May 16th is The American Psychological Association’s Blog for Mental Health Day. They have asked its members to post an article about the importance of good mental health. To kick it off, my post today is about talk psychotherapy. What is it, and how does it actually help? Although psychotherapy has been a part of the American and European cultures for almost two centuries now, the actual process of psychotherapy still feels like an enigma to many people.
Patients often come to psychotherapy through the positive recommendation of a friend or family member. Nonetheless, they enter treatment with some unease about the therapy process and its effectiveness. Their inexperience, coupled with the therapy setting, doesn’t make them feel any more comfortable with the process. They enter an office that looks much like someone’s living room or home study. There are no medical machines to signify it’s both a science and an art. There are only two chairs or a couch, a box of tissues, a painting or two, and a bookshelf. The only instrument in the room is the therapist who listens while you talk, responds from time to time, and depending upon his/her school of psychotherapy, may even give you some advice. For sure, the way of talk psychotherapy is as mysterious today as it was when it first began.
The talk therapies began in the late nineteenth century with Viennese physiologist Dr. Josef Breuer. His patient, Anna O., was unable to speak her native German, but she could speak French and English, or drink water, even when she was thirsty. Breuer discovered that if he hypnotized her, she would talk of things she did not remember in the conscious state, and afterwards her symptoms were relieved. Hypnosis permitted her to recall the conflict that led to her symptoms. But, it was talking about the conflict, putting language to it, that took the air out of her symptoms, so to speak. Breuer called his treatment method the “the talking cure” (PBS.org, A Science Odyssey). And, with the help of Sigmund Freud’s conflict theory of personality, the talking therapies were born.
Today, talk therapy refers to a range of psychotherapies that are derived from the talking cure. But, unlike Drs. Breuer and Freud, it’s not hypnosis, but rather the therapist’s empathy and skill at developing a therapeutic relationship that is the instrument for patient change. Through connecting, listening, and helping patients to put language to their whole experience, patients gain understanding, feel better, and begin to change. Hence, the key to the talk therapies is the empathic nature of therapists and the alliance they are able to form with their patients. The empathic therapists connect and listen deeply to their patients, to understand the expressed and unspoken meanings they give to their experience. The empathic connection helps to regulate patients’ emotions, which opens them to new understandings that lead to change. This is supported by recent research. Through various physiological markers, like sweat gland activity (GSR) and the brain’s utilization of blood sugar (Positron Emission Tomography or Pet Scan), psychotherapy researchers have found that as people learn how to regulate their emotions, they begin to change, as reflected in the stimulation of the brain’s prefrontal cortex. This seat of higher-brain functions help in making sense of experience and giving meaning to it, organizing and planning behavior toward a goal, tolerating frustration and delaying gratification of impulses, and using imagination toward reality-based possibilities (Talk Therapy: Off the Couch and Into the Lab, the Scientific American).
I think it’s fair to say that the empathy of the therapist is equally as important as their education, training, and experience. You don’t want one without the other. So, if you have been thinking about going to a therapist who does talk therapy, you want to choose him or her wisely. It may take a few sessions for you to find out how empathic your therapist actually is. Certainly, you want a therapist who has a wide-range of training, education, and professional experience. But, you also want a therapist whose sensibilities are well-honed.
Dr. Peter Breggin is founder of The Center for the Study of Empathic Therapy, Education and Living. He has an excellent guideline that describes fifteen characteristics and qualities of the empathic therapist. Although it is meant as a guide for therapists, you can use it as a guideline to know what you should be looking for in a therapist who does talk therapy. I’m giving you a few of the 15 here. But, you can go to the link I provide you in this paragraph to get the full guideline.
The Guidelines: As Empathic Therapists –
- We treasure those who seek our help and we view therapy as a sacred and inviolable trust. With humility and gratitude, we honor the privilege of being therapists.
- We rely upon relationships built on trust, honesty, caring, genuine engagement and mutual respect.
- We bring out the best in ourselves in order to bring out the best in others.
- We create a safe space for self-exploration and honest communication by holding ourselves to the highest ethical standards, including honesty, informed consent, confidentiality, professional boundaries, and respect for personal freedom, autonomy and individuality.
- We encourage overcoming psychological helplessness and taking responsibility for emotions, thoughts and actions—and ultimately for living a self-determined life.
- We offer empathic understanding and, when useful, we build on that understanding to offer new perspectives and guidance for the further fulfillment of personal goals and freely chosen values.
- We do not reduce others to diagnostic categories or labels—a process that diminishes personal identity, over-simplifies life, instills dependency on authority, and impedes post-traumatic growth. Instead, we encourage people to understand and to embrace the depth, richness and complexity of their unique emotional and intellectual lives.
I hope you liked my post today. Please let me know by selecting the Like icon below. And, remember, psychotherapy is a wonderful, deeply fulfilling experience when you have the right therapist. Warmly, Deborah!