Do you think that psychotherapy really helps?

I like the relatively unstructured aspect of therapy. I'm not sure why, but it works for me. (Maybe my brain is unstructured.) I think if my therapy were too structured, there might not be space for whatever needs to come up that day to come up. There could be something important we would miss if we were too structured. Surprising and wonderful and healing things have happened in therapy because my T and I just "went with it" and allowed ourselves to follow the horn in the distance. Some of my best sessions have been completely unexpected.

On the other hand, an unstructured format can make it too easy to avoid things. There have been times recently when I asked for T's help with this, and told him I am avoiding X and I need help in bringing up this topic next time. So T will raise the topic next time, and provide that structure for me.

Sunrise, i agree about the clinical psych students. I know some of them, and it just seems like there are a few whom just radiate ....that special something, and its just like, you get that warm feeling around them.
But others...sometimes I think..they might need to work on some of their own stuff for a while...or maybe they would like researching better.
It's that jenes se quio?
Ha, i'm trying to say that french phrase that means, the un-identifiable trait. But it seems like there isn't a big test of aptitude like you would think in the programs.
I used to work for a group of T's...and there was like this one T who you could just TELL wasn't into it...and he eventually left practice and went to work for an insurance company. His job was to deny mental health claims. not kidding.

I'm so sorry you "feel so broken"
I can relate to that feeling.

I can't even express how much therapy has helped me...... I question whether I'd even be on this earth today were it not for therapy. (had some real rough patches)

maybe if you can figure what it is that seems broken-- like if you struggle with friendships, or family dynamics, or substance abuse or low confidence...etc... etc... then you could search for a T. that specializes in that area-- for starters anyway.

I feel for you it can be so rough feeling broken.

Please keep us posted on how it's going!

fins

[sun_flower, I hope you'll bear with us. I'd like to think this digression isn't entirely off topic.]
Suppose it wasn't. In order to even compare it to something else that you thought might work better, you'd still end up quantifying both therapies, accurately or not: "If you're at point X in therapy and T says A, he/she is doing Rogers's kind of therapy; if he/she says B instead, he/she is doing the other kind. If T's response isn't clearly A or B, here's how you rate it as one or the other, or neither, or both. If there's doubt about whether you're really at point X in therapy, here's how you tell that..." If point X mostly occurs in one kind of therapy and not the other, you may have to compare it to whatever in the other therapy seems to you closest to it.

I'd argue that this is not because more behavioral kinds of therapy "work better", but because those are easier to study, to talk scientifically about, to train students to do, and to grade them on.

By the way, I see an insidious sort of self-fulfilling prophecy here:

------- Entering Fool Zero's fantasy -------
Please watch your step.

Suppose you're a researcher and the only way you know to measure whether therapy works or not is behaviorally: if the client is showing more behaviors from Column A and fewer from Column B, you and your colleagues will agree he/she is getting better; if the other way around, he/she must be getting worse. When you compare therapies, the ones that produce the most obvious "behavioral improvement" will score highest while those that address primarily what the client is experiencing will tend to fall through the cracks. Any study conducted under these assumptions will, naturally, prove conclusively that only behavior-oriented therapies produce any measurable results at all. Even if other therapies produce more changes and bigger changes in the long run, the changes won't all be in the same direction. A client who presents with anxiety attacks that are interfering with their plans to become something worthwhile like a research psychologist, may discover in therapy that they'd rather be a housewife, a musician, or a Rogerian therapist instead. How can that possibly be scored as a change for the better?

-------

You're walking down the street one night and you see someone searching for something on the sidewalk. "Are you looking for something?" you ask them.

"Yes, I dropped my car keys and I don't see them anywhere."

"Maybe I can help you find them. Do you remember where you were when you dropped them?"

"Yes, I was over there under that tree somewhere."

"Then why are we looking over here?"

"Because this is right under the streetlight and we can see much better."

------- Leaving Fool Zero's fantasy -------
Please watch your step.

That's the objective argument. IMO, good therapy has to address subjective factors -- especially subjective factors. I say a client who ended up saying and doing all the right things but hating it, wouldn't have benefited much from therapy. You recently illustrated this discrepancy nicely in another thread, where you wrote...Your T's policy may have been best by objective (observable, quantifiable) standards -- but that doesn't sound like it was much consolation to you at the time.

I say you can teach them (if they stay around long enough) to say and do the right things, go through all the motions of being good therapists [scrupulously decline gifts from clients ] -- but I question whether their clients will respond to measurably "good" therapy anywhere near as well as to the "naturally good" kind. I'd argue that making the "art" of therapy into a "science" will leave us with all the elements of effective therapy except those that actually work. Kind of like the old fable about killing the goose that laid the golden eggs.

My therapist has saved my life, litterly, at least once probally several times. So yea it can help.

Fool Zero, thanks so much for your post. I have been trying to understand what it is about behavioral methods that made me still question. Your example with the streetlight.. wow, absolutely. I see exactly what you mean.

I know I seem behaviorally oriented but truly I am on the fence. I used to be somewhat anti-behavioral, was very put off by this objectifying of the human experience. And now I work in a very behavioral psychology clinic with a very vocal boss and it is hard to resist indoctrination. These are his arguments which I mostly spout hoping someone will disagree so that I can think more clearly about this.

I don't have an adequate response to your post because my ideas are not well-formulated yet. But I have forwarded your words to a colleague. I hope you don't mind. You've finally given me the coherence of thought I needed from the other side. So thank you. Your words may spout good discussion in our lab.

I still think it may be possible to quantify the therapeutic process, and it is still my dream to help do this so that research in psychology can be improved (so practice can be improved, so we are measuring the right things). But the medical model is surely lacking.

Sorry I've come a bit late to this thread but wanted to say that I totally believe in the process of psychotherapy, I think it does work. But I also believe that the process is only as good as the therapist conducting it.

Like you Sunflower I’ve seen a number of different therapists over the years, and never found one who was able to help me. Now I’m finally seeing a T whom I believe is helping me - and it’s down to who he is and how he presents in sessions. It’s ALSO down to ME having learned as much as I can about what’s involved in psychotherapy, doing lots of digging around in my own mind and being as clear as I can about what I think I need and what would help me. I am so lucky to have found a T who actually listens to me and tries very hard to relate to the ‘real’ me - it’s entirely down to his flexibility and willingness to try and give me what I need.

So on the whole I reckon it’s the calibre of the therapist that determines whether psychotherapy is successful or not, and that really is an imponderable - it’s so totally subjective.

Having said that, one thing I learned by reading forums like this and listening to people talk about their experiences in therapy is that it works so much better if the client can be as open as possible about EVERYTHING including confronting a T on things that are confusing or that come across as negative. And questioning every response, every comment that comes across as uncomfortable or critical - that’s the way to get a sense of whether the T is the right person or not. That means taking risks, and giving T’s the benefit of the doubt in the first place.

Easy huh? lol.

I definitely think therapy is helpful, although I've got to admit it's darn hard, exhausting, and painful work. Kind of like climbing a mountain -- every so often, it just feels too difficult and you temporarily throw yourself down on the ground and say "forget it, I can't do it anymore." But -- you're on a cliffside, so you regain your strength, pick yourself up, and move forward. From time to time, you look down and say "Hey, I've really come a long ways!" You feel the increased strength in your legs and arms. But occasionally, you wonder "If i'd known it was going to be this hard, would i have started this climb?"

I would say that it does help some people, when they find the type of therapy and the right T. Personally it hasn't helped me (yet), but I hope one day I will find a good T who 'fits' with me & doesn't tire of my slow progress so it will help. I don't think it is a quick process, but that you only realise it has helped when you look back on how you were/behaved a few years previously.

*Willow*