Effectiveness of Psychotherapy

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    larc posted Tue, 26 Feb 2002 23:55:00 GMT(2/26/2002)

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    On a previous thread, the question of the effectiveness of Psychanalysis came up. Since then, I have done some research.

    A recent article* summarized the results of three literature surveys, and the author came up with the following conclusions:

    1. For major affective disorders, and major psychoses, psychpharmacological treatment works best.

    2. For symptomatic anxiety based disorders, such as phopias, generalized anxiety disorders, panic disorder, obsessive complulsive disorder, and post - traumatic stress disorder, cognitive and behavioral treatments work best.

    3. For personality disorders and complex comorbid disorders with an underlying personality disorder, long term relationship therapies work best. Among these theraputic types would be pscyhoanalysis.

    So, in the history of theraputic intervention, psychoanalysis has gone from a cure all, to one method of several that can be called upon to help in category three above.

    Misuse of psychoanalysis. Case 1. A woman with a phobia spent 10 years in psychoanalysis at a cost of $20,000 with no improvement. With cognitive/behavioral intervention she was cured in three months.
    Case 2. A woman became severely depressed and was placed in a mental hospital at the age of 28, where she stayed for two months. Talking therapy did not help and this woman had reoccuring episodes for the next 15 years. At that point, lithium treatment for manic depressives was introduced. Once this woman was put on lithium, she never had another episode again.

    * References provided upon request. I don't want to be accused of being a name dropper

    Seeker posted Wed, 27 Feb 2002 00:00:00 GMT(2/27/2002)

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    I generally agree with that. Evidently we were arguing at cross-purposes before, talking about different areas.

    Marilyn posted Wed, 27 Feb 2002 00:17:00 GMT(2/27/2002)

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    What does cognitive and behavioral treatments consist of? Is t someone re shaping your thinking?

    Marilyn

    F Lady Lee posted Wed, 27 Feb 2002 00:59:00 GMT(2/27/2002)

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    the simple answer would be that behavioral therapy focuses on your behavior (phobics would be slowly desensitized to the object of the phobia)

    Cognitive therapy would focus on the understanding of the problem and ways to deal with it.

    Both cognitive and behavioral therapies might have components of the other within the therapy but the main focus would be one form of therapy.

    MY personal opinion is that for real long-term change to occur every person needs adequate and correct information about their problem. Part of any therapy should include the cognitive component - even for those who most benefit from the medications that can do wonders for those who need them.

    Sadly not enough people are adequately informed of their problem or the possible recommended solutions.

    As for reshaping your thinking - I would say the answer is YES it does. In the hands of an ethical therapist this is a good thing. Many problems that people have stem form incorrect thinking - like the assault victim who blames herself for the assault instead of blaming the perpetrator. This is the kind of thinking that would need to change.

    Rejoice in the healing and not in the pain.
    Rejoice in the challenge overcome and not in the past hurts.
    Rejoice in the present - full of love and joy.
    Rejoice in the future for it is filled with new horizons yet to be explored. - Lee Marsh 2002

    wonderwoman77 posted Wed, 27 Feb 2002 02:36:00 GMT(2/27/2002)

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    Marilyn...as an occupational therapy student I am trained in cognitive behavioral therapy. It helps people change faulty thinking that is causing them anxiety, depression or other problems. It is really interesting. I have some more info, if you would like it email me....

    Marilyn posted Wed, 27 Feb 2002 04:37:00 GMT(2/27/2002)

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    Lady Lee and Wonderwoman, thanx for your responses. I am interested in getting more information about this. I live in Australia where therapists are often average at best. I don't want to talk too much about it here, but I would like to learn more. If either of you have more inforamtion email me on famurf@bigpond.net.au

    much appreciated
    Marilyn

    proplog2 posted Wed, 27 Feb 2002 06:48:00 GMT(2/27/2002)

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    I think cognitive therapies are good as quick band-aids. Real growth requires you discover the constitutional underpinnings of your personality. You need to know what you want out of life and your preferred way of getting what you want. You need to know what you avoid in life and your preferred way of avoiding what you don't want.
    You can never change this structure. You can only manage it - live around it.

    larc posted Wed, 27 Feb 2002 07:57:00 GMT(2/27/2002)

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    Marilyn,

    You might also check at your library or book store for books by Albert Ellis and Wayne Dyer. The are propents of the cognitive approach.

    Proplog,

    I don't know if I would call it a band aid. When people are suffering, they feel great relief once they feel normal. Once they feel much better, then they can think and plan as you indicate.

    larc posted Wed, 27 Feb 2002 08:16:00 GMT(2/27/2002)

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    Proplog,

    Let me elaborate on a point I made. For an agoraphobic who is house bound as a result of their phobia, effective therapy releases them from a self imposed slavery, not of their choosing. That is why I say that effective treatment is far more than a band aid for those who are suffering.

    F waiting posted Wed, 27 Feb 2002 12:02:00 GMT(2/27/2002)

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    Dear Larc,

    Thank you for returning to this subject. I think the average person thinks the sum of therapy as talking. Talking is a great part of it, but if the patient will do it, the therapist can/will also recommend a variety of books to further insight into the patient's situation.

    What's on the open market is not necessarily what's the most precise, correct, information available - at least 10 years ago. I asked my therapist about this (books dealing on boys being raped) - and her response was: "Books will be published for the general public what the publishers think the general public will absorb, or accept." At that time - the general public had a hard time accepting descriptive accounts of boys being raped either by males or females.

    Different therapists, if they're good, will assess the capabilities of their patients also - what techniques the patient is currently using/not using for pain/comfort, what they feel the problems really are vs what the patient thinks they are, what they've read, what they believe, and their outlook on what they expect out of therapy.

    I've known people who just say they went to therapists - and just *kinda* talked - turned into same ol' same ol' and they stopped going. Fortunately, the 2 out of 3 therapists I went to were very good. Virginia M. from Boca Raton was an RN educated (with training in family/alcohol), power-driven, female idiot.

    A "band-aid" could be considered that - or it could be a life-saving tourniquet - absolutely necessary at that time, and necessarily must be applied correctly. Both apply pressure to a wound.

    Thanks again.

    waiting

    After twelve years of therapy, my psychiatrist said something that brought tears to my eyes. He said "No hablo ingles." Ronnie Shakes

    F Lady Lee posted Wed, 27 Feb 2002 13:03:00 GMT(2/27/2002)

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    Ideally the best therapy is the one that works for you. And the best therapist is one who knows their limitations and will refer when needed.

    It has also been my experience that an eclectic therapist - meaning one who will use any and all methods available to them to help the client. This sometimes means working with a psychiatrist who can prescribe needed medication that keep the patient stable enough to do much of the hard emotional recovery work for real change to occur.

    <<I think cognitive therapies are good as quick band-aids. Real growth requires you discover the constitutional underpinnings of your personality. You need to know what you want out of life and your preferred way of getting what you want. You need to know what you avoid in life and your preferred way of avoiding what you don't want.>>

    Good therapy does exactly this - it is not a bandaid solution

    Rejoice in the healing and not in the pain.
    Rejoice in the challenge overcome and not in the past hurts.
    Rejoice in the present - full of love and joy.
    Rejoice in the future for it is filled with new horizons yet to be explored. - Lee Marsh 2002

    M ThiChi posted Wed, 27 Feb 2002 15:30:00 GMT(2/27/2002)

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    Joined 5/29/2001

    Please read "Going Crazy : An Inquiry into Madness in Our Time
    by Otto Friedrich"

    hillary_step posted Thu, 28 Feb 2002 00:38:00 GMT(2/28/2002)

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    Larc,

    I have found the best psychotherapy available is to climb the nearest 6000 metre mountain until you are quite positive that you are dead.

    Everything afterward, apart from Julio Igleses, seems to make more sense.

    Best to you and Mrs larc, as ever - HS

    PS - This is a fluff post

    F waiting posted Fri, 01 Mar 2002 02:49:00 GMT(3/1/2002)

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    with a name like "hilliary," a man kidding about fluff may be taken seriously

    waiting

    OUTLAW posted Fri, 01 Mar 2002 04:47:00 GMT(3/1/2002)

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    Hey hillary_step,Julio Igleses?(LOL)I find Enya very calming...OUTLAW

    larc posted Sat, 09 Mar 2002 12:35:00 GMT(3/9/2002)

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    On my first post, I provided a brief summary as to which methods are generally the best for treating various conditions. I pointed out that long term "relationship therapies" would only be considered for personality disorders. This infomormation was found by doing a search on "psychotherapy, effectiveness." Since then, I have done a search on "personality disorders," and found further information at a cite called, The Mental Help Network.

    At this cite, they come to a different conclusion reagarding personality disorders. They believe short term congnitive - behavioral methods are best for treating most conditions. Of the 10 personality disorders mentioned, they only suggest "group psychoanalysis" for one condition. This leads me to the conclude that psychoanalysis is almost never recommended.

    At this time, there may be a negative bias against psychoanalysis, since very few therapists use this method. It is definitely out of favor in the view of the vast majority of practitioners.

    In order to get the view of the pssychoanalysts, I contacted one in my area. We had a very pleasant talk, and subsequently he emailed me two articles he had written. The articles are very long, complex and detailed, and I am still in the process of digesting them. What I have read so far indicates that the psychoanalyst of today is very eclectic and has borrowed many tools from other approaches, which makes sense.

    On another subject: for anyone interested in learning more about the American Psychological Association, you can put APA in a search and find their official website. It is very detailed and provides, among other things, a description of eash division, and the requirements for membership.

    APA also has a printed directory of all members, which I find useful in looking up my class mates from grad. school.

    F waiting posted Sat, 09 Mar 2002 21:09:00 GMT(3/9/2002)

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    Howdy larc,

    On the subject of the name APA. Somebody was arguing back/forth with Amazing about what the initials stood for when referring to M. Singer (on mind control).

    Several variations were tossed around - until the sarcasm ended with American Poodle Association.

    In class the other day, my prof. kept referring to the APA - and I was going to tell him the variant meanings.....but I tactfully refrained. Pretty good thinking on my part, eh?

    As for psychoanalysis, as performed by Freudian followers - how is it done.....and how's it different from when somebody goes to a therapy. How does one know what kind of therapist/psych. they're getting?

    I always enjoy your posts when your in this mode, btw. Thanks.

    waiting

    ps: How much do you know about memory and the current research on both sides of the argument on it? E. Loft is the new president for the APA, and she's a strong opponent to repressed memory, so I'm assuming that the formal stand will be against it? I've read one of her books, and several of her papers on the net. Interesting, but not totally the answer, in my not so knowledgeable opinon.

    larc posted Sat, 09 Mar 2002 21:38:00 GMT(3/9/2002)

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    Waiting,

    I'll take your easiest question first. How do you know what kind of therapist you are getting? Ask them.

    How does pscyoanalysis work? Freud used several methods to get access to a person's unconscious and the traumas of early childhood that were buried there. He used hypnotism, dream analysis, and free association. He used free association the most. In this process, he might have a person free associate words or a particular set of memories at a certain time in child hood. When the therapist noted a person vering away from a subject or changing subjects, the therapist would take this a a sign of some buried trama. The goal of treatment was to break through the unconcsious barrier which would cause an out pouring of memories with a great release of emotion, called catharsis. Freud believed that with catharsis would come a cure.

    As I am reading the two papers I mentioned, it appears that modern psychoanalysis is far different than the original version that lasted at least 70 years.

    Regarding Loftis, I read her original article in American Psychologist and found it to be very impressive. I have not read the pros and cons of her ideas since then, so I can not give a fair appraisal of her work. You probably know more about this subject than I do.
    Thanks for your continuing interest.

    F waiting posted Sun, 10 Mar 2002 12:09:00 GMT(3/10/2002)

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    howdy larc,

    Just wanted to make sure you knew - I truly enjoy talking about this *stuff* with you. Sometimes class is hard when it hits on a vulnerable subject - such as memory & how it works. It's still speculative in many aspects. It's like a person swaying back & forth continually - but trying to stay centered all the while.

    My prof. was trying to get us to understand the difference between the terms subconscious vs unconscious. We couldn't see it. Then he explained that when one *buys into* someone's theories (like Freud), one has to buy the entire theory - which is hard to do, after more studies/research is done.

    So, therefore, the next person will take the same concept (such as Freudian unconscious) and rename it to fit into the expanded theory. Therefore again, still accepting some of the general principles of what Freud put forth - but not all. Then taking that partially acceptable hypothosis(?) - and putting it forth with new information.

    Until the next guy comes along.........

    Thanks for the explanation on Freudian psychoanalysis - I've, then, never been to one of them. I always assumed (and that bit me on the butt) that the therapist knew more than I. In general, that worked. But it was mainly just talking every other week for 50 min. I got many insights and I could speak freely. Also, they knew how to *center* me again - which is of utmost importance. I came in with the crappy stuff - then we'd talk about it, put it into perspective, and ....'til next time. Worked.

    waiting

    Julie posted Wed, 27 Mar 2002 19:45:00 GMT(3/27/2002)

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    This is an interesting thread.....

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