Zois is a leading proponent of short-term dynamic therapy, a respected, aggressively compressed version of Freudian psychotherapy that forces a patient to drop all defenses in order to face up quickly and honestly to troubling problems. The therapy is aimed not at psychotics but at neurotic people who have problems at work or in their relationships. All they have to do, Zois suggests, is answer some quizzes about their feelings to help identify the defenses they use. Then they can begin to solve their problems.
Well, maybe it’s not quite that easy. Breaking through the defenses is the first step toward emotional growth, but it’s a tough step to take. Zois divides the defenses people use into three types: helpless, emotional and intellectual. People who use helpless defenses tend to be passive, thinking of themselves as victims to keep from focusing on what’s really bothering them. Someone with an emotional defense uses emotions to mask underlying pain-weeping when your boss criticizes you unjustly in order to avoid feeling anger, for example, because the anger reminds you of childhood emotions you are trying to repress. In an intellectual defense, people use rationalization to make excuses for their behavior and prevent them from doing something about what’s really bothering them. According to psychodynamic theory, people build defenses to shield themselves from the anxiety of looking at buried emotions. To let the defenses go, they have to learn to tolerate some anxiety so that they can deal with the conflicts that created the defenses in the first place.
Some psychiatrists wonder if self-examination of defenses is even possible. “Since the defenses are unconscious,” says Sidney Hart, a lecturer in psychiatry at Yale, “people are usually unaware of them, so acknowledging them on your own is very difficult.” Zois admits that taking a quiz won’t automatically reduce anxiety. But he insists his book can make people more aware. In one test, for example, Zois provides sample responses to the suggestion that you’ve put on some weight. If you say you’ve gained 2 pounds when you know you’ve gained 10, you’re using the defense of denial. Instead of acknowledging the obvious and taking steps to change, you try to minimize the issue so you won’t have to deal with it. This indicates a tendency to use denial when other problems arise.
Zois doesn’t believe his book should replace therapy for those people who have access to it and can afford it. But he says that the vast majority of people who will suffer from a diagnosable mental disorder sometime in their lives-more than 40 million, according to National Institute of Mental Health statistics-will never get help: “There isn’t the money and there isn’t the manpower to reach all the people who need help.” The odds are against people getting all the help they need from this book, too. But using them to justify not trying would be a rationalization.
