Psychotherapy research: Playing the Game of Thrones


I have been amusing myself thinking of all the players in mental health care as characters in the Game of Thrones. WARNING, if you haven’t been got by GoT you wont want to read this post.

Long ago, the first men, from Plato and Aristotle, to Mesmer, Pinel, Gall, Weber, Gage, Darwin, Broca, Galton, Wernicke,  explored the untamed lands of the human brain and mental processes. The children of the forest unwittingly created the first white walker (1878, Hall) by plunging a piece of dragon glass into his heart and declaring the brain and not the heart as the organ to study, and building a wall.

Was Freud the first Targarean? Their reign was strong, incestuous and peppered with occasional  madness. Until the rebellion.

So our story starts as it has always, with the field of psychology saying “winter is coming” The southerners (Psychiatry) mock this doomsday prophecy, but are themselves recovering from the era of the mad King.

Standing guard, the watchers on the wall, protecting the realm from Wildlings (aka counsellors, mental health workers, case workers). We discover they are actually people too with their own set of skills and resourcefulness. And they cope pretty well with the winter. But still, the common people are told stories that ignite fear perpetuated by the raiding parties as Wildlings fight for their survival. Despite their skill set they are thought of as lesser beings.

In the capital, the Crown is half a kingdom in debt to the Lannisters, so decisions get made, not for the good of the people, but to assuage the self interests of the investors. So too in psychotherapy research. If you think Prozac was made by the Lannisters you won’t be too far wrong. If you are going to spend their money you’d better make sure they look good.

Now the Starks were an honourable bunch, with great integrity, and so they didn’t last long. Ned stark, however, before his beheading inadvertently created the Brotherhood Without Banners, a rebel group sworn to protect the small folk from anyone preying on them.

Enter the activist for trustworthiness and transparency in science, calling out vested interests and conflict of interests in big Pharma and unfounded claims of miracle treatments. Yet sometimes their methods leave a lot to be desired.

John Snow, arguably the most loved character, who’s honour is only matched by his courage and creativity was willing to admit when he was wrong and change directions, including taking risks that were politically and personally dangerous. ( See Scott Miller, Bruce Wampold and their clan folk) Alas, killed as a traitor by his own men, though only mostly dead, he rose again, readying to reclaim territory stolen by the Boltons, aka CBT! (A bit harsh maybe, but it did invade Sweden and cause great suffering)

On a different note, Mance Rayder, the King beyond the wall United the Thenns, Hornfoots, WIldlings, Ice River Clans as none had done before. Probably learned this from Jeff Zeig bringing the field together at  the evolution of psychotherapy.

Milton Erickson of course inspired the three eyed Raven, and many might wish to be his disciple, but of course I’d say it was Rob McNeilly

In further speculation, was Jay Haley  Maester Aemon, and Michael Yapko  Jeor Mormont

G.R.R Martin created a brilliant story, but, despite the many fans of his books it was HBO TV that really brought it to the masses. So too attempts to bring science to the masses began in the media, but like the arming of the faith militant, things went terribly wrong. Someone, somewhere must have thought it was a good idea, but what followed was alarming. Using the power of persuasion, poor studies with low power, small sample sizes, undisclosed analytic flexibility, impossible to reproduce findings too weak to build theories on, were sold as tantalizing certainties based in science and so became armchair truths to the ordinary people.

As we wait for the next exciting installment, we know, that the best is yet to come.

2 thoughts on “Psychotherapy research: Playing the Game of Thrones

  1. You’re a very sick woman, and I agree with everythiung you have written, well almost anything. I’m predicting that the wall will come down, and the Whites will be resored to more or lesas human form.


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