Sunday, January 13, 2013

Thoughts on Therapy

A few days ago I received a comment requesting my thoughts on therapy. I frequently recommend people seek the help of a therapist, but never really do into detail beyond that. Having relationship problems? Odds are good those problems are a function of your own problems. Fix those problems before tackling relationship issues.

The Importance of Therapy

Mental health interventions can be invaluable to improving quality of life. As much as we would like to believe we have a firm grasp on our own thoughts and behaviors, we're more or less blinded by the biases inherent in our frame of reference. It's sort of like a fish not recognizing it's in water because it's the only frame of reference it's ever experienced. 

People around us, like friends and family, can provide a different frame of reference, but their perspective is often flawed by their own self-interest. They may offer advice, but it will likely be skewed because they will always keep their interests in mind.

A good therapist will provide that unbiased frame of reference that will help you see yourself in a different light. They train extensively to observe, understand, interpret, and offer opportunities to change your thoughts and behaviors in an unbiased manner. 

When confronted with unpleasantnesses about ourselves, we tend to get defensive and do what we can to avoid admitting our faults. If our friends are pointing this out, we'll make excuses, deflect, or employ some other strategy to evade actually changing.

Good therapists recognize that pattern. They call us out on our bullshit.They're not fooled by the facades we build. That ability is what makes a good therapist invaluable. We can't fix what we don't acknowledge, and they guide us toward acknowledgment.

What is a "Good" Therapist?

Therapy comes in many different flavors based on the theoretical framework the therapist studied. Like anything else, a therapist from one school will insist their approach is best. The problem is different types of therapy work better for certain types of people or certain problems. In short, we're all individuals with different needs, so our therapy needs will vary. There's no "one size fits all" solution.

The key is to find a therapist that will actually help, which may take some time. Good therapists will be completely honest about their abilities and will be more than happy to set up an initial consultation to assess the situation. If they think they can help, they will. If not, they can refer us to someone that can.

Understanding the basics of the major schools may help narrow that initial search. These are the major categories. Note I'm really generalizing these schools of thought. Many specific therapies would fit under one or even more of these general umbrellas. 

Psychodynamic school: This is the stereotypical "therapy." Couches. Taking about your childhood. A therapist silently nodding on occasion while taking notes. Remember the show "Frasier?" He was a psychoanalytic therapist based on the theories of Sigmund Freud. His brother Niles was a psychdynamic therapist based on the somewhat related theories of Carl Jung.

This therapy is effective at helping people understand the connection between past experiences and current thoughts and behaviors. Once these connections are understood, changes could be made to make positive improvements.

I was very skeptical of this method until actually going through it. I can credit much of the progress I've made in improving my life to this approach. 

The negative- this approach takes time. As such, it can be expensive. Insurance may not cover this therapy in its entirety, but most psychdynamic therapists have adapted to that limitation.

Humanistic school: The humanistic school is based on a simple idea: Humans are fundamentally good. Bad behaviors are a function of bad choices. Humanistic therapists teach personal responsibility and decision-making skills to help people reach their full potential, usually utilizing our motivations to meet our own survival and social needs.

This is an overwhelmingly positive approach to therapy. It emphasizes the idea that we have free will, and we can learn to use choices to maximize our potential. One of the hallmarks of the humanistic school is the tendency to resist diagnosing "problems." The other schools usually identify a problem, name it, then work to fix it. The humanistic folks empower us to improve. 

This specific school is also known fr the tendency to look at the human potential to always grow. As such, humanistic therapy would be appropriate for anyone, not just those experiencing problems. 

I actually utilize many of the tenants of humanistic psychology in everyday life, namely the idea that we always have the capacity to grow and learn. Furthermore, we have the capacity to help those around us [spouse, kids, family, friends, blog readers :-)] continually grow and learn. It's a major motivation to continue doing what I do.

Cognititve-behavioral school: The cognitive-behavioral school is an umbrella term that covers A LOT of different methodologies. Back to Frasier- remember his life Lillith? She was a behavioral experimental psychologist. As an experimental psychology student, I trained under a bunch of behaviorists. 

The cognitive-behavioral approach is heavily rooted in fixing problems. If you have a specific problem, these therapists will create a strategy to fix the problem. There's little concern for the past or underlying causes of the problem, they focus on solutions.

This type of therapy is especially effective for specific problems that may be holding a person back, like phobias or negative thoughts about a certain issue.

Potpourri: Okay, this school isn't really called "potpourri." It's usually called something like "eclectic" therapy. It's essentially a hybrid between different schools. Each of the above has distinct advantages and disadvantages. a therapist that can utilize all methods can be extremely effective.One specific method may be effective for some issues but not all.

I'll use myself as an example. After about six months of therapy with my psychodynamic therapist, we had pretty much solved all the relevant problems related to my earlier years. The last two months or so were mostly done in conjunction with Shelly and her psychodynamic-based theorist solving our relationship issues. Our last two individual sessions were spent geeking out about the field of experimental sexuality research. 

At that point, a cognitive-behavioral psychologist could have helped with very specific issues I was having that weren't easily addressed with the other methods. A humanistic approach could have helped improve my decision-making skills. [sidebar- my therapist was actually capable of that, but we agreed I had enough understanding of the concepts to do it myself.]

Difference Between a Psychologist and a Psychiatrist

This is another important consideration when looking for a therapist. The major difference- psychiatrists are medical doctors, psychologists are not. As such, psychiatrists can prescribe drugs. 

My personal recommendation would be to seek out a psychologist first unless there's alife or death situation related to mental state. If they determine there's a need for drug therapy, they will refer you to a psychiatrist. Drugs work by screwing with brain chemistry. Before taking that leap, trying non-drug therapies is a good idea.

The Searching Process

Therapists, at least honest therapists, welcome the therapist-shopping process. They understand a comfortable fit is necessary for successful outcomes. The best method is to do more research beyond this post. Find therapists in your area. Check out their websites. Give them a call. Or email them as I did... I hate the phone. Yes, I still have issues. :-)

Once you contact those that seem like they'd be a good fit, I would recommend meeting in person. They will probably go through an assessment process that will vary based on their theoretical background. That process should be enough to determine which therapist would be the best fit.

What About Couples Therapy?

Couples therapy, or marriage/relationship counseling, can be an incredibly effective means of improving relationships. In most cases, the therapy involves learning good relationship skills. I highly recommend it for any couple experiencing troubles.

HOWEVER, there is a serious caveat to couples therapy. If one or both partners have significant baggage from past experiences, it's unlikely couples therapy will be effective. Each partner has to figure out their own issues before they can tackle their relationship issues. This is why I always recommend both people in a relationship seek individual therapy prior to seeking couples therapy.

This is a general rundown on my take on therapy. When done properly, therapy can result in amazing life-changing outcomes.



1 comment:

  1. My wife thought it would be a good idea to go see a marriage counsellor. I agreed and said to her ,let me know how it went when you get back home.