Saturday, June 8, 2013

Psychotherapy Basics

Psychotherapy is a well-researched and extremely effective treatment for many mental health disorders. Disorders that can be treated with psychotherapy include major depressive disorder, post-traumatic stress disorder, generalized anxiety disorder, personality disorders and many others. Psychotherapy can also be very helpful in disorders like schizophrenia and bipolar disorder which require treatment with medication but which can be made more manageable through psychotherapy. Psychotherapy can also be called counseling, talk therapy, or just therapy. Whatever you call it, the research data is out there to say that it works. The problem is, many people don’t want to give psychotherapy a try.

There are many barriers to psychotherapy; cost, access to services, time, stigma. However one of the biggest barriers I have seen is lack of knowledge. Many people are not aware of what psychotherapy is and what it can do for them. As a therapist, I have heard many people ask “Why should I spend time on psychotherapy? How is just talking about my past or my problems going to help me?” Well, they are right that just talking about the past or the problems they are having is not going to help much. But they are wrong in thinking that psychotherapy is mainly about talking about your problems or your past. Psychotherapy is about talking about solutions.

Good psychotherapy is a learning experience. You spend time with a qualified teacher (your therapist) and learn new ways to think and behave that are more effective than what you have already been doing. You might spend some time talking about a problem but it will be in order to think up a new approach to that problem. Or you might spend some time talking about your past but the purpose will be to understand how the past is influencing you in the present and how you can make changes that will make life easier and less painful. But the overall focus should be on reducing your suffering and increasing your ability to function in your day to day life.

Like learning any new skill, psychotherapy requires significant effort on your part. Therapists will typically assign you homework, either formally or informally. These can be things to do (like exercising a few minutes each day, or starting to try something that frightens you) or they can be things to think or write about (such as writing down your thoughts about a situation and then analyzing them to see if they are true and helpful). If you don’t complete the homework then you are much less likely to make any improvements. Your therapist will often ask you about uncompleted homework and what obstacles prevented you from completing it.

Successful psychotherapy also requires you to be willing to change. It can be difficult to change longstanding habits and ways of thinking. It can be really painful and difficult to admit that you need to change some of the ways you have been approaching life in order to feel better. It can feel like you’re being told that you are wrong or bad sometimes and at other times it just feels really scary. Other people in your life may not understand or approve when you try to make changes. It’s important to keep your goal in mind – feeling better and making your life work a little more easily.

One of the key steps in successful psychotherapy is finding the right therapist and treatment for you. Research has demonstrated that the most important factor in successful psychotherapy is the relationship between the therapist and the patient. If you think about it, this makes sense. Of course you are going to learn more from and be more willing to work hard for a teacher or coach with whom you have a strong, positive relationship. There are also different kinds of psychotherapy that work better for different kinds of people and different kinds of problems. Some therapies are short and tightly focused on a specific problem while others are longer and more broadly focused on patterns in your life that may be causing problems. Some types of therapy will have you do almost all of the talking, while in others your therapist may do about half the talking. Whatever type of psychotherapy you choose, go into it with honesty and a willingness to change your approach and pretty soon you will be feeling much better.