, P. D., Freud: Inventor if the Human Mind, 2006, New York: Atlas Books
2 Froman, Creel, Language and Power, 1992, New Jersey: Humanities Press International, Inc.
3 May, Rollo, Power and Innocence: The Search for the Roots of Violence, 1971, New York: W. W. Norton and Company, Inc.
4 Carnegie, Dale, How to Win Friends and Influence People, 1964, New York: Simon and Schuster
5 May, Rollo, The Courage to Create, 1975, New York: W. W. Norton and Company, Inc.
6 Tillich, Paul, The Courage to Be, 1952, New Haven, CT, Yale University Press
7 May, Rollo, The Meaning of Anxiety (Revised Edition), 1977, New York: W. W. Norton and Company, Inc.
8 Becker, Ernest, The Denial of Death, 1975, New York: The Free Press