Chapter Introduction

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MYTH OR SCIENCE?

Is it true …

  • That psychologists are never allowed to prescribe medications?

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  • That therapy is only effective if it is provided by a clinical psychologist or other highly trained therapist?

  • That the different types of psychotherapy generally have similar results?

  • That, for some disorders, psychotherapy and medications lead to similar changes in brain activity?

  • That antidepressants are a much more effective treatment than placebos for the vast majority of cases of depression?

  • That electroconvulsive therapy (ECT), once called “shock therapy,” causes permanent brain damage and memory loss?

  • That it is never ethical for therapists to date clients?

15

Therapies

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“A Clear Sense of Being Heard …”

PROLOGUE

IN THIS CHAPTER:

  • INTRODUCTION: Psychotherapy and Biomedical Therapy

  • Psychoanalytic Therapy

  • Humanistic Therapy

  • Behavior Therapy

  • Cognitive Therapies

  • Group and Family Therapy

  • Evaluating the Effectiveness of Psychotherapy

  • Biomedical Therapies

  • PSYCH FOR YOUR LIFE: What to Expect in Psychotherapy

HOW WOULD WE DESCRIBE MARCIA? She’s an extraordinarily kind, intelligent woman. Her thoughtfulness and sensitivity are tempered by a ready laugh and a good sense of humor. She’s happily married, has a good job as a feature writer for a large suburban newspaper, and has two young children, who only occasionally drive her crazy. If Marcia has a flaw, it’s that she tends to judge herself much too harshly. She’s too quick to blame herself when anything goes wrong.

Juggling a full-time career, marriage, and parenting is a challenge for anyone, but Marcia always makes it look easy. The last time your author Sandy had dinner at Bill and Marcia’s home, the meal featured homegrown vegetables, made-from-scratch bread, and fresh seasonings from the herb pots in the kitchen. Outwardly, Marcia appears to have it all. But a few years ago, she began to experience a pervasive sense of dread and unease—feelings that gradually escalated into a full-scale depressive episode. Marcia describes the onset of her feelings in this way:

Physically, I began to feel as if I were fraying around the edges. I had a constant sense of anxiety and a recurring sense of being a failure. My daughter, Maggie, was going through a rather difficult stage. Andy was still a baby. I felt worn out. I started worrying constantly about my children. Are they safe? Are they sick? What’s going to happen? Are my kids going to get hurt? I knew that I really didn’t have any reason to worry that much, but I did. It finally struck me that my worrying and my anxiety and my feelings of being a failure were not going to go away on their own.

Marcia decided to seek help. She made an appointment with her therapist, a psychiatrist whom Marcia had last seen 10 years earlier, when she had helped Marcia cope with a very difficult time in her life. Marcia summarizes her experience this way:

How has therapy helped me? My feelings before a therapy session may vary greatly, depending on the issue under discussion. However, I always find the sessions cathartic and I invariably feel great relief. I feel a sense of being understood by someone who knows me but who is detached from me. I have a clear sense of being heard, as though my therapist has given me a gift of listening and of allowing me to see myself as the worthwhile and capable person I am. It is as though therapy allows me to see more clearly into a mirror that my problems have obscured.

Over the course of several months, Marcia gradually began to feel better. Today, Marcia is calmer, more confi-dent, and feels much more in control of her emotions and her life. As Marcia’s mental health improved, so did her relationships with her children and her husband.

Psychotherapy has also helped me communicate more clearly. It has enabled me to become more resilient after some emotional conflict. It has had a preventive effect in helping me to ignore or manage situations that might under certain circumstances trigger depression, anxiety, or obsessive worry. And it makes me a better parent and marriage partner.

Therapy’s negative effects? I’m poorer; it costs money. And therapy poses the risk of becoming an end in itself. Psychotherapy has the attraction of being a safe harbor from the petty assaults of everyday life. There’s always the danger of losing sight of the goal of becoming a healthier and more productive person, and becoming stuck in the therapy process.

Marcia’s experience with psychotherapy reflects many of the themes we will touch on in this chapter. We’ll look at different forms of therapy that psychologists and other mental health professionals use to help people cope with psychological problems. We’ll also consider the popularity of newer ways to deliver mental health care—including self-help groups and technology-based treatments—and how they differ from more traditional forms of therapy. Toward the end of the chapter, we’ll discuss biomedical approaches to the treatment of psychological disorders. Over the course of the chapter, we’ll come back to Marcia’s story.