Reality Therapy In Action. - Review - book review

USA Today (Society for the Advancement of Education), March, 2001 by Gerald F. Kreyche

REALITY THERAPY IN ACTION BY WILLIAM GLASSER, M.D. HARPER COLLINS PUBLISHERS 2000, 243 PAGES, $24.00

Psychiatry has taken many twists and turns since Sigmund Freud died in 1939. After much controversy, it has won recognition at last, not only by the public, but by the medical profession, albeit begrudgingly in many cases.

It has been popularized by the "I'm Okay, You're Okay" group, but gained scientific respectability through psychologists such as Rollo May and Carl Rogers, and existential psychiatrists such as Victor Frankel.

The number of those who may need some sort of psychotherapy has grown so large that much present-day psychiatry is pharmacological. Long counseling sessions can be tedious and expensive and, in our age of instant gratification, a quick fix is pressured upon the psychiatrist. Besides, there is big money in drugs. Hence the overdose of Ritalin for hyperactive kids and Prozac for anxious adults.

In Reality Therapy in Action, William Glasser roundly condemns this drug pattern, as he has had international success in curing traditional "mental illnesses" with counseling sessions. If you have ever wondered why "Dear Abby" usually advises counseling for her troubled readers, you will find out what that entails in this well-written book, for it is a case study of people with problems such as obsessive-compulsive disorder and others who have suicidal, schizophrenic, or paranoic tendencies. Panic attacks are given attention as well.

In a kind of legitimate eavesdropping, the reader is put into an anteroom, so to speak, to listen in on a conversation between doctor and patient. The apparently simple handling of these cases through conversations and questions with the patient is intriguing. Yet, Glasser's technique embodies the art that conceals art. It reminds one of Dr. Watson remarking, after Sherlock Holmes solves another difficult case, how simple it was--of course, always in retrospect.

The general problem with those who need help can be characterized as "disconnectedness." They aren't in tune with their friends and acquaintances, their home, their work, or themselves. Glasser concretizes this by referring to incidents and characters in the movie, "As Good as It Gets," which stars Jack Nicholson. In fact, Glasser recommends that his patients view the video. Essentially, the characters are disconnected and end up sadly realizing that this condition was as good as it gets. (Mistakenly, critics called the movie a comedy, when, in fact, it is sheer tragedy.)

The key notions Glasser tries to embed in his patients are creating relationships, making choices, and taking responsibility for those choices. He helps them escape being controlled by the external forces of the world and teaches them that all controls must come from within. Paradoxically, Glasser explains to them how they chose to be in their unhappy condition and need to and can choose differently to help effect a cure. (This proves shocking to the reader and patient, but the doctor argues his case well.)

At odds with mainstream psychiatry, Glasser eschews the damages he claims follow from drug therapy and electroshock treatments. He refuses to "waste" time with the patient going endlessly over his past to discover some "devil that made him do it" Only the present really matters. We can't do anything about the past, as it is over and done with, hence the name of Glasser's method as reality therapy.

GERALD F. KREYCHE American Thought Editor