process of change in psychotherapy

As small children we can’t “think,” at least in the critical sense, so how do we learn things, in the classical sense, when we can barely say ‘‘dada’’ or ‘‘mama’’? A lot of what we learn, especially early on, we learn the same way a puppy learns. Psychologists refer to this as ‘‘conditioned’’ learning.

For example, we get “potty-trained”; we get positive reinforcement or praise when we do something ‘‘right’’ and hear ‘‘no-no’’ when we mess up. We also learn how to react to people and events around us by feeling emotions — emotions we likely can’t even define or call out by name. Yet, we learn to avoid Uncle Al, but run up to hug Daddy. And all of this is conditioned learning — learning that is stored in our emotional “gut,” not in our thinking “mind.”

The problem arises as we grow older, since then we may react emotionally to someone who is much nicer than Uncle Al, but react to him as if he actually was Uncle Al! Or, to someone who is pretty nasty, as if she actually is Mommy. The point is, even though our word-thinking mind knows better, our emotional gut still reacts the same way.

As these misplaced emotional reactions replay themselves again and again, we can go through a lot of needless suffering. That is, unless we get the right kinds of “new” experiences to retrain our emotional gut and break those old patterns. That’s what psychotherapy, at its most effective, does for its patients

A psychotherapist’s job is to use the individual therapy setting (ideally, combined with group therapy) to help people experiment in a safe setting with behavior that runs counter to what their misplaced emotional reactions otherwise lead them to do.

When it works, people change in their emotional gut, not just in their word-thinking mind. Yet, just like in physical therapy, both therapist and patient must work hard and in concert. It isn’t easy and it can be painful, but this process provides more than temporary relief of symptoms.

Many people find that their whole life has been changed. Is it worth seven or eight years — and a financial investment — to live life freed from personal ‘‘demons’’ from the past? You’ll have to decide on that one.

How to determine a candidate for successful in-office treatment

At the IIGP, we attempt to help patients change in fundamental ways by working with their underlying illnesses. The relationship between patient and therapist is critical; we have to get them involved with us — similar to their experience with their original caretakers. It isn’t just one “thinking brain” to another “thinking brain.”

The therapy must be able to stimulate all types of old feelings (fear, pain, sadness, love) that we experienced — and became recorded — in our “emotional” brains early in life. But it’s not enough to just trigger a lot of these old reactions because that would simply be like salt in the wound.

Something has to go beyond that. There must be a corrective emotional experience that occurs. When a person’s strong intense emotional reactions are juxtaposed with their knowledge of reality, the feelings start to lose their grip on a person’s life. This requires that a person be able to see the reality in the midst of strong feelings: “I feel scared, yet I know there is no danger here.” Then the person has to be willing to take a step forward in spite of the irrational fear.

Because the patient needs to commit to not acting out when the feelings get strong, there are certain disorders that are not conducive to in-office therapy. For example, people with psychotic disorders and sociopathic disorders, and people with poor impulse control would be hard to treat in the office.

In-office treatment can help with issues including anxiety disorders, panic disorders, depression, relationship problems and eating disorders, as long as the patient has enough health to not live impulsively and can develop a trusting relationship with their therapist.

For more information on this subject, click here. To contact IIGP, please call (248) 353-5333 or contact us online, here.