Emotional Health

The Healing Power of Psychotherapy

13553296935_e8514d714d_zPhoto by Let Grow Therapy via Flickr (Creative Commons License)

Advances in neuroscience and our ability to research the brain have led to brilliant new discoveries about how the brain functions. But as Richard Friedman, M.D., points out in an article in The New York Times, this research has led to very little progress in psychopharmacological treatment. This is true even though, more and more, drugs are the method of intervention prescribed and biological treatments are almost exclusively the only types attracting research dollars. Dr. Friedman laments:

“As a psychiatrist and psychopharmacologist who loves neuroscience, I find this trend very disturbing. First, psychotherapy has been shown in scores of well-controlled clinical trials to be as effective as psychotropic medication for very common psychiatric illnesses like major depression and anxiety disorders; second, a majority of Americans clearly prefer psychotherapy to taking medication. For example, in a meta-analysis of 34 studies, Dr. R. Kathryn McHugh at McLean Hospital found that patients were three times more likely to want psychotherapy than psychotropic drugs.”

Insurance companies are also much less willing to cover the bill for psychotherapy than they used to be, even though research has consistently supported its effectiveness. And the zeitgeist itself seems to be against the kind of in-depth, long-term work it requires. Drugs are not the only alternatives to therapy being offered to ease psychic pain: yoga, coaching, meditation, healthy eating, pet therapy, etc., are all frequently recommended as likely mood enhancers and increase happiness and well-being.

And they are all effective. But many people suffer from emotional problems that were years in the making and may have complex roots that require a skilled clinician to diagnose and treat. As Friedman points out, “many of our patients have histories of trauma, sexual abuse, the stress of poverty or deprivation. There is obviously no quick biological fix for these complex problems.” All of the interventions listed above, including psychotropic drugs, are often very useful additions to therapy, but they are not substitutes for it when people need clinical treatment.

But what is therapy and what makes the process of psychotherapy work? Why does it heal, and how is it different from talking to a friend? Since the turn of the 20th century, when Sigmund Freud discovered that patients obtained relief from suffering using a method he called “free association,” which was essentially verbalizing anything that came to mind without censorship, “talk therapy” has been the mainstay of the psychotherapeutic method, (though there have been many methods developed, such as cognitive behavioral therapy, or CBT, developed through the years that are deservedly very popular). Initially, Freud believed that it was the retrieval of unconscious memories that provided the relief, and to some extent that was true (especially for the types of patients, called hysterics, he was seeing in the late 19th and early 20th century). But he soon realized that was only half the story.

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