The Softest Science?

You may have heard therapists or others interested in mental health complain about CBT - cognitive behavioural therapy. It is, perhaps, unfortunate. It isn't really the CBT that they are complaining about, but rather the almost singular focus NHS funding has seemed to have given it. It is no surprise. CBT has a fair amount of evidence to show progress in a short time - effective and cost-effective. You can't really blame the government for seeking such a magic bullet in an overextended and underfunded situation. (As an aside, I love the NHS without reservation. I am American and I have seen the truly devastating impact of the opposite system. With its faults, which all health systems have, it is largely a competent and compassionate system.) CBT is not a magic bullet and some studies do suggest that its efficacy wanes over time. That said, people in the thick of crippling experiences like severe anxiety are not always able to throw themselves into more long term, deep therapies. CBT can be a wonderful therapy and can liberate people from the worst of their suffering in some cases. It just may be that the work is not done for some people.

The problem, inherently, is that therapists tend to think the work may never be completely done. You come to therapy, do some work, step out of it, return, and repeat. This is what many therapists themselves do - always working, little bit by little bit, at greater self-development. Of course, it is often enough for people to just get past the suffering - and then live with some of the smaller things in their life and ways of being that they struggle with. There is absolutely nothing wrong with that, but for some people the suffering will keep returning without long-term work - which does not always need to be traditional talking therapies. The nature of this very soft science of therapy - even softer than the already often maligned academic world of psychology - is that there really are no numbers that can prove or encapsulate the very qualitative measure of what therapy does for you.

Yet, there is some growing biopsychological evidence that therapy can help people better cope with things like trauma, which so often is the starting place for people's 'stuff'. There is some evidence, for example, that therapy can help brains 'recover' from things like epigentic changes from trauma that lead to overactivation of parts of the brain dealing with anxiety, stress, and depression. The article below simplifies and misconstrues the reality of psychotherapeutic theory. It is not the theory that 'fixes' people. The theory is merely a cognitive box for us to contextualise the work that therapists and clients do together. The one piece of clear, reliable, and replicable research on therapy's success is that what matters most is the relationship between the client and the counsellor. That is what is most linked to the client's sense of change and success in study after study.