What is therapeutic progress?
On a sunny day we decided to move the process group to the patio – unconventional process tends to be the norm working with six teens. The group was anxious and in flux. I could feel malaise and an aura of intimidation, everyone was stuck in their own lane. As the goal of my process groups is to “become a group,” I commented about what I thought was getting in the way.
“What is authenticity?”
“Basically, I’m always real. I always keep it real. Sometimes to a fault. I don’t give a f*%$.”
“I mean, it’s like, some people are so afraid of being rejected that you can just feel them, like, adapting to other people. Pleasing the crowd. That type of stuff just makes me crazy. Like, be real, be you. If you have to pretend, you shouldn’t be with those people anyways.”
The group was reeling under its own desire to pounce. Each member seeing through the others’ projections, each member frozen in their own fear of the topic. I’ve discussed, death, suicide, drugs, prison, sex and serious violence with these teens before, and never have I seen them so nervous as with this topic. The content was failing. I was silent and so were they. I asked questions and got glib responses. The members offering the responses looked to me with such a need of validation and the others looked to me with such a plea that I would call the other group members out. I couldn’t decide what to do. I was silent for a while and thought I’d make the best guinea pig.
“When I think of authenticity I think about inauthenticity. And I wonder ‘when am I not authentic?’ And for me—”
“–You’re pretty authentic bro.”
I smiled and chuckled at the notion.
“Oh yeah, I’ve got that one in the bag? I don’t know”
I continued. “For me I was just thinking about this. I was considering buying a car, but I got stuck. What kind of car am I? Who am I? Am I a truck guy, or a Toyota guy?”
“Certainly not a KIA guy,” said one of the group.
Everyone laughed knowing about the dingy little car that I’ve had since grad school.
I laughed and I asked
“But what is authenticity when I don’t know myself? How do I find authenticity then?”
This question didn’t land and the group was awkward. Members of the group diverged and started talking in different subgroups. I had thrown everything into turmoil. Yet, I wonder: Was that group a failure, and how do I know when a group is a success?
What is Therapeutic Progress?
It is common to not understand both how therapy is supposed to work, and to not know if it is working. And if we think of therapy and therapeutic progress in a classic, linear sense, it’s easy to focus on the dichotomy of success and failure. But that paradigm might not be as satisfactory as it seems. Therapy has many ways of working, and many ways of failing, and there can be a large overlap between the two.
Recent work in psychoanalysis has expanded the paradigm of understanding to include states, sensations and even kinds of language and communication that are increasingly distant from our current understanding of knowledge. Some authors have referred to this progress as attending to ontology rather than epistemology. Others have conceptualized it as an expansion of analytic “listening,” (Bastianini, Ferruta and Degl’Innocenti, 2025)
This may be appropriate. The essence of what knowledge and understanding are, perhaps more than ever, are now hotly contested. In 2023 Noam Chomsky wrote an opinion article in the NY Times opining against the reverence and even preponderance of AI programs in their current iterations like ChatGPT. Chomsky described them as simple programs capable of scanning massive reams of data for patterns and probabilism to make statistical predictions about what would likely be the best response.
Chomsky described that ‘real’ intelligence is not only the ability to predict what could happen, but what couldn’t happen and what else may be going on. Infinite horizons that are incompatible with linear statistics and correlational models that require known variables. Chomsky added that intelligence is not an accomplishment but a process “Intelligence consists not only of creative conjectures but also of creative criticism. Human-style thought is based on possible explanations and error correction, a process that gradually limits what possibilities can be rationally considered,” he refrained.
Chaos Theory and Therapy
Chaos theory grew tremendously around the development of the computer age in part to facilitate the tremendous increase in complexity of human systems and their departure from linear events (those with identifiable inputs to both cause and effect). It is a modern field designed to pursue the most mercurial of predictions: weather. Chaos theory disputes the classic understanding of how to think about non-linear events, which was to approximate them based on lines. Such to say to average all the variance out and make an approximated line.
Galatzer-Levy (2004) covered the applicability of chaos theory to psychoanalysis. Chaos Theory created new ideas to manage problems that had arisen in linear physics. Problems like the three-body problem (where instead of a planet orbiting a star, some third body jumps in and makes Newtonian physics unintelligible). Rene Thom’s early critique of human belief in applied mathematics led to his “catastrophe theory.” It described that mathematics appeared to be such a strong fit in describing physics not because of the link between the logic and the real world, but rather because of the human capacity to simply ignore intractable problems. Thus, allowing the models to seemingly shine.
In fact, much of the development of the fields of non-linear progress homed in on the reality that systems that depend on change or adaptation are complex. And complex systems are ever on the brink of chaos – ever teetering between change and constancy as endless little variables play out their roles in either the stasis or change of the system.
Attractors in this theory are the inputs that lead to motion or change. Strange attractors are those which exert some pressure on the system but are not neatly followed or avoided. Strange attractors are pursued but not directly, they lead to change, but not in a linear sense. At times they are even dialectic, like the Lorenz attractor, a latent attractor behind oscillations describing that the organism is pulled to both of two options such as a.) slowing and b.) speeding up – and its oscillations both represent the attractor (and its inherent strangeness).
This leads to other important concepts in chaotic dynamics, that unlike linear dynamics small changes can have very large impacts, massive changes can have very small effects and over time, rapid unpredictable shifts in the system are absolutely natural to the (complex) system.
These descriptions better fit general human development, and especially development in the presence of trauma, than a more linear stage-based or epigenetic model. The outcomes is unknown and is a process of the interaction of the infinite variables of interaction and the organisms’ adaptation in unique or “chaotic,” ways. This is a constant balancing act between being open to change, and closed to trauma, and navigating not going over either edge.
Complex systems also change differently than simple systems when they do change. Complex systems vary in the gradient of change, and often work in fits and starts, or undergo massive change after a long period of perceived latency. Adaptation is different that stage-based and progressive development. The requirements of adaptation permit a variety of ways to meet them, or the amount of change or “development,” any entity undergoes in order to meet them may have almost endless options.
Therapy is this kind of process. One like real intelligence which is a process of correcting errors, or non-linear progress. It is a small-scale evolution. There is no real desired outcome in the natural world, not besides adaptation. One may learn to crawl or to dance the tango in order to make it to the other side of the room and expend vastly different energies, undergo incomparable trials and “failures,” on the way to said “success.”
Abormal Development is… Normal?
In an epigenetic model, the environment supplies a timely and needed input to engage a change of the organism on its developmental trajectory. In chaotic or non-linear development, there is no pre-programed destination. The organism adapts to its experience and does so based on interacting with almost countless variables, and (hopefully) finds adaptation through any degree of great advancement or near stasis.
In my group, we were not only struggling with a difficult challenge, we were all both individually pursuing what our adaptation to authenticity would be. And much more intricately we were figuring how all of our versions of authenticity were going to work together to ‘become a group.’
In Michael Chrichton’s Jurassic Park, the rock-star-esque “Chaotician,” Ian Malcolm repeatedly says that the outcome of failure in the park is easy to predict, not because he knows how that failure would occur, but because he knows that it is almost impossibly complex to prevent. Or that a linear sense of the park’s progress would not be natural. The natural system would respond with major changes to minor inputs and vice versa and could not possibly go as planned. Since success required following the plan – he ruled that out as a possibility.
Hubris-defined capitalist John Hammond rejected the notion of inevitable failure outright. As did his scientific engineer, Henry Wu. He felt the park was, as everything else, orderly, or else to say predictable… linear. He thought the many glitches in Jurassic Park were a result of their solutions being just around the corner. That complexity was just a longer book as orderly as any of the other shorter books in Newton’s universe. He did not understand that the system of the park was too complex, that its glitches were a part of its adaptation.
Dinosaurs coming to life lead to dinosaurs breeding. Dinosaurs thriving led to embryo thief Dennis Nedry trying to thrive, by shutting down the security to steal the genetic samples. The wonders of the imagination in seeing real-life dinosaurs became the terrors of seeing them face-to-face. Life… found a way.
This is true of psychic life as well. Bastianini, Ferruta and Degl’Innocenti (2025) described the complexity of the psyche-soma’s development. They covered the vital connection between our living, feeling body, and our abstract consciousness.
The authors noted that trauma intercedes in the already vastly complex system between the body/brain and conscious thought. Trauma becomes something that cannot be thought (or communicated consciously). In this lens, they asked for an ability to think of communication as so complex that it encompasses all the experiences in life. Like a baby crying, and kicking because of emotional experiences, and the mother, talking (unintelligibly) making resonate vocal sounds, touching, holding, tucking-in… A chaotic universe of communication.
If we try to listen to ourselves in this way, regarding communication and relationship as complex as they really are, we think of their strange attraction. They adapt rather than develop, with unpredictable change rates and apparent latency. Let’s return to my vexing process group and my many attempts to right the ship.
Walking out to the patio, so much more was going on than the words I was saying. Each patient reverberated their state of being. There was effusiveness, rejecting subordination, anxiety about doing the group “well enough,” traumatic retreat into unthinkable places of solitude.
I asked some questions. Each patient resoundingly amplified their state. None of us are synchronized, we are each one like pendulums in our own rhythm. Each patient begins talking about the self, they show, physically, exactly what it is like to be them, their anxieties, their anger, their eagerness to please and impress. They each listen to the other and understand the verve of what is being discussed.
We became like pendulums attached to a wall, eventually synchronizing. I was still talking about nonsense, about authenticity in a very inauthentic way. I broadcasted what it was like to be in the group, authentically inauthentic. I showed my burden (that of adult responsibilities, to lead when the group does not, to try to make examples of my life experience). Everyone else showed theirs.
Chaotically we are all beginning to synchronize. We are not attracted to discussing authenticity in words, but in somatically presenting our own inauthenticity. Presenting inauthenticity becomes the most authentic thing we can do, this is exactly who we are, exactly what we feel in the moment. We make no pretense of consciousness; we are all kicking and crying like babies.
Had I been able to notice this, I might have been able to see that the adapting group was unpredictable. I might have been able to understand our need of “living witnesses,” of our traumatic flight, our dissociation from our various experiences, all strangely evoked by the attractor authenticity. I may have been able to understand the complex progress going on as we used an “indispensable defense,” and had recognized and accepted that as therapeutic growth.
I might have been able to understand that mental health, like Jurassic Park, cannot be contained in park fences.
It needs to be understood as a very complex a very chaotic piece of nature. When we judge success or failure in therapy, it is important to do it this way. To think of it as a part of adaptation to an unknown. To recognize that there is no great order or master plan towards which we are pulled – rather there is an endless and chaotic dance.
Bastianini, T., Ferruta, A., & Guerrini Degl’Innocenti, B. (2025). Extending the Psychoanalytic Listening Paradigm: Listening with all the Senses (1st ed.). Routledge.
Chomsky, N. (2023) NYT: Noam Chomsky: The False Promise of ChatGPT. The New York Times.
Crichton, Michael. Jurassic Park. Random House, 2012
Galatzer-Levy, R. M. (2004) Chaotic possibilities: Toward a new model of development. International Journal of Psychoanalysis 85:419-441