I don't understand why anyone would go to a psychotherapist after witnessing how they are portrayed in the media. Especially the know-it-all shrinks who are sure they are right when you agree with them and are sure they are right when you disagree with them. (In the latter case, they would probably say you are using a "defense mechanism" that prevents you from recognizing the truth.) I just cringe when I hear that.
Unfortunately, many therapists who treat actual patients are similar to those on television. This type of therapist assumes the patient's perspective is wrong, and then sets himself or herself high above the patient as an expert who knows all, and who believes that the patient has to spend years gaining insight instead of focusing on problems the patient is experiencing today.
A patient I saw on television goes to a therapist because she has to make a decision about her marriage. Instead of helping her carefully examine her values and look at the advantages and disadvantages of staying in the marriage, the TV therapist had her talk endlessly about her childhood experiences. Another patient was experiencing panic attacks. The therapist did not focus on helping the patient prove to himself that his symptoms, though very distressing, were benign. Instead she focused on the patient's dysfunctional relationship with his mother.
It's enough to drive one crazy.
Well, not all psychotherapy is the same. Some modalities have a strong evidence base that demonstrates their effectiveness. Other modalities have never been shown to be effective. Yet they continue to be practiced by psychotherapists who consider an evidence base to be unimportant.
Research over the past 30 years has shown that Cognitive Behavior Therapy (CBT) is effective for a whole range of psychiatric disorders, such as depression, anxiety disorders, eating disorders, substance abuse and even (in conjunction with medication) for schizophrenia and bipolar disorder. It's also effective for many medical conditions, such as insomnia, obesity and chronic pain, and psychological difficulties such as couples' problems, and school and work problems.
What happens in a typical CBT session? You don't lie on a couch. You don't talk for the whole hour about whatever pops into your mind. You don't assume that you need to delve into childhood issues. Instead, you sit at a desk or a table with your therapist, who asks you at the beginning of each session what problem or problems you want help in solving. In the context of solving your current problems, you learn skills, such as how to correct your unrealistic or unhelpful thinking and how to modify your behavior to reach your goals. You and your therapist discuss what solutions you want to implement and what cognitive (thinking) and behavioral changes you want to work on between sessions.
You don't go back to childhood issues unless your problems stem from childhood and you get stuck just working in the present. Even then, you focus on changing the unhelpful ideas you developed as a result of adverse childhood events and discuss how new perspectives can help you today. CBT is a psychotherapy that just makes sense--and it works.
But consumers tend to be naive when it comes to mental health treatment, much more so than medical treatment. If you were wheezing and had chest discomfort, you would ask your doctor for the treatment that research has shown is most effective. You wouldn't want the outdated treatment that your doctor learned in medical school twenty years ago. You wouldn't necessarily want the medication that the last drug rep left for your doctor to distribute. I hope you would want the treatment that has the best chance of reducing your symptoms--and your suffering--as quickly as possible.
Need a psychotherapist? When you call for an appointment, find out whether the therapist uses evidence-based treatment. At the end of your first session (which should include a diagnostic evaluation), ask the therapist what the treatment plan will be. Make sure the plan makes sense to you. If the therapist doesn't provide you with a cogent, sensible plan, it's probably a signal that you should look for treatment elsewhere.
If you have a problem, don't let television therapists deter you from getting the help you need.
Judith S. Beck, Ph.D.
President, Beck Institute for Cognitive Therapy and Research
Clinical Associate Professor of Psychology in Psychiatry,
University of Pennsylvania
www.beckinstitute.org and www.beckinstituteblog.org
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Judith S. Beck, Ph.D.: How Much Guilt Is Too Much?
Judith S. Beck, Ph.D.: Cognitive Behavior Therapy: Myths and Realities
What is Cognitive-Behavioral Therapy?
Beck Institute for Cognitive Therapy and Research
Cognitive Therapy - What Is Cognitive Therapy?
The American Institute for Cognitive Therapy - Home
This column will change your life: Trailblazing in cognitive therapy
Some people on this forum have asked for more information about CBT. There are some very good self-help books out there in a workbook format (i.e., David Burns' books, New Harbinger books). While I don't intend to "plug" my website here. I have an online workshop about CBT that you might check out. It can be found at AllAboutDepression.com. You can find the link for this workshop at the bottom of the home page.
CBT is a good therapeutic approach overall. It is easy to implement, many clients take to it very well, and they learn life-long tools for managing mood disorders, anxiety disorders, etc. I'm glad it got some attention here.
Dr.P :)
Some people on this forum have asked for more information about CBT. There are some very good self-help books out there in a workbook format (i.e., David Burns' books, New Harbinger books). While I don't intend to "plug" my website here. I have an online workshop about CBT that you might check out. It can be found at AllAboutDepression.com. You can find the link for this workshop at the bottom of the home page.
CBT is a good therapeutic approach overall. It is easy to implement, many clients take to it very well, and they learn life-long tools for managing mood disorders, anxiety disorders, etc. I'm glad it got some attention here.
Dr.P :)
There have been many studies done that show psychoanalysis works as effectively as most mainstream medical treatments (i.e., about 80 percent of the time) for patients who have been properly selected.
See this arcticle in the Walrus Magazine from a few years back that describes very well the issues surround traditional psychoanalysis
http://www.walrusmagazine.com/articles/2005.09-culture-history-psychoanalysis/1/
through the years for bouts of depression and have wasted so much time and money with these
therapists that just sit there and listen, while I ramble on and on about whatever pops in my head.
I've come to conclusion on several occasions that the therapist was more screwed up than me!
I like your approach because my biggest problem is replaying negative thoughts over and over in
my mind. To learn how to recognize and control my thoughts would be very helpful and it makes
sense. I have a poor opinion, in general, about therapists due to my experiences with them. So
speaking as a patient, I found your article very helpful... thank you. I also find it interesting that
most of the negative responses on this post, are from other "therapists", not consumers.
"CBT has come under fire from non-CBT therapists who claim that the data does not fully support the extent of attention and funding it receives, and that the limitations of the CBT model when used to blanket-address psychological suffering are unrecognized. Psychotherapist and professor Andrew Samuels stated that this constitutes, "a coup, a power play by a community that has suddenly found itself on the brink of corralling an enormous amount of money. Everyone has been seduced by CBT's apparent cheapness."
Presenters at a psychotherapy conference in July, 2008 criticized the increased spending on CBT and the widespread belief that CBT is more effective than other forms of psychotherapy. In this conference professors issued a joint statement, which briefly stated:
As more research focuses on CBT, more studies are published on CBT. This reinforces the logical error that CBT is superior and this has a direct negative effect on other forms of therapy, which are well documented but have smaller bodies of research.
People who get therapy improve substantially, regardless of the type of therapy they get. When therapies are compared to one another, they usually appear to be equally effective.
Excessive spending on CBT and discouraging other forms of therapy hurts the public.
At the same conference, professors presented their unpublished meta-analysis of more than 80 studies where person-centered psychotherapy was shown to be as effective as other forms of psychotherapy, including CBT."
Second, no form of therapy is "right" for all people or all situations or all diagnoses. If CBT works (and it does for many people), then why not use it... whether alone or in combination of other therapies? Isn't the end result to help the client feel better? All of this discussion here simply sounds like professional in-fighting. Meanwhile, the clients (or patients, if you will) are left on the sidelines. The fact remains that not all people do get better no matter what therapy they use. My son, in fact, got substantially worse until we found the appropriate treatment FOR HIM.
http://www.livingfithealthyandhappy.com/2009/12/cognitive-behaviour-therapy-skills-to-help-yourself-in-six-weeks.html
I believe that cognitive behavioral therapy (CBT) puts individuals in a position of control over their lives.
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After staying sober in AA for a number of years, I found I had some problems that I wasn't able to address in AA. I tried several kinds of therapy and generally found the therapists I saw to be more screwed up than I was. I finally found a therapy that not only produces healthy therapists who have done their own work but actually affects real internal healing. It's called Internal Family Systems. Find a good therapist who specialized in IFS and check it out if you need some therapy. You won't be sorry.
I have never met worse psychologists in my 10 years of trying to get help. All the "techniques" they teach and charge good money for can easily be downloaded of the 'net for free.
My pain was diagnosed as a rare disease a year ago, and I was introduced to a community of people with Chiari (includes Johnny Cash's daughter) and it is well known that cognitive psychologists are the people that docs send you to when they've done minimal testing and still can't figure the cause out, they are the ones the diagnose Somatoform(a disease in which one is making up symptoms in head) so you can't go back and sue original negligent doctor for malpractice.
Doctora are as cruel and terrible as they were 60 years ago,new tech doesn't solve the institutional problems which encourage ignorance.