In a recent "Dear Annie" column in the Marin Independent Journal
(10/2/03), a writer signs her query: "Through With Therapy in the
Midwest." She complains she's fritted away thousands of dollars
on a variety of therapists and concludes therapy is a "waste of
money." In the response, Annie observes: "Therapy does not
work for everyone."
Both Annie and the hapless patient make a crucial error. They
speak as if all psychotherapy were the same. But therapy comes
in two major flavors.
Traditional therapy, popularized by Freud, assumes an adult's
psychological problems stem from their dysfunctional childhood.
Treatment consists of months or often years of relating to your
therapist the details of your misbegotten youth, along with your
dreams, free associations, and transference feelings.
The cognitive-behavioral approach, on the other hand, focuses
on the here-and-now cause of your problems: your irrational
self-talk. Numerous studies support the efficacy of this
approach for a wide range of problems: anxiety, depression,
procrastination, relationship problems, and addictions.
My client Tim, for example, felt insecure in his intimate
relationships. A traditional therapist would likely conclude this
insecurity came from being rejected by his parents at a young age,
and would focus on having Tim discuss his early upbringing.
This could go on for years.
Using the cognitive-behavioral approach, I helped Tim identify his
unrealistic demands in his current relationship, including: "I NEED
my partner's approval, otherwise I'm unlovable." Tim learned to
change his view to: "I strongly PREFER to have my partner's love,
but don't NEED it. It would be sad to lose it, but that only proves,
at the worst, that I'm an imperfect human, not an unlovable loser.
With practice, I can learn to accept myself with my flaws, and thereby
considerably enjoy life whether or not I am loved."
After nine sessions, Tim had largely overcome his irrational views,
and was on his way to fully accepting himself and immensely
enjoying his relationship.
Before attempting traditional therapy, first consider short-term
cognitive behavior therapy (CBT) for a long-term solution.