Wednesday, March 9, 2016

Therapies – how to choose the best one

As with any other aspect of life, therapies and therapeutic approaches are subject to time – be it the contemporary developments of science and research, the newest fad, the current focus of society and what has become more important for people at any given time.

Recently something started to change, in a very gradual way, until it became very visible. Psychoanalysis started to be taken seriously, again. Not that Freud ever faded from our collective memory. His iconic image, the typical jokes about him (usually involving repressed memories about caregivers or sexual innuendos, or both), and the global image of the ‘hm-hm’ therapist who simply sits there, are still all over books, movies, TV shows, memes, gifs, you name it.

Not only in popular culture have Freudian ideas been present, but also in scientific research. From time to time it’s possible to find articles that still aim to either prove or disprove Freud, especially in the neurosciences. But psychoanalysis is not merely Freud, and a lot has evolved since his early ideas about people, the mind and relationships; a lot has changed since the 1800s, and that includes psychoanalysis itself, obviously. To try to hold on to those early steps of a theoretical body and to try to disprove it by, for example, scanning the brain to find physical proof of the psychic apparatus (super ego, ego and id – which are concepts and not actual parts of the brain), seems to be a waste of time.

Earlier this year several articles posed the question: Are there still things to learn about psychoanalysis? This shift might have occurred because research is showing that if we consider improvements over the long term, some more (modern) empirically based therapies are not as effective as once thought and psychodynamic therapies do look better, particularly when you’re not thinking short term and you aim for a deeper understanding and lasting effects. If we really think about it, psychotherapy isn’t easy for anyone, so it makes sense to make it really worthwhile and just dive deep.

Interestingly enough, researchers are also coming to the conclusion that the most important factor for effective change in therapy is mainly linked to the quality of the relationship established between client and therapist, and not so much the techniques or theoretical approach. That makes sense. When dealing with painful things, change is much more likely to occur if it happens in a safe, caring environment.

So, more than choosing a specific approach, it might be better to choose the therapist you feel most comfortable with, who eventually gives you clues that she/he actually cares for your well-being and progress and is trying her/his best, even if she/he is not perfect.

Lea Pereira