Episode 3: Does therapy help?

There are so many forms of therapy today that it can be hard to decide which is best for you. One of these types is “psychotherapy,” which sounds a lot scarier than it is. In this episode of “Ask a Psychiatrist” we learn about what psychotherapy is, how it can benefit your thought life, and why fears about undergoing psychotherapy still persist.

Dr. Erik Messamore explains the history of psychotherapy and how Freud’s findings dominated professional psychiatric thinking for decades. After about the 1960s or so, Dr. Messamore explains, psychology underwent enormous strides to get us to our modern psycho-pharmacological thinking. And it is better than it’s ever been.

Discussing both the therapy methods and our evolving understanding of psychoactive drugs, Dr. Messamore tears away the veil and shows why psychotherapy is nothing to be afraid of. Differing from “supportive listening,” true psychotherapy targets the causes of psychological symptoms and provides a framework for handling them in your day-to-day life. Whether or not medications are necessary is decided on a case-by-case basis, but the interesting thing is that the relationship between your thoughts and your brain chemistry is reciprocal. Mood-altering drugs can “correct” brain chemistry, but so can corrective thoughts. What each person needs for their own therapy will vary.

Overall, psychotherapy is not a form of healthcare that should be feared. Your doctor will help you feel safe, comfortable, and help you to understand every step of the therapeutic process. To fear this is to miss out on great work you can do in your own life.

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KEY TAKEAWAYS:

• (03:00) – Fear of psychotherapy is common—but it can be overcome.
• (05:30) – Freud developed a technique called ‘psychoanalysis’ to understand underlying urges in the subconscious
• (09:00) – Today, there are many psychotherapeutic approaches that don’t require dredging up the past.
• (10:30) – The notion of “chemical imbalance” has a convoluted history.
• (15:00) – Chemical changes can constrain thoughts—but thoughts also affect brain functioning.
• (17:15) – Evidence-based research today has been able to improve the brain’s “wiring,” enabling more effective connections between the parts that generate emotion and the parts that regulate emotion.
• (19:00) – When Dr. Messamore asks his patients if they have ever done any psychotherapy, and they too often say no.
• (21:30) – It’s important to be given an explanation, in psychological terms, as to why symptoms are being produced. Psychotherapy would give patients a set of techniques to apply to their own situations.

• (23:45) – The data has shown that psychotherapeutic techniques can help patients get well.
• (25:30) – There should be measurable and noticeable improvements through proper therapy.
• (27:20) – A good therapist should be able to tell you all about the process and point you to the right research.
• (29:20) – Most people who enter the field are going to be looking out for your well-being.

QUOTABLE:

• “Freud’s view was that these top-level symptoms have, at their origin, a conflict between the id and super-ego.”
• “Psychoanalysis is a valuable and rich form of therapy, but it’s certainly not for everyone.”
• “The research points to psychotherapeutic approaches that focus on the here and now.”
• “Saying antidepressants correct a chemical imbalance is extremely over-simplified and probably not applicable to every person experiencing a psychiatric symptom.”
• “For a person with depression, and who feels like a failure, it’s much easier for them to believe that they may have just made some mistakes than to believe that everything is going to be alright.”
• “The data shows that the people who practice these techniques become well. They get better at regulating their own emotions.”
• “The right therapy should be deployed for the right condition.”
• “The goal is to be comfortable, and it’s your therapist’s job to guarantee that.”

About the Host:

Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.