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To Get Better Do You Need a Quick Fix or a Deep Dig?

One is a Band-Aid for now. The other is a toolkit to equip you for future use.

What Short-Term Treatments Do

In some therapies, such as cognitive behavioral therapy (CBT), you work on yourself in present time. You discover ways to alter your thinking and behaviors that lessen symptoms of distress. CBT is quick.

Gerd Altmann/Pixabay
Source: Gerd Altmann/Pixabay

In other therapies, such as supportive therapy, you get help from a therapist to get you back to where you were before you became depressed, anxious, or had other symptoms. Other treatments use medications to remove or lessen feelings of distress and restore you to your prior state of feeling and function. These are all rapid treatments.

For these therapies the assumption is twofold:

1. That you were thinking and behaving in unhelpful ways about things and this needed correcting.

2. The way you were before you developed distressing symptoms is where you should return. You should get back to your old self.

Effectiveness of Rapid Treatments

Are these assumptions beneficial for your emotional well-being for the long term for the rest of your life? Do you deserve only removal of your distress now, or an overhaul and inoculation against present as well as future symptoms and problems?

Do you need only a psychological feel better band-aid or a psychological arsenal of preventive equipment you can call up when you need to fend off and solve your emotional problems in the future?

A 1960s bumper sticker said, “Therapy Means Change, Not Adjustment.” It was true 60 years ago and still true today. Many quicker, less deep digging and less enduring psychological treatments have come into vogue and are provided to emotionally fraught people.

Currently in the USA, over the course of a year, 17 percent of the population take psychoactive medicines—over 78 million people (CCHR). Sixty-nine percent of psychologists use Cognitive Behavioral Therapy (CBT) (The New York Times), More than half of psychiatrists use CBT techniques (Psychiatric News). Far fewer therapists use long-term insight-oriented psychotherapy. Are we better off with so many people using briefer forms of treatment? Do we have less emotional distress and mental illness with these quicker fixes?

Source: Tumisu/Pixabay

In the USA suicide rates were up by 31%-58% between 1996 and 2016, especially among youth (Centers for Disease Control and Prevention). Seven percent of adults suffer with depression—17.3 million adults (National Institutes of Mental Health (NIMH). Eighteen percent of adults—40 million people—have anxiety disorders [NIMH].

Almost 1 in 8 adults and teenagers (12.7%) take antidepressants, a quarter of them for more than ten years (CDC). One-third of patients find antidepressants lose effectiveness (Johns Hopkins Medicine). It appears we are not conquering people's emotional difficulties with our briefer therapies and more people are both becoming and staying emotionally ill.

What the Deep Dig of Long-Term Insight-Oriented Psychotherapy Offers

In 40 years of doing long-term insight-oriented therapy, I discovered people need the psychological arsenal of equipment both to get better and stay better. This is developed in long-term insight-oriented psychotherapy.

I also learned that peoples’ prior “good functioning” was not usually desirable. The way people functioned before the onset of their anxieties and depressions created the problems they now had. If they returned to how they were before, they would become ill again.

To be rid of their illness everyone I saw needed help digging deeper into who they are—how they functioned, thought, behaved, dealt with emotions and how they learned to function the ways they did. They needed to change who they were, especially how they managed relationships. I am not talking about a huge change to a different personality, but tweaking.

Who You Are Is Rooted in Childhood

I discovered it was important to uncover what happened in childhood when the personality forms. That is when people learn how to conduct relationships with others. This is when we lay the groundwork for later depressions, anxieties, and substance abuse.

Gerd Altmann/Pixabay
Source: Gerd Altmann/Pixabay

I uncovered how each person was emotionally conditioned—how each was shaped to respond to parents, expected to be good, obedient, and look after others’ feelings, or to be impulsive and disregard others’ feelings and ideas. Were you expected to put yourself first, or others first? Did you learn to delay wants and needs, or expect others to give you immediately what you wanted? Who indulged you? Who failed to care for you when you needed it?

Did family treat you gingerly, believing you too delicate to withstand common stressors? Or, did they confront you with inordinate expectations and problems to solve when you were young and inexperienced? Did they believe you were so psychologically strong you could handle anything? Answers to these questions indicate the kind of emotional shaping you received and what kind of personality you have.

Personality endures and patterns learned in childhood operate in adult life. These patterns have everything to do with anxiety, depression, panic, obsessions, and other symptoms you now have.

How Long-Term Psychotherapy Provides You a Psychological Toolkit

After I helped people unearth their psychological components, I helped them improve the poorly working parts—the conditioned roles from childhood that are maladaptive. These parts operated automatically and were hidden from them. Together we made these parts conscious. Then people decided how they wanted to change to avoid the emotional illnesses they suffered.

As they practiced making changes in their lives, they gathered a psychological arsenal of ways to rid themselves of suffering. Once practiced, they had the equipment to prevent future emotional distress. In both the present and future they could employ the knowledge they gained in long-term psychotherapy. They were psychologically equipped and infused with how to prevent and minimize future psychological suffering.

They could say, “Since I am this kind of person with this legacy of childhood messages and experiences, I know I am prone to depression or anxiety when such and such goes on in my life and relationships. I know what I need to do to get better and prevent full-blown depression, anxiety or panic episodes in myself.”

Oliver Kepka/Pixabay
Source: Oliver Kepka/Pixabay

People ask how long long-term psychodynamic or insight-oriented psychotherapy takes. I use the analogy of getting braces on teeth. Teeth cannot be moved immediately. It takes several years of daily pressure to push teeth in a new direction. Psychotherapy is like that. You discover an unfolding of who you are and the changes you want to make to improve your distress.

Don’t get in a hurry. You will discover a lot about yourself and will acquire the know-how to emotionally protect yourself along the road. You will enrich your life.


Harriet Brown, "Looking for Evidence That Therapy Works," The New York Times, 25 March, 2013.

Psychiatric News, 3 February, 2006.

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