There was an episode of Mad About You I remember seeing when I was a kid. Paul and Jamie are seeing a therapist, but are feeling unfulfilled since she just nods, says "Uh-huh," scribbles in a notebook, ending with, "See you next week."
According to a psychotherapist, that's where psychiatry is today. People sit on a couch for years pouring out their troubles, which gains them no progress, when true improvement should not take even a fraction of that time.
Proponents of long-term therapy have argued that severe psychological disorders require years to manage. That may be true, but it’s also true that many therapy patients don’t suffer severe disorders. Anxiety and depression are the top predicaments for which patients seek mental health treatment; schizophrenia is at the bottom of the list.In my experience, most people seek therapeutic help for discrete, treatable issues: they are stuck in unfulfilling jobs or relationships, they can’t reach their goals, are fearful of change and depressed as a result. It doesn’t take years of therapy to get to the bottom of those kinds of problems. For some of my patients, it doesn’t even take a whole session.Therapy can — and should — focus on goals and outcomes, and people should be able to graduate from it. In my practice, the people who spent years in therapy before coming to me were able to face their fears, calm their anxieties and reach life goals quickly — often within weeks.
And while blaming one's parents in session may feel good, frankly it has no bearing on current issues; if one wants to move on, there is only forward.
Many patients need an aggressive therapist who prods them to face what they find uncomfortable: change. They need a therapist’s opinion, advice and structured action plans. They don’t need to talk endlessly about how they feel or about childhood memories. A recent study by the National Institute for Health and Welfare in Finland found that “active, engaging and extroverted therapists” helped patients more quickly in the short term than “cautious, nonintrusive therapists.
And that whole "How do you feel about that?" line? To put it plainly, crap. Duh, she just said she's not happy with her boyfriend. Ergo, she is unhappy. And the method which advocates patients drawing their own conclusions can take too long.
Long-term and fruitless therapy can result in co-dependence; the psychiatrist is armed with a regularly-paying client, the patient has someone who validates feelings. While they may feel better, they certainly aren't evolving.
The author's end note? Don't keep on doing something if it doesn't work for you. And that can apply in many ways.