WHAT IS PSYCHOTHERAPY? Simply stated, psychotherapy is a special form of learning.

This "course" of learning has two goals: to move ahead to a better life or to get back to a time when you felt better about yourself and how you functioned in your world. The learning in therapy is similar to other kinds of learning. The main difference is that therapy is collaborative, and in a collaborative relationship people often discover their own solutions. Alan Siegel, PhD explains it like this:

"The purpose of therapy is to provide a relationship in which we can begin to face up to what we have most tried to avoid or forget, and to discover ways of facing our troubles without compromising too much of our real identity, our relationships with others, and the chance to fulfill our personal destinies." (i)

Therapy should be about what's right with you, not what's wrong with you, as some professional traditions have practiced.  Sometimes therapy is about uncovering conflicts so that we can feel more genuine, avoid less, and act effectively.  Here's a cartoon that illustrates our shared "talent" for being conflicted -- and the trouble that gets us into:

In short, therapy is a special form of learning that is proven to help people make the changes they want to make.  Therapy is not a showcase for the spirit-killing Ds -- deficits, defects, and dysfunction (ii).

Put another way, therapy is a brief or longer conversation that individuals use to understand their past and their present, to have regular time for quiet reflection, and to decide how they will face the ordinary (and not so ordinary) problems that life presents. 

IS THERAPY EFFECTIVE? Yes, it is. Research over six decades with thousands of clients, adults and children, representing a wide range of problems, has demonstrated the effectiveness of therapy.
• At the end of treatment, the average psychotherapy client is better off than 80% of comparable, untreated individuals. These results have been found for many kinds of problems that clients bring to therapy.
• The road to recovery is not long. After even as few as 8 to 10 sessions, approximately 50% of clients show significant change. About 75% of clients are significantly improved after 26 sessions or 6 months of weekly therapy. For each person, results may be achieved more quickly or more slowly than this.
• Improvement from psychotherapy lasts. Although no one can predict life’s future challenges, many clients retain their healthy change for long periods. (iii)

I track our effectiveness at every session. At the start of our session clients complete a brief form about their progress with the goal they have set. At the end of our session, clients complete another brief form about how well our work reflected the client's goals during the session. These forms are simple and brief. They bring science right into my office, to help clients reach their goals.

Psychotherapy can change brain function. Richard Friedman, MD, writes, "... [T]here is no question that both psychotherapy and medication are quite effective in treating depression; there are literally hundreds of well-designed clinical trials that show this. What is fascinating is that psychotherapy and medication can produce very similar changes in the brain in patients who respond to treatment. For example, several studies comparing cognitive-behavior therapy and interpersonal psychotherapy with antidepressant medication in depressed patients showed nearly identical brain M.R.I. changes in patients who responded to either treatment. In other words, psychotherapy is ultimately a biological treatment." (iv)

This isn’t all that surprising considering what we’ve learned from the pioneering work of the Nobel Prize-winning psychiatrist and neurobiologist, Dr. Eric Kandel. He showed that learning (in the sea slug Aplysia) involves the creation of new neuronal connections. "The clear implication for humans is that learning literally changes the structure and function of the brain. If you think of psychotherapy as a form of learning, it’s no stretch to see that when therapists talk to their patients, they help them learn and change their brain function — perhaps for the long run."

HOW DOES CHANGE HAPPEN? Fifty years of research has provided insight on how people change, whether on their own or with a professional. Change happens when we:
  • Discover and put to use our own ideas about how we change.
  • Use our inherent strengths and resources in supportive relationships, such as therapy.
  • Feel hopeful
  • Create a plan, tailored to our ideas, to devise practical solutions to everyday problems. (v)
“Psychotherapy changes people because one mammal can restructure the limbic brain of another. . . When a limbic connection has established a neural pattern, it takes a limbic connection to revise it." Thomas Lewis, M.D.,
A General Theory of Love

(i)   Siegel, A (2005). Conference on Treatment of Anxiety Disorders. Harvard Medical School
(ii)  Duncan, B. (2010).  "What Makes Psychotherapy Work? Molly Explains it all."
(iii) Mark Hubble, Barry Duncan, Scott Miller (1999)
(iv)  NYTimes, Jan. 8, 2006
(v)   Source: Barry Duncan (2005).

email: DrEliseBonRudin@gmail.com
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