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Why Insight Is Not Necessary For Lasting Therapeutic Change

To change it is not necessary to know the cause or reason for your problem

Unfortunately, many therapists are still trained in the old school approaches of analytic or dynamic psychotherapy that traces back to Freud and his disciples. Hence, people who find themselves in the care of these clinicians will often undergo extensive and costly, psycho-archeological excavations into their past, or their "unconscious," in an effort to provide insight that is believed to be essential for progress and positive change.

The fact is, however, that insight is not sufficient nor even necessary for lasting therapeutic benefits. Thus, focusing on making specific changes in thought and action in the "here and now" instead of dwelling on the "there and then" has been proven the most effective way to go.

For example, if a person seeking help for panic attacks ends up in the care of an old school practitioner, usually after a lengthy and expensive process, it might be discovered that as a young child he or she woke up one night with a virus and couldn't find his or her parents who had stepped out for a few minutes to have a drink with a neighbor. AH HA! This epiphany, then, will likely be proffered as the explanation for why panic is a problem today because it stems from unconscious, rejection and abandonment anxiety that originated in early childhood.

But even if that's true, it won't stop the panic attacks. What will beat panic is learning that panic sensations are uncomfortable but not dangerous (i.e., cognitive relabeling); how to do corrective breathing and relaxation (i.e., skills training); not avoiding anxiety provoking situations (i.e., behavioral change); and gradually triggering panicky feelings so with practice they can be neutralized (i.e., exposure). Thus, rather than trying to understand the reasons for one's problems - the WHY of it - learning corrective thinking and corrective action - the WHAT to do about it - is almost always the most effective approach to take. In other words, it is specific treatments that help patients, not theories. We don't treat people with theories which may or may not be correct, we help them with methods and techniques that have been proven to be safe and effective.

To underscore this very important point further, consider that when penicillin entered the market in the 1940's it's mechanism of action - how it cured infections - was poorly understood. What's more, the cause of most infections was similarly shrouded in mystery and misunderstanding. For instance, some doctors believed that pneumonia was caused by an imbalance of the body's fluids. This "humoral disequilibrium" was corrected by the introduction of penicillin. Other doctors believed pneumonia was caused by the body's electrical balance being disturbed and because of its electromagnetic properties, penicillin restored the body's natural, electric balance. Still other physicians thought that pneumonia was due to an infectious germ that penicillin killed.

Still, no matter what a doctor believed the cause of pneumonia was - fluids, electricity, or germs - if he or she administered penicillin to the patient, the patient was usually cured. Thus knowing WHAT to do was far more important than knowing WHY the patient was ill.

Today, many therapists believe that panic (and virtually all psychological problems) are caused by early, childhood experiences and the dynamics of one's family of origin. Many others believe it's caused by a neurochemical imbalance. Still others maintain panic is a conditioned response that is learned and reinforced by certain behavioral patterns.

Nevertheless, regardless of what a therapist's pet theory is about the root cause of panic, if he or she helps panicky clients with the proven methods of CBT, more than 80% of the time they will (often quickly) conquer their panic without the use of medication. This is also true of most other psychological difficulties, not only panic.

To sum it all up, to change your life it is necessary to do something in the present rather than trying to figure out the past.

Remember: Think well, act well, feel well, be well!

Copyright Clifford N. Lazarus, Ph.D.

For the interested reader, here is a link to beating panic with CBT.…

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