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How Does Therapy Work?

July 30, 2012

Many theorists have written about what we call “the curative factors” in therapy.    There are many opinions and varied techniques for helping people achieve their goals in therapy.

Here are only a few of the main curative factors.

INSIGHT.  Many people pursue therapy in order to gain insight into their psychological dilemmas.  With a therapist guiding a thoughtful and “objective” examination of one’s inner life, people attempt to outsmart their self-sabotaging patterns.  Think about it: how  powerful would it be to observe how you shoot yourself in the foot over and over again.  It is in fact awe-inspiring to notice how you are quick to repeat the same mistakes, and very very humbling.  This is surely an important aspect of therapy.

VENTING/(ABREACTION).  Many people find that they need to vent, at least once a week.  They feel that they have an accumulation of feelings that need airing out, and they feel that they do not want to burden their friends.  Some have believed that feelings build up and eventually create a pressure cooker kind of effect on the person, who then needs to let those feelings out in order to reach equilibrium.  However, there is little in the literature that supports this theory.  Yet, there is evidence that articulating previously unarticulated feelings can do wonders for a person’s mental health.  Talking about feelings, putting them into words, writing about them, helps one feel more in control of one’s experience and less at the mercy of feelings.

CHANGING THOUGHTS AND BELIEFS.  Some begin an inquiry into the nature of their thoughts.  Often people play the same inner tape (of thoughts) over and over again.  It’s like a inner commentary that is on “repeat” despite the external stimuli changing constantly.  Put another way, even though people go through different life experiences their interpretation is often the same.  One example is someone who always concludes that she is to blame, or that something is wrong with her, regardless of the situation.  Therapy begins the work of identifying these repetitive thoughts and core beliefs, and then challenging them.  For instance, maybe it’s time to begin to interpret situations in a new light, and not always take on the blame?

CORRECTIVE EXPERIENCE.  Some people carry emotional wounds from childhood, often inflicted unwittingly at the hands of close caregivers.  Therapy is an opportunity to have a “corrective emotional experience” with a therapist who hopefully takes a genuine interest in the conflicts of the patient, and creates an accepting and supportive environment in which the patient can explore without shame and ultimately thrive.

MEANING MAKING.  People tell the story of their lives in a particular way.  Beginning therapy can allow a person to tell her story again in a new light incorporating new meaning which arises with reflection.

EXPERIMENTING WITH NEW BEHAVIORS.  The therapist might suggests new ways of being and acting in the world, which represent a departure from previously destructive sets of behavior.  Sometimes this involves literally learning new coping or social skills, and then trying them out in the world.  Often, the therapist and client collaboratively create a list of challenges/fears for the patient to gradually confront in a pace that is comfortable.

Each therapy treatment is different and may involve all or just one of the above mentioned factors.  Ultimately, research suggests that the factor that best predicts the outcome (success or failure) of the therapy is the quality of the therapeutic relationship….it is NOT the use of a specific technique or modality!  That is an unbelievable research finding, when you think about it!  That means that if  you feel connected to your therapist, if you feel she is helping, and that there is a sense of warmth and empathy and collaboration in addressing whatever ails you, then you will most likely perceive yourself benefiting from your treatment.

Good luck with your therapy!  Please take a moment to participate in this poll and share your views on what makes therapy work.

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