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How Can Psychotherapy Help?

How can psychotherapy help?What is the purpose of psychotherapy? Many new patients ask, “How can psychotherapy help? How will talking about my problems make my life better?” The question seems well founded. People often seek psychotherapy when they feel at a loss for what to do about the misery in their lives. They may recognize that their sleep is disrupted or they are gaining weight, preoccupied by distressing thoughts, easily angered or irritated, arguing with their family and friends, and wondering who or what is to blame.

Television commercials for the latest pharmaceuticals inform the public that a person’s misery is likely the result of undiagnosed or unmedicated mental illness. We are shown depressed, manic, and psychotic people miraculously transformed by a new drug that will return them to happy and productive lives (albeit with the legal disclaimer that there may be a host of significant, even fatal, side effects). But the take-away is clear, if you are unhappy in your life you have a medical disease that is victimizing your happiness. What possible benefit could come from talking to a therapist?

All too often, some therapists see their role as helping people accept their fate as being mentally ill and encouraging them to simply take medications. In fact, not encouraging your patients to take medications might be considered unethical and incompetent. The overriding message from the medical mental health community is that mental illness is a disease, like diabetes, degenerative heart disease, or Alzheimer’s.

The assertion is compelling, but what is the evidence? We now know about the role of neurotransmitters, various brain regions, and genetic correlations that support a physiological basis for our emotional and behavioral experience. This empirical evidence, however, is descriptive not explanatory. We can describe how the physiology of the body creates and influences our mental life, but it doesn’t explain why a person may be miserable. All disorders in the DSM are determined by the appearance, frequency, and intensity of various emotions or actions, i.e. symptoms. Symptoms are signifiers of an illness. Chest pain could be a symptom of a heart attack, a headache could be a symptom of a brain tumor, high blood sugar levels could be a symptom of diabetes, but the symptom is not equivalent to the disease. Further examination is necessary to determine if there is an organ malfunction, a tumor, or some other underlying disturbance. In no case, however, is simple symptom reduction competent or ethical treatment.

Psychiatric diagnoses, by contrast, equate the symptom with the disease, such that the presence of a “symptom” is considered empirical validation of the disorder—a misguided example of circular logic that removes the person of the patient from the equation. Rather than considering the unique circumstances or subjective experience of the person’s life as significant to their emotions and actions, they are replaced by a generic diagnosis.

A teenager who cuts herself at night is said to have a “non-suicidal self-injury disorder;” a middle-aged man who stays up nights watching pornography rather than being with his wife is said to have a “sex-addiction.” These conditions are presented as if they exist independent of the persons who possess them. What is rarely considered is that these people are trying to retain their sanity with solutions that have become an expression of their suffering. What is the teenager trying to release from her body? Who or what imaginary world is the sex-addict trying to find on the internet?

Rather than helping patients understand themselves, modern disease-based treatments aim to substitute the suffering with a generic condition (a diagnosis) that can be medicated. No wonder there appears to be an epidemic of mental illness if nearly every expression of human misery is made to fit into a diagnostic category. Consider that, since the DSM-III (1980), there has been nearly a 100% increase in the number of diagnosable conditions, as compared to the current DSM-5 (2013). (DSM-II had 182 disorders, DSM-III had 265, DSM-IV had 279, DSM-5 has 500).

Freud introduced the “talking cure” as an alternative to the radical, and sometimes barbaric, treatment of persons who suffered from psychological distress. For over 100 years we have seen the growth of psychotherapeutic treatments evolve into many forms whose effectiveness rivals that of medications. These treatments typically center around the significance of human-to-human relationships that provide acceptance, empathy, and self-empowerment. How can psychotherapy help? Patients are helped to find a voice for their personal truths that expresses how they have come to understand themselves and others and to challenge beliefs that may not be valid. The therapist’s role serves to facilitate that self-expression and to bear witness to truths that may seem unspeakable. The goal is not to be a panacea for the human condition, but rather to help persons develop and sustain the necessary skills to manage life with dignity and humility.

7 Reasons Why Psychoanalysis Is Still Relevant Today
Psychoanalysis is still relevant

Psychoanalysis is still relevant because:

  • Psychoanalytic theories and therapies strive to understand the unique phenomenology of a person. In doing so, the meaning and values that give significance to our lives are honored and supported. In our modern era of brain research, a person’s experience of living is sometimes reduced to a discussion of biochemicals and brain structures. Love, happiness, sadness, or misery can be simplistically “explained” by neuropathways, select brain regions, and neurotransmitters. While the remarkable advances of science have allowed researchers to understand how biological systems function during the experience of such emotions, they actually offer descriptions of how they happen, not explanations for these phenomena. By reducing the essence of the human experience (or any living creature’s experience, for that matter) to an objectified mechanistic system, we deny the most salient of human abilities, our imagination! Our capacity to create seemingly limitless ideas and stories has allowed the mind to be emancipated from the constraints of sensory reality. We imagine, invent, create, and transcend beyond the material world toward a world of potentialities.
  • All civilized societies require that persons conform to the standards, rules, and expectations that are necessary to live cooperatively. Our socialization begins at birth and requires that a person learn to adapt to social demands and to internalize those demands as one’s own. The primary task for mental health is to achieve this conformity while preserving one’s personal integrity. This integrity requires us to respect our diversity in many forms, such as ethnic, religious, sexual, etc., while balancing our needs for social connection and acceptance.Psychoanalytic therapies have kept theseexistential considerations central to the mission of advancing human understanding and promoting personal growth.
  • As today’s technology has allowed us nearly immediate gratification for many of our needs, such convenience can undermine a person’s emotional maturity by circumventing the ability to tolerate frustration. Tolerating frustration involves the ability to delay gratification, self-containment of tension states, inhibiting reflexive action, and the ability to engage in thoughtful, reflective planning. Lacking in this capacity, one is prone toward impulsive and potentially addictive lifestyles. No wonder, then, that these addictive and impulsive styles have historically been seen as characteristic of adolescence, where mature brain development has not yet been achieved. If, however, needs and demands can be satisfied in nanoseconds, there is little motivation to cultivate self-containment. Psychoanalytic therapies are not quick fixes, intentionally, so as to allow for the facilitation of the maturing processes to unfold. So, while some might call this old-fashioned, it is actually a principle aligned with how nature works.The emergence and unfolding of the mind is better supported by engaging our internal emotional and cognitive potentials to grapple with life’s challenges, than by adopting canned answers from the internet or random facts from Google searches.
  • Psychoanalytic therapies strive to enhance self-awareness. Patients are encouraged and empowered to seek their personal truths through introspection and insight. The role of the therapist serves as a guide who accompanies the patient through the exploration and examination of one’s private mind. As a guide, the therapist offers some protection from the fear of self-knowledge and, most importantly, serves as a witness to the self-truths that may need to be proclaimed.Guiding and witnessing are among the most important interpersonal functions as they offer a secure acceptance and validation of the individual. These functions establish the conditions for healthy attachment and honor a person’s value and purpose.
  • As a system for understanding mental illness, or human suffering, psychoanalytic models provide a compassionate and normalizing perspective. Whereas symptoms are expressions of suffering, they also represent a person’s best effort at retaining whatever sanity that person has achieved. Psychoneuroses are distinguished from other forms of misery by referring to the mental suffering derived from conflicts within and between persons. The gift of our imagination can also be a curse when it comes to facing unfathomable thoughts, fantasies, and recollections. Psychoanalytic therapy allows the patient to distinguish perceptions from fantasies, desires from needs, or speculations from truths. Insight and corrective emotional experiences with the therapist can help us regain our ability to care for ourselves and our loved ones.
  • Why do critics of psychoanalysis say that it is not a science and that it does not stand up to rigorous empirical validation from scientific testing? This criticism is partially true, but misleading.In psychoanalytic therapies, the focus of inquiry and treatment is exclusively upon a person’s unique subjective experience and thus each treatment is unique in itself.Therefore, every therapy is tailored to the specific needs of the individual based upon his/her personality, background, abilities, and maturity. One person’s therapy cannot be accurately compared to another’s, precluding the meaningful comparisons needed for scientifically controlled research studies. Simply put, psychoanalytic therapies treat people, not diagnoses. This approach to therapy values the person over the diagnosis. That is, the focus of treatment is to help a patient achieve an improved quality of life, not simply to reduce problematic symptoms. This goal may be achieved by reducing symptoms to some degree but may also include acceptance of one’s self and that some of life’s issues need to be survived rather than “fixed.” Furthermore, many studies have shown that the single most important factor for any successful psychotherapy, regardless of type, is the quality of the relationship between the therapist and the patient. The therapeutic relationship has been the cornerstone of psychoanalysis since its inception.
  • Nobel laureate, Eric Kandel, has stated that psychoanalytic theory offers the most comprehensive understanding of the mind among all other psychological theories.The ideas and concepts have undergone over a century of revisions and modifications aimed at helping to understand the human condition.As complex and multi-faceted creatures we are endowed with an incessant curiosity and remarkable resilience. We not only invented science, but also the humanities. Art, music, literature, and dance are methods humans have created to express the enormity of our shared lives and the drive to understand the essential meaning of our existence. Psychoanalytic theories also examine our relationship to these humanities as they may hold personal significance for the individual. Psychoanalysis evolved from Freud’s devotion to understanding himself and others as members of a dominant world species. All of our methods for expression serve to approximate, but never fully elucidate, human uniqueness.

Psychoanalysis is still relevant today; in fact, it has never been more important.

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