How to Figure Out When Therapy Is Over

How to Figure Out When Therapy Is Over
By RICHARD A. FRIEDMAN, M.D.
Published: October 30, 2007 New York Times

If you think it’s hard to end a relationship with a lover or spouse, try breaking up with your psychotherapist.

A writer friend of mine recently tried and found it surprisingly difficult. Several months after landing a book contract, she realized she was in trouble.

“I was completely paralyzed and couldn’t write,” she said, as I recall. “I had to do something right away, so I decided to get myself into psychotherapy.”

 

Meditating through mental illness

The Toronto *Globe & Mail* includes an article: “Meditating through
mental illness” by Anne McIlroy. 15 Aug 08.

Here are some excerpts:

[begin excerpts]

The patients are sitting still, their eyes closed, meditating, on the
floor of a group therapy room at the Centre for Addiction and Mental
Health in Toronto.

It is the fifth week of an eight-week training course in mindfulness
meditation for people recovering from depression.

Their goal is to treat any troubling thoughts or emotions with the same
detachment with which they monitor the breath flowing in and out of
their bodies.

Mindfulness-based psychotherapy is growing rapidly in popularity, and
these patients are part of a $2.5-million clinical trial to assess
whether it can prevent relapses as effectively as antidepressant medications.

 

Non-drug treatment for depression – Newsweek interview

Prozac Nation No More?

In a new book, psychiatrist James Gordon explains why he believes there’s a more effective and drug-free way to treat depression and anxiety.
Anne Underwood
Newsweek Web Exclusive
Updated: 8:56 AM ET Jul 8, 2008

Do we really need Prozac? James Gordon, founder of the Center for Mind-Body Medicine in Washington, D.C., says there’s a better way to treat depression—through diet, exercise and meditation. Roll your eyes all you like. He’s used the approach for 35 years with a wide range of patients, from runaway children and middle-class adults in Washington, D.C., to victims of war in Bosnia, Kosovo, Israel and the Gaza Strip. This week, Gordon is heading to flood-stricken Iowa to see if he can be of assistance there. About 10 percent of American women and 4 percent of men now take antidepressants (according to a 2004 CDC report). Gordon’s new book, “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression,” outlines a treatment program he believes can be an alternative to medication. NEWSWEEK’s Anne Underwood spoke to Gordon about his recommendations and how he’s implemented them around the world. Excerpts:

 

Mindfulness in therapy – article

5/27/2008 *New York Times* includes an article: “Lotus Therapy” by
Benedict Carey.

Here’s how the article begins:

The patient sat with his eyes closed, submerged in the rhythm of his own
breathing, and after a while noticed that he was thinking about his
troubled relationship with his father.

“I was able to be there, present for the pain,” he said, when the
meditation session ended. “To just let it be what it was, without
thinking it through.”

The therapist nodded.

“Acceptance is what it was,” he continued. “Just letting it be. Not
trying to change anything.”

 

Patients do better with therapists who meditate – study

*Science Daily* released an article: “Patients Do Better With
Psychotherapist Who Practice Zen Meditation, Study Suggests.”

Here’s the article:

An investigation by German researchers headed by Professor Nickel
indicates the practicing Zen meditation by psychotherapists matters. All
therapists direct their attention in some manner during psychotherapy. A
special form of directing attention, ‘mindfulness’, is recommended.

 

Psychotherapies for PTSD

*Clinical Psychology Review* (June, 2008, vol. 28, #5) includes an article: “The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta- analysis of direct comparisons.” The article is by Steven Benish, Zac Imel, & Bruce Wampold.

Here’s the abstract: “Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.”

 

To Reap Psychotherapy’s Benefits, Get a Good Fit

New York Times (21 Aug 2007) includes an article: “To Reap
Psychotherapy’s Benefits, Get a Good Fit” by Richard A. Friedman, M.D.

The author note states: “Richard A. Friedman is a professor of
psychiatry at Weill Cornell Medical College.”

Here’s the article:

Americans seem to like psychotherapy. Whether it’s for the mundane
conflicts of everyday life or life-threatening illnesses like major
depression, psychotherapy is widely viewed as a healthy, if not
harmless, pursuit.

Yet unlike most other medical treatments, psychotherapy can take
considerable time. An infection can be cured in days, but remission of
severe depression or anxiety disorder usually takes weeks or months, and
a personality disorder typically requires years of intensive psychotherapy.

So if the outcome may be months or years away, how can a person tell
whether his psychotherapy is any good?

 

What creates successful life changes? How does therapy work?

• A climate of mutual safety and respect is paramount
• We have within us the seeds of the solutions we need. In therapy we discover these, learn to trust them, and then have the courage to live them, each in our own way.
• Positive change can occur more easily than you might expect. We may believe we are more stuck than we are.
• Understanding and practice are both essential. Insight needs to be applied. Action needs awareness. We learn to live what we know, and to know what we are living.
• We have more inner resources than we know. Our own truth is one of these resources. My job is to remind you of this.
• Mind and body are intimately connected. Change in one can lead to change in the other.
• Small changes add up. We need to persist with these.
• Sensible risks are essential. Learning to act from confidence and love, rather than fear, makes this possible.
• Different people and problems require different therapeutic approaches.
• There is more to us than we know. Maybe more than we can know.
• Some problems respond well to a head-on approach. Others need us to respect their mystery and depth. Learning to know the difference saves us much frustration.
• You do some of this in sessions and some in your life.
• All of the above works when we are being mindful. Mindfulness means non-judgmental, interested awareness of our present experience.
• In therapy, we learn to pay close attention to how we feel, think, and respond to the world and other people. Doing this helps us to see where our resources and strengths are, and where we are living out old belief patterns that no longer serve us.

My goal: To understand and accept your truth and choices (though not excuses), help you to discover and know what your life requires of you, and encourage you at every step to know and to act from what is most true for you. I have no agenda for how you should live your life. That is your choice and responsibility. But I do wish my clients to live with awareness of themselves, with their needs, feelings, choices, and history, and to be true to themselves. The rest flows from there. I hope people will choose to become more truly themselves, maturing and becoming free to choose well how they live and react.

If therapy has risks, it is that we may experience what we feel, who we are, and the impact of previous events strongly at times. We may be called to try out different behaviours, have new experiences, and to relate differently to others. It may all take time, patience, and persistence. And in therapy, as in life, there are no guarantees. You can and should talk about how therapy is going with your therapist. Everyone comes to true therapy as a volunteer, which means that you conclude when you wish to and you will never be compelled to go against your true wishes.

Brian Grady, Ph.D