What’s the cure? What does psychotherapy do?

If my answers here seem arbitrary, I encourage you again to read the earlier pages in this website before looking at this one. (Think of how strange it might be to someone who knows nothing of the human nervous system if you try to explain to him that the pain in his leg -- sciatica -- is caused by disc problems in his back. "My leg hurts, and you want to examine my back? What kind of quack are you?")

The cure for psychological problems is increased awareness of the "other agendas" discussed in Why go. Psychotherapy is the process that accomplishes this. The less aware we are of our motives, feelings, thoughts, actions, perceptions, the more they control us and the more we stay stuck in old patterns that don’t work anymore. Relief from symptoms lies in discovering and incorporating into our constant, every-day consciousness that which is being masked, distracted from, or indirectly "acted out" in symptoms. (Take a look at the characters in Personality for examples of this process.) Virtually all psychotherapies work in this way, by expanding awareness (which is why the term "shrink" is so silly; psychotherapy is supposed to do the opposite). In fact, even when the focus of treatment is not symptom relief, when the goal is a general increase in contentment, power, freedom, happiness -- "self-actualization" it’s sometimes called -- the key is awareness.

Before you say, "But I know what I feel, do, believe": If we were perfectly aware, we would have no symptoms. [Jim, Ed, Ed - II, Evan] We would experience reasonable emotional reactions to the ups and downs of life instead of sinking into incomprehensible panic, anxiety, depression. We would behave rationally, putting our talents, intelligence, and energy towards gratifying ends. We would learn from our mistakes; we would not hurt the ones we love nor be drawn to those who hurt us. Again, if this idea is hard to swallow, take a look at the earlier pages, especially Why Psychotherapy.

Of what exactly do we need to become aware? No, not of some forgotten childhood memory; that’s too glib and rarely is the answer. Rather, we need to recontact the specific experiences -- wholly lived moments of perception and feeling, regardless of where they originated and even if not attached to specific events -- that are being both avoided and indirectly expressed via symptoms. The bully needs to become conscious not of who bullied him (if anyone did), but of his fears of humiliation and powerlessness. Only by such means can he cease the constant compensation for those fears -- the insistence on total control of people and situations, the self-imposed isolation when he isn’t assured of such control, even the phobias and panic attacks that such people can develop when they fear losing that control. The flincher, too, needs to recall that same original horror so he can stop fearing it around every corner. Think what this means: To get over his symptoms, a person must face exactly that which his defenses were created to protect him from; he must face his worst nightmare.

The good news is that this awareness is the one magic psychotherapy has to offer. I have seen it again and again, in all kinds of patients, in friends, in myself: When you feel whatever it is you spend your energy trying not to feel, you feel better and you function better. [Jim, Ed - II, Ed, Ron]

What Cures - II: Why a Psychotherapist?

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