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Q: psychotherapy ineffective
asked by: opus on June 3rd, 2008
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Hello again,

This is my second time posting on this site. I'm just wondering if anyone else has found psychotherapy to be ineffective. I find it somewhat artificial, and a little too 'touchy-feely'. Not at all how the 'real' world is, in my opinion. Anyone else agree? Disagree?
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goffers
replied on June 30th, 2008
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Some thoughts about therapy
Psychotherapy does not work for everyone. That being said, sometimes there can be a problem of matching the right type of therapist with a client. Not all therapies or therapists are necessarily 'touchy-feely'. Generally the therapy with the strongest trail of evidence is Cognitive Behaviour Therapy. This therapy does ask you to look at feeling states, but generally in order to identify what thoughts and beliefs might be leading to such states (e.g. when, after not getting a job, I think to myself "I am NEVER going to find a job! I am a FAILURE." etc, it would be expected that you would feel despondent.). The key to this type of therapy is in identifying and then challenging thoughts which are unfair, unrealistic and unhelpful, as these can keep even a generally healthy person paralyzed with anxiety or depression. This type of therapy also examines behaviour patterns that can either improve or exacerbate such conditions and aims at changing these.

Still, therapy is not the only solution available, but for many conditions (e.g. panic disorder, depression, phobias) evidence indicates that it is the best treatment for most people, often times in combination with medications, physical exercise, and other modalities.
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miltos1
replied on July 11th, 2008
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Things to know about therapy
My long-term experience with therapy leads me to often forget that most people have no or very little experience with it. I have been going to therapy for the last 26 years - no joke. I'm not always in therapy, but I go when I feel like I'm stuck or having emotional issues that I just can't work through on my own. Just to give you context, my issues are not all that severe. I have Atypical Depression and take meds, and most of the time I feel fine. I have used therapy to help me deal with the times I am depressed, to help me work through emotional issues from my family and childhood (nothing drastic, just emotional stuff) and to help me work through issues in intimate relationships. I like the unique support that the therapeutic relationship offers. But...

Here are some key things I think people should know about therapy and therapists.

1. "Therapy" represents a very large group of approaches to dealing with emotional issues. Within this group of "therapy" there are TONS of different approaches, some VERY different from others. Indeed, as goffers says, Cognitive Behavioral Therapy (CBT) has been shown to be one of the most effective therapies for depression (though it was not helpful for me). You should do some research on different therapeutic approaches to see which one "feels" best for you. If one type feels too "touch-feely" you can almost certainly find another type that feels comfortable for you. As an analogy, thinking that "therapy" refers to a single approach that all therapists follow is like thinking that "medicine" refers to one single approach that all doctors follow. Many of you probably know that you could take the same symptoms to 10 different doctors and end up with 10 different diagnoses and/or treatments.

3. Most therapists use multiple approaches. The majority of therapists refer to themselves as "eclectic" - they use tools and processes and theories from multiple therapeutic approaches (Jungian, Gestalt, Transpersonal, CBT, Group, Systems, Psychoanalysis, Psychodynamic, Psycho Drama, EMDR, Somatic/Body-Centered, etc.). For instance, most therapists incorporate some CBT into their work - but there are CBT therapists who use the CBT approach exclusively. Although most are eclectic, you can usually find someone who specializes in one specific approach.

2. INTERVIEW YOUR POTENTIAL THERAPISTS. I cannot stress this enough; however, I realize that when someone is in crisis mode s/he may just not have the ability to do this. Do what you can.
Therapists are just like any other service provider. One, they are all different. Two, as mentioned above, there are many different therapeutic approaches. When I am looking for a therapist I typically see between 3-8 different people first. Most will do either a free 1/2-hour initial session, or the first session is free unless you start seeing them regularly.
Of course, the ideal is to find someone you like and keep seeing them. But, things that have led me to seek a new therapist are: I'm moving, the therapist is moving, therapist retires, or realizing that the therapist was just not able to help me.
It's like finding someone that does a great job cutting your hair; life changes and you have to go find someone new to cut your hair.

3. Therapists are people too - all different. Just as with doctors, people often assume that if someone has a license and a degree, then they are just as "good" as anyone else with that license and degree. It's simply not true. Are all electricians and plumbers equally skilled? Not in my experience. Having a degree just means that they studied at an accepted school and a license just means that they passed a test and did a certain number of "supervised" hours in their specialty. So they meet the minimum qualifications, but that says nothing as to how good they will be in dealing with YOU and YOUR issues. Even after interviewing and selecting a therapist and seeing that person for a while, I have found a few to be incapable of helping me because they just didn't have the experience, or because they were so stuck in their way of seeing things that they couldn't be creative in helping me (when their way of seeing things just didn't fit).

4. Therapy is a relationship. And because of that, you have to realize that it can take time to find someone you are comfortable having that relationship with. Could you be good friends with literally anyone? Could you have an intimate relationship with literally anyone? Of course not, and the same goes for therapists. Therapy is only as good as the relationship you and your therapist are able to create, and that relationship is the product of who the two of you are. So, just like with friends and relationships, it can take some time to find someone you can relate to.

So, for anyone considering therapy, or wondering if it will be helpful, just realize that it's not a cookie-cutter process that will be the same no matter who you see. If you don't like one particular therapist, do some research on the different kinds of therapy and interview a few more. Therapy isn't for everyone, but don't dismiss it just because you met one or two therapists you didn't like.
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Ortley
replied on December 31st, 2008
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If a therapist is not suitable, the patient should be referred
I was in therapy for 16 years without benefit. I remained in it because I was told that " it is a process" and evidently that is supposed to mean that you stay in it no matter what. I was diagnosed as schizophrenic and put on antipsychotics even though I was not psychotic in the first place. The meds made me feel crazy. I was verbally abused by a therapist who now writes books about how to be a good therapist. (Disgusting) I free associated about my father for years, which only succeeded in making me feel awful. I was told that it's good when therapy makes you feel awful.

Finally, I found a therapist who specializes in autism spectrum disorders. She immediately began talking about things that really matter to me, such as social skills and OCD symptoms. It was a completely different experience, and it was definitely useful.

But now I am even more angry than ever. Knowing that appropriate therapy exists, why wasn't I referred to a suitable therapist immediately? I was a teenager when I first went into therapy. I had to wait until middle age to find something worthy to be called "therapy." There is something seriously wrong with that. The patient shouldn't have to find the right therapist. For one thing, some patients are still just kids. The patient should be referred to a suitable therapist.

I am angry.
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jshlackm
replied on May 6th, 2009
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variability of therapy...
Most mental health treatment approaches are relatively limited, not addressing a full spectrum of who we are as individual beings. We are thoughts, feelings, energy, chemistry, and underlying all of that we are Spirit-Consciousness. Most college training programs provide a limited understanding of consciousness and the human experience and don't even explore some of the most effective therapeutic resources, such as nutrition, hypnosis, transpersonal, and energetic therapies. Just as with modern medicine conventions directed at physical health issues, effective natural therapies are often suppressed or ignored in order to steer people into drug therapies that just block symptoms while helping you chronically maintain your underlying problems. Overall, therapy is relatively ineffective due in part to these limitations, while sometimes it can be very helpful if you find a therapist who offers the tools or insights that are best-suited for you at the time. The best therapies help empower you to transform yourself and don't promote dependency on medications or many years of regular therapist visits. That's been my observations from working in the field for well over a decade.
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