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Common Misconceptions About Psychotherapy
Some of the ideas about therapy shown so often in history I find myself wondering how many writers use them deliberately and how many do not realize that they are not correct. Here are six of the most common, with some information on more standard current practice.
1. He was lying on the couch
Fact: Therapy clients don’t lie on the couch; some doctor’s offices don’t even have chairs.
So where does this come from? Sigmund Freud had his patients lie on a couch so he could sit in a chair behind their head. Why? There’s no deep scientific reason – he just doesn’t like people looking at him.
There are many reasons why today’s therapy clients will not be happy with this. Imagine telling someone about difficult or embarrassing experiences and not only not being able to see them, but having them react with silence. Why on earth would you want to return?
The best therapy plan, and they actually teach it in graduate school, is to have both seats turned inward at about a 20 degree angle (give or take 10 degrees), usually with 8 feet or 10 among them. Often the therapist and the client end up facing each other because they turn to each other in their chairs, but with this setup the client doesn’t feel like he/she is being targeted.
Even if there is a couch in the room, the therapist’s chair will almost always be turned at an angle to it.
2. Therapists analyze everyone
The truth is: Doctors do not diagnose people much more than people in general, and sometimes less.
Sadly, the only people trained in Freud’s make-the-patient-lie-on-the-couch-and-free-associate-about-Mother (aka psychoanalysis) are taught to analyze at all. All other therapists are taught to understand why people do things, but it takes a lot of energy to figure people out. And to be very honest, while therapists often take care of people who want to help their clients, in everyday life they are dealing with their own issues and don’t necessarily have the time or space to care about everyone else’s problems. or attitudes.
And the last thing most therapists want to hear about in their spare time is stranger problems. Therapists get paid to treat other people’s problems for a reason!
3. Therapists have sex with their clients
Fact: Therapists do not, ever, ever have sex with their clients, or friends or family members of clients, if they want to keep their licenses.
That includes sex therapists. Sex therapists don’t watch their clients sexually, or ask them to take an exam in the office. Therapy is often about learning and dealing with relationship problems, because those are two of the most common reasons people have sexual problems.
Therapists are not supposed to have sex with former clients, either. The rule is that if two years have passed and the former client and the therapist run into each other and somehow hit it off (ie this is not resolved), the therapist cannot be expelled from the professional organizations and they cancel the license But in many other cases the therapists will still see them as suspicious.
The reason behind this is simple – therapists have to listen and help without including their own issues or needs, which creates a power differential that is difficult to overcome.
And truth be told, the roles that therapists play in their offices are only aspects of who they really are. Therapists focus all their attention on clients without ever complaining about their own concerns or insecurities.
When people think they want to be friends, they usually want to be friends with the therapist, not the person, and true friendship is sharing strengths, and flaws, and caring for each other to some extent. Getting to know the therapist as a real person can be stressful, because now they want to talk about themselves and their own issues!
4. It’s all about your mother (or childhood, or past…)
Fact: One branch of psychotherapeutic theory focuses on childhood and the unconscious. The rest don’t.
Psychodynamic theory rejects Freud’s psychoanalytic belief that early childhood and unconscious processes are important to later problems, but many modern practitioners recognize that we are exposed to many influences in daily life that are important.
Some therapists will tell you your past is irrelevant if it is not relevant to your current problem. Some believe discussing the past is an attempt to escape responsibility (Gestalt therapy) or hide from working actively to change (some types of behavioral psychology). Some believe that the communities and the cultural environment we live in today are what cause the problems (systems, genders, and traditional treatments).
5. ECT is painful and used to treat seriously ill patients
Fact: Electro-convulsive therapy (in the past, called electro-shock therapy) is a rare, last-resort treatment for clients in and out of hospitals for suicidality, and for whom the More conventional treatment, like drugs, haven’t worked. In some cases, the client is so depressed that he cannot do the work to get better until his brain chemistry is working more efficiently.
At the time ECT was considered, some clients were eager to try it. They have tried everything else and they just want to feel better. When death seems like the only other option, having someone running through your brain while you sleep doesn’t sound like such a bad idea.
ECT is not painful, nor does it jitter or shake. Patients are given muscle relaxation, and because it is scary to feel numb, they are also placed briefly under general anesthesia. Electrodes are usually attached to only one side of the head, and the current is made in short intervals, causing a grand mal seizure. Doctors monitor electrical activity on a screen.
Seizures cause the brain to produce and use serotonin, norepinephrine, and dopamine, all brain chemicals that drop when someone is depressed. Some people wake up feeling like a miracle has happened. Several sessions are often needed to maintain the changes, then the individual may switch to antidepressants and/or other medications.
ECT is less dangerous than other procedures administered under general anesthesia, and many potential side effects (confusion, memory loss, nausea) can be as a result of anesthesia as the treatment itself.
6. “Schizophrenia” is the same thing as having “multiple personalities”
Fact: Schizophrenia is a biological disorder with a genetic basis. It usually causes hallucinations and / or delusions (strong thoughts that are contrary to traditional beliefs and are not supported by reality), with impairment in daily activities. Some people with schizophrenia periodically become catatonic, have paranoid thoughts, or behave in erratic ways. They may talk strangely, become rambunctious (verbally rambling, often in a way that doesn’t make sense to the listener) using written words (made up words), social media (rhyming) or, in more severe cases, producing word salads (sentences that sound like a bunch of jumbled words and may or may not be grammatically correct).
Dissociative Identity Disorder (which is a common personality disorder) is caused by trauma. In some situations, the usual protective technique of dissociation can be used to “divide” traumatic memories. In DID, the split also includes the part of the person’s “core” that is attached to that memory or series of memories. A separate identity often has its own name, traits, and quirks; and it may or may not age at the same rate as the rest of the population (or populations), if it ages at all.
Therefore, referring to the body as “schizo” or “schizoid” or “schizophrenic” when one means one has an alter ego or an anti-personality does not make sense (and is guaranteed to make the psychologically wise wince )!
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