Thursday, June 7, 2012

Psycho Mumbo-Jumbo

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. 


Pretzel said...

Eh. This may be true for some therapists but applying it to all is quite a generalization.

Asking how one feels - like in your example of the patient not happy with her boyfriend - unhappy is an extremely broad description. Is she unhappy because she feels misunderstood? taken advantage of? not important? etc. etc. Each of those 'root' causes/feelings means something else. And can help her better understand herself and her feelings.

Don't get me wrong, I agree that paying someone to validate/listen to you and not help you affect change is a waste of time and money and doesn't help you live a better life. However, that is not to say that all of one's problems could be solved in less than one session and that long term therapy is always pointless.

Princess Lea said...

It's not my example; it's from the article.

Quoting him, he's saying that in many cases not always is more than one session necessary. Not that in all cases is only one session needed.

His point is if long term therapy is simply rehashing your past, you are not moving forward. And that is what a successful life is, moving forward, not backward.

Long term therapy should have some progress along the way.

Anonymous said...

A good cognitive therapist will tell you that if someone needs more than 6-8 sessions they aren't going to benefit from counselling at all. Rather they're using it for social reasons. At least the therapist listens to them!

Princess Lea said...


%Shocked% said...

I found it fascinating and understood what was being argued until I came across the words "short term" which completely destroyed the validity of the article. The whole point of therapy for people who genuinely need it is to get to the root of it all, which I can't see happening in a session or two.

The whole point of intensive long-term therapy is to help for the long term. Sure, if the patient has a single problem that needs to be addressed, then ya, a session or two or three could do the trick. But someone who has deep-seated issues going back years and years, I don't think there's a quick fix.

Well, the quick fix may help in the short-term, but who's to say that the issue won't return eventually... and worse at that

Princess Lea said...

I think his point is that people focus too much on the past. People wallow in it, and don't consider the present and future, which is what matters.

Obsessing about what has happened doesn't always allow someone to move forward. While what happened in the past can be terrible, no amount of analyzing it will change it. One has to let go of it so they can live life to the fullest.

%Shocked% said...

"While what happened in the past can be terrible, no amount of analyzing it will change it." Eh, analyzing it for the sake of analyzing it, fine. But if that occurrence is affecting the person today, then analyzing it to understand it will help the person move on from it.

Princess Lea said...

How can one understand serious trauma? An abusive parent. Witnessing something terrible. A loved one being taken away. Those traumas cannot be understood. They cannot be analyzed, or made to be less painful.

It is said that those who suppressed memories of 9/11 functioned better psychologically than those who dwelled on them. If it cannot be explained, then you have no choice but to move on.