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Tiffany looked great and was obviously thrilled with the results of her weight control and stress management program, so Nadia decided to give it a try. “I don’t understand it, ” she said, dismayed, “I’ve been following the same program religiously, but I’m just not getting anywhere. What’s wrong with me?”
Virtually all introductory psychology courses teach that everyone is unique, but this important fact is often forgotten. As a result, we find all sorts of general facts, figures, and average statistics that often have no personal validity.
For example, almost everyone has seen the typical charts that list ideal weights according to body mass index or BMI. And while a generally valid guideline, BMI is not the ultimate metric for a healthy body weight that many people think it is. This is because it fails to take body composition into account. Therefore, very athletic and muscular people can register as overweight, or even obese, based on a simple BMI. For example, in his prime, Michael Jordan was “overweight” with a BMI 28 yet his waist was less than 30 inches. And, believe it of not, with a BMI over 30, Arnold Schwarzenegger was “obese” during his reign as Mr. Olympia! Consequently, the recommended number on the BMI chart may be too low or too high for certain individuals.
This is because people are complex and multidimensional beings who cannot easily be reduced to simple, one dimensional numbers, labels or terms. (This includes psychiatric diagnoses, too.)
Or, take those numbers that have appeared in numerous publications and purport to measure degrees of stress. “Death of a spouse” heads the list. The implication is that all marriages are the same, that everyone loves and cares for his or her spouse equally, and that, therefore, everyone will be equally devastated by the demise of a marriage partner. Unfortunately, we have probably all met couples where such an event would be as much of a relief as a source of extreme stress!
And how about those diet books that provide sample menus? After studying a recommended diet plan, one of my patients remarked that if she followed such a program she would gain, not lose, a pound a week. She was correct. When she followed that plan she gained weight. Her metabolic rate called for far fewer calories than most people require.
Similarly, in the mental health field, too many therapists have a standard regimen that they use on everyone. Frequently, a form of treatment that might be helpful for someone else might be unhelpful or even harmful for you. What’s worse, some therapists have only a single tool in their therapeutic toolbox. Obviously, if all one has is a hammer one will be tempted to treat everything (or everyone) like a nail.
These one dimensional and single focused clinicians use a “Procrustean bed” approach when providing therapy. In the Greek myth, Procrustes was a son of Poseidon. He had a bed in which he insisted that every passer-by spend the night. If a guest was shorter than the bed, Procrustes would set to work on them with his smith's hammer to stretch them to fit. If the guest proved too tall, Procrustes would amputate the excess length because Procrustes demanded an exact fit.
Hence, a Procrustean bed is an arbitrary standard to which exact conformity is forced. Therapists who employ Procrustean bed approaches to psychological treatment basically have a single method or intervention that they use on everyone. Rather than modifying their therapeutic approach to fit the needs of unique individuals, they insist their clients conform to their preferred method. Thus everyone they see in therapy will get whatever they like to dispense, whether or not it’s what the client really needs. So, regardless of one’s presenting complaint (i.e., anxiety, depression, panic, OCD, trauma, stress, etc.), a Procrustean bed practitioner will provide only DBT, or ACT, or standard CBT, or psychoanalysis, or mindfulness, or hypnosis, or EMDR, or medication.
Unlike Procrustes, a really good therapist will tailor the treatment to suit your specific needs, rather than attempting to fit you to his or her preferred method. This, of course, requires that therapists are flexible and adaptable, and have an eclectic therapeutic toolbox containing a variety techniques, strategies, and procedures; ideally ones that have scientific backing and empirical support. And they need to know when and how to use them because people have to be ready to change before they are able to consistently apply and practice the therapeutic methods they’re taught during therapy. Indeed, determining where a given client is on the readiness for change spectrum is a crucial part of the therapeutic process. So, even if a one-size-fits-all clinician is treating a person for whom their singular method is appropriate, unless the client is ready to meaningfully participate in the process little will be gained.
My advice is as follows: Nobody is average; everyone is unique.
• Make sure that your personal and individual needs are carefully considered, including the foods you eat, the medication (if any) you take, the amount of sleep and rest you need, the type and extent of exercise that suits you best, and so forth.
• If something seems to be disagreeing with you, try to consult an authority who will tailor the treatment plan to suit your individual needs.
Don’t assume that a specific medication, a course of action, or a particular treatment will be good for you because everyone you know thinks it’s great. Also, don't hesitate to ask your therapist why he or she believes a recommended treatment will be helpful for you and what other methods can also be of benefit.
Also remember: Think well, Act well, Feel well, Be well!
Copyright Clifford N. Lazarus, Ph.D. This post is for informational purposes only. It is not intended to be a substitute for professional assistance or personal mental health treatment by a qualified clinician.
To find therapists near you, see the Psychology Today Therapy Directory.
