Do you think therapy consists of staring at your navel? Think again


In the middle of a recent lecture about my research in psychology, a brilliant graduate student asked a familiar question.

“I’ve heard that psychotherapy makes people more self-centered,” they said. “So how can you encourage a practice that has such a negative social impact? »

I am often struck by these negative stereotypes, despite the growing demand for advice – especially in the midst of the pandemic. The ingrained image seems to be that psychotherapy is an indulgent, narcissistic cocoon where therapists allow patients to “stare at the navel” and blame others for their problems.

Full disclosure: I have seen examples of this in my 27 years of practice. But most patients are genuinely trying to improve their close relationships, regain meaning and purpose, and live consistent with their core values. Mental health care often focuses on reducing patients’ symptoms. However, a growing body of research, including a project I co-lead with psychologist Jesse Owen, is investigating therapeutic approaches that also focus on increasing patients’ overall sense of well-being, or “thriving.”

In many times and places, these types of concerns would be considered part of character development, or of an ethical or religious nature. In fact, a large body of research shows that most people want to address spiritual, religious, or existential issues in mental health treatment, and that psychotherapies that engage patients’ spiritual practices are effective for mental and spiritual health. .

Dual factor treatment

Decades of research show that psychotherapy is effective in relieving the most common forms of psychological suffering, such as anxiety and depression. But well-being is not just about reducing suffering.

Over the past three decades, the field of positive psychology has grown, emphasizing how people can foster their strengths, virtues, and well-being. Many thinkers, such as psychologist William James and minister and author Norman Vincent Peale, explored similar ideas in the 20th century. But now, empirical research has demonstrated that counseling informed by positive psychology can be effective in improving well-being and increasing qualities such as forgiveness, compassion and gratitude.

The project I co-lead with Owen, funded by the John Templeton Foundation, is part of a growing trend of researchers seeking to integrate positive psychology, spirituality, and holistic wellness practices into mental health care, paying particular attention to individual patients. ‘ different needs.

For example, Mary Zanarini, international expert on borderline personality disorder, is testing group therapy that builds skills in virtues such as forgiveness, humility and gratitude, as well as other strategies, such as reflective and the regulation of emotions.

In a 2020 study of patients diagnosed with borderline personality disorder, she found that patients’ ability to forgive and accept correlated with their long-term ability to maintain work or school and a close relationship, in addition to the remission of their symptoms.

In a separate clinical study with patients who also suffered from borderline personality disorder, my colleagues and I also found that as patients developed a greater ability to forgive, they experienced fewer mental health symptoms and less anxiety and frustration in close relationships.

These projects reflect a move toward what psychologists call two-factor approaches, which reduce symptoms of mental distress while trying to increase fulfillment.

Two-factor frameworks recognize that mental health symptoms and well-being are not mutually exclusive. For example, in a study of patients between the ages of 18 and 29, our team at Boston University identified a subgroup of patients that we termed “resilient”. They showed the highest rate of symptoms, the lowest levels of life satisfaction, and multiple severe stresses. Yet this resilient group functioned better in relationships, at work, or at school than expected. During treatment, many have moved into the “thriving” category.

Cultivate your strengths

So what contributes to resilience in the face of suffering? A few months into the pandemic, we examined this question in a follow-up study of adults.

Similar to the previous study, people in one group had a higher wellness score than expected, given their mental health symptoms. They showed courage, finding opportunities for growth even in the midst of stress. Those in another group, who were also functioning better than expected given their mental health symptoms, demonstrated active forms of coping, such as deepening relationships or developing new hobbies, spiritual practices or creative interests.

Philosophers from many different cultures have suggested that humans evolve toward fulfillment by cultivating virtues in the midst of hardship. The word “virtue” can imply rigidity or perfectionism, but its original meaning is to tap into human strengths and practical wisdom to navigate life – like the courage that participants showed in our study.

Humility, gratitude, and forgiveness are what some psychologists call “relationship virtues,” those that promote healthy relationships. Our team is studying how these three virtues could contribute to positive mental health over time.

Our initial evidence across two clinical studies is that patients generally tend to become less narcissistic and feel less superior to others during psychotherapy. As patients develop more humility, their relationships improve and they report fewer symptoms of anxiety and depression.

feel connected

For many people, relational virtues are linked to their spiritual or religious practices, which are themselves important for the well-being of these patients. Among those who value spirituality, a sense of being connected to the sacred was positively related to their overall functioning.

Based on our research, a key factor linking virtue and positive mental health appears to be growth in emotion regulation, such as learning mindfulness skills and dealing with complicated emotions such as shame, fear, and feelings. envy or pride. Our theory is that relational virtues often emerge in therapy when patients experience a balance of challenge and support and their core values ​​are taken seriously.

We need a lot more research to further validate these links between relationship virtues, emotion regulation, and fulfillment. But there are already enough data points to paint a more complicated and constructive public picture of psychotherapy than the cynical stereotype.

This article is republished from The Conversation, an independent, nonprofit source of news, analysis, and commentary from academic experts, under a Creative Commons license.


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