Stop expecting therapy to fix you
Summary
TLDRAna Udin, a Clinical Psychology doctor and fiction author, challenges the expectation that therapy can 'fix' mental illness. She outlines the evolution of therapy from Freudian psychoanalysis to modern CBT, emphasizing therapy's role in symptom management rather than cure. Udin advocates for a holistic view of mental health, integrating emotional acceptance and personal growth, and warns against the pitfalls of seeking quick fixes, which can exacerbate suffering.
Takeaways
- đ Therapy's Evolution: The field of therapy has evolved from psychoanalysis to humanistic, existential, systemic, and cognitive-behavioral approaches.
- đ§ Freud's Influence: Sigmund Freud's theories about the conscious and unconscious mind, and the ego, superego, and id, have had a lasting impact on psychology, despite some being debunked.
- đ Jung's Expansion: Carl Jung expanded on Freud's work, introducing the collective unconscious and the significance of shared symbols and mythology.
- đ€č Humanistic and Existential Therapies: These therapies focus on the individual's expertise in their own life and the search for meaning, rather than 'fixing' the person.
- đ Systemic Family Therapies: These therapies consider the individual within the context of their relationships and system, acknowledging the roles people play in each other's lives.
- đ§ CBT's Dominance: Cognitive-behavioral therapy (CBT) is currently the most researched and evidence-based approach, focusing on thoughts, emotions, and behaviors.
- đĄ Therapy's Limitations: Despite being evidence-based, not all therapies are easily quantifiable, and some are more about long-term insight than symptom reduction.
- đ Resistance to Pain: The script emphasizes that resistance to pain and emotional struggles often exacerbates suffering, rather than alleviating it.
- đ Embracing Darkness: The idea that experiencing and understanding one's 'darkness' or emotional struggles can be a part of the healing process is highlighted.
- đ€ The Therapeutic Relationship: A key aspect of successful therapy is the relationship between the therapist and client, which is unique and facilitates growth and understanding.
- đ± Flourishing Mental Health: Mental health is not just the absence of illness but a state of living with meaning, joy, gratitude, and connection, including resilience and self-compassion.
Q & A
Why does Ana Udin believe that therapy cannot fix mental illness?
-Ana Udin suggests that therapy cannot fix mental illness because it has evolved to address different aspects of mental health, and the expectation of a quick fix is misguided. Therapy aims to help individuals understand and manage their mental health rather than providing a cure.
What is the historical context of therapy according to the script?
-The script outlines the history of therapy starting from the Victorian era with psychoanalysis by Freud and Jung, moving to humanistic and existential therapies in the 1950s, and then to systemic family therapies and cognitive-behavioral therapy (CBT) in the 1960s.
What are the key concepts introduced by Freud and Jung in psychoanalysis?
-Freud introduced the concept of the conscious and unconscious mind, as well as the structure of the mind with the ego, superego, and id. Jung expanded on Freud's concepts by introducing the collective unconscious, shared symbols, and the influence of mythology.
What is the main focus of humanistic and existential therapies?
-Humanistic therapy focuses on treating the client as the expert of their own life, while existential therapy aims to help clients find meaning in their lives, rather than just fixing or curing them.
How does Ana Udin describe the approach of cognitive-behavioral therapy (CBT)?
-CBT focuses on cognitions, behaviors, and emotions, examining how thoughts influence emotions and behaviors, and correcting distorted thoughts to promote more adaptive behaviors and emotion regulation.
Why did Ana Udin initially favor CBT over other forms of therapy?
-Ana Udin initially favored CBT because it was considered the gold standard of therapy with the most extensive research and evidence-based outcomes. She was skeptical of other forms of therapy that seemed less tangible and quantifiable.
What changed in Ana Udin's perspective on therapy as she progressed in her career?
-As Ana Udin delved deeper into her studies and therapeutic experiences, she realized that she aligned more with psychodynamic therapy, appreciating its focus on the deeper, underlying issues rather than just addressing symptoms.
What is Ana Udin's view on the role of quick fixes in therapy?
-Ana Udin believes that seeking quick fixes in therapy can augment distress rather than alleviate it, as it often leads to resistance and avoidance of the underlying issues, which can transform pain into suffering.
How does Ana Udin define good mental health?
-Good mental health, according to Ana Udin, is not just the absence of mental illness but a life filled with meaning, joy, gratitude, flow, and beauty. It includes having quality relationships, self-compassion, resilience, and authenticity.
What is the role of the therapist in the therapeutic process according to the script?
-The therapist's role is to provide a special relationship that includes walking with the client through their struggles, offering evidence-based interventions, psychoeducation, and emotional processing within a safe and structured environment.
Why does Ana Udin argue that AI will not replace doctors?
-Ana Udin argues that AI will not replace doctors because there will always be a need for a human element in healthcare, where patients can find someone to blame when issues aren't resolved, reflecting the societal expectation for accountability in health outcomes.
Outlines
đ The Evolution and Misconceptions of Therapy
Ana Udin, a Clinical Psychology doctor and fiction author, discusses the common misconception that therapy can 'fix' mental illness. She provides a historical overview of therapy, starting with psychoanalysis in the Victorian era, through the contributions of Freud and Jung, to humanistic and existential therapies, and finally to cognitive-behavioral therapy (CBT). Ana emphasizes that therapy has evolved from exploring the unconscious mind to treating individuals as experts of their own lives and correcting thoughts and behaviors for better adaptation. She also challenges the myth that all therapies are evidence-based, highlighting the importance of different therapeutic approaches.
đĄ Rethinking the Goals of Therapy and Mental Health
The script addresses the societal shift towards expecting quick fixes for complex mental health issues. Ana criticizes the hyper-empirical approach to health that has devalued emotional and qualitative aspects. She discusses the impact of insurance companies on therapy practices, favoring short-term symptom reduction over long-term insight. Ana argues that mental health is more than the absence of illness; it involves living a life filled with meaning, joy, and connection. She introduces the concept that successful therapy is not about curing symptoms but about helping individuals flourish despite their struggles.
đ Embracing the Inevitability of Mental Anguish
Ana explores the idea that mental anguish is an inevitable part of life and that resistance to it can exacerbate suffering. She differentiates between pain and suffering, emphasizing that while pain is unavoidable, suffering arises from resisting this reality. Ana uses the book 'Forged in Darkness' to illustrate how confronting and understanding one's inner darkness can lead to growth. She argues against the modern tendency to sanitize and control darkness, advocating instead for a psychology of depth that acknowledges the unknown parts of ourselves.
đ€ The Role of the Therapeutic Relationship in Healing
In the final paragraph, Ana Udin emphasizes the importance of the therapeutic relationship in the healing process. She explains that while therapy cannot provide a quick fix, it offers a unique and valuable relationship that supports individuals in their journey towards mental health. Ana points out that the success of therapy depends on the client's active participation and willingness to change. She concludes by stating that therapy is not about curing but about helping individuals manage their mental health and live fulfilling lives, even with the presence of mental illness.
Mindmap
Keywords
đĄTherapy
đĄMental Illness
đĄPsychoanalysis
đĄHumanistic and Existential Therapy
đĄSystemic Family Therapies
đĄCognitive Behavioral Therapy (CBT)
đĄEvidence-Based Therapy
đĄPsychodynamic Therapy
đĄResistance
đĄMental Health
đĄFlourishing
Highlights
Ana Udin, a doctor of Clinical Psychology and fiction author, discusses the misconception that therapy can 'fix' mental illness.
The history of therapy is explored, starting with psychoanalysis in the Victorian era and Freud's theories on the conscious and unconscious mind.
Jung's expansion on Freud's work by incorporating symbolism, mythology, and the collective unconscious is highlighted.
The emergence of humanistic and existential therapy in the 1950s, focusing on the client as an expert on their own life.
Systemic family therapies and CBT in the 1960s, emphasizing relationships and the interplay between thoughts, emotions, and behaviors.
CBT is considered the gold standard of therapy due to extensive research and evidence-based practices.
Ana's personal journey from favoring CBT to aligning more with psychodynamic therapy for its focus on deeper issues.
The societal shift from viewing therapy clients as 'patients' to 'clients' reflects a change in the approach to mental health.
Critique of the expectation that medicine should provide quick fixes for all health issues, including mental health.
Ana argues that AI will not replace doctors due to the need for human accountability in healthcare.
The difference between pain and suffering is explained, with suffering resulting from resistance to pain.
The importance of not sanitizing darkness and embracing the messiness of life for personal growth is emphasized.
Ana discusses the limitations of surface-level psychology that fails to address deeper emotional and spiritual aspects.
Mental health is defined not just by the absence of illness but by a life filled with meaning, joy, and connection.
The role of the therapist is to facilitate change, but the responsibility for healing lies with the individual.
The unique value of the therapeutic relationship in the process of healing and personal growth.
Ana concludes by stating that therapy is not about a quick fix but about managing and flourishing despite mental health challenges.
Transcripts
I'm Ana Udin I'm a doctor of Clinical
Psychology and a fiction author and
today I want to talk about why therapy
cannot fix mental illness why therapy
won't fix you like so many people these
days expected to which might be a little
bit surprising to hear from someone
who's a doctor of Clinical Psychology
but allow me to explain
[Music]
in order to understand why therapy won't
fix you we have to look at a history of
the field of therapy the field of
therapy first emerged in the Victorian
era in the 1890s when psychoanalysis was
born through Titans in the field like
Freud and Jung Freud the father of
psychology believed that we have a
conscious mind and an unconscious mind
he also believed in the structure of the
Mind split up into the ego super ego and
ID he was a very prolific writer so he
had a lot of opinions a lot of them have
been debunked in this day and age but a
lot of them were also very
groundbreaking and are still useful
today such as the concept of the
unconscious Jung was one of his
followers who I think came to surpass
him I'm personally much more of a yian
person than a Freudian person Yung
expanded on Freud's concepts by looking
at symbolism and mythology and the
collective unconscious as he called it
not just the personal unconscious shared
symbols and meaning and images that we
have throughout humankind psychoanalysis
reigned for the first few decades and
then in the 1950s came something called
humanistic and existential forms of
therapy these were basically a reaction
to some of the
pathologizing hierarchical nature of
original psychoanalysis the humanistic
Parts focused more on treating the
client as the person who is the expert
on their own lives who isn't somebody
that we need to you know analyze and
tell them everything that's wrong with
them and how they don't know themselves
well like psychoanalysis in its early
stages did existential therapy goes kind
of hand inand with humanistic therapy
it's really focused on helping the
client make meaning of their lives and
again not with the purpose of fixing
them or bringing awareness necessarily
to something that's unconscious in the
1960s came systemic family therapies and
in the 1960s also arose CBT cognitive
behavioral therapy systemic family
therapies acknowledge the relationships
between different people in a system not
looking only at the individual but also
the different roles that people play in
relationships with each other cognitive
behavioral therapy in turn was very
different from humanistic existential
therapy in that it focused on cognitions
behaviors and emotions looking at how
our thoughts influence our emotions and
our behaviors correcting distorted
thoughts behaving in more adaptive ways
regulating emotions and CBT is now the
gold standard of therapy meaning it has
been most extensively researched in
scientific studies it's considered the
most evidence-based now if you went to
school for therapy you probably
understand that that is a myth that
actually all therapies are
evidence-based and just because some
operate on Concepts that aren't as
tangible and easily quantifiable such as
making meaning or the unconscious that
that doesn't mean they're not effective
forms of therapy you can see from this
that the field of therapy went through
an evolution over the course of its
short existence it went from
understanding that there is a dark side
of us there's an unconscious that must
be accepted and must be brought to light
to validating a person as a human being
to acknowledging that a person is part
of a system and to correcting a person's
thoughts and feelings and behaviors to
be more adaptive I was very much gung-ho
for CBT in the early stages of my career
I thought that psychoanalysis was stupid
I remember when I took a class on
psychodynamic therapy I was very upfront
about the fact that I was skeptical
about a lot of the concepts in there and
my Professor actually commended me on
having a very open mind about it despite
my bias and the deeper I got into not
only grad school but also my own
therapeutic experiences the more I
realize that I actually align a lot more
with psychodynamic therapy those earlier
forms of therapy because I came to
realize that a lot of the interventions
I was doing with clients and a lot of
the interventions that I was myself
doing in therapy were very cerebral and
a lot of times would just sort of
pivot the problem to something else the
problem would just jump from one thing
to another without ever resolving
because it wasn't going deeper for
instance in the early stages of grad
school I remember that a lot of the
interventions I would do were like
cognitive challenging getting clients to
sort of talk back to their inner critic
and I still think that that's a decent
intervention to try if you have a
powerful inner critic but what I
realized later on was that I was
actually avoiding sitting with my own
emotions and sitting with my client
painful emotions and in doing so I
wasn't truly getting at the root of the
issue and so I became somebody who
self-identified as more psychodynamic
although I still see a lot of value in
CBT interventions and I think they can
be helpful in the short term I think
that they also need to be balanced out
with something that causes long-term
insight and progress so the problem I
think is that as the science is Advanced
including psychology but also others you
know medicine as well in the second half
of the 20th century we began expecting
medicine to sort of solve every
pathology and we began to take a very
hyper rational hyper empirical approach
to health and wellness they completely
disregarded it and devalued the more
emotional qualitative intangible aspects
of Health it's very much reflected in
the shift from how we went to calling
people patients to calling them clients
patient in its original form just means
somebody who suffers a sufferer whereas
a client is somebody who pays for a
service this this perfectly exemplifies
what I think is wrong with the way we
approach mental health today is that in
therapy we went from seeing people who
come to therapy as people who are
suffering who are in need of help to
somebody who's going to pay for a
service and we see so much litigiousness
at least in the United States against
providers of all kinds all kinds of
doctors and therapists even when there
wasn't any sort of like recklessness or
when there wasn't anything wrong done by
the provider simply because people are
Bec frustrated with the notion that
providers can't fix them that not
everything can be fixed this is why I
think AI will never replace doctors
because when you use AI you see all
these disclaimers about how they're not
responsible for giving you accurate
information and all that Society wants
somebody to blame when issues aren't
resolved when something goes wrong there
will always need to be a doctor on the
other side of that because there needs
to be a person that people can blame
when they don't have a quick fix and I
think scientific methods also started to
prioritize therapies that gave brief
periods of symptom reduction that were
often followed by relapse I mean when
you look at what evidence-based therapy
means very rarely do studies look 10
years out 20 years out to see if that
person relapsed and insurance companies
oftentimes only compensate therapists
who provide such treatments that were
shown to be short-term effective because
Insurance wants to pay therapists as
little as possible so they want
something quick that's going to fix the
problem as opposed to helping the people
with insurance make more meaning gain
more insight on themselves move through
the world in a healthier way now the
insurance companies don't care about
that okay the insurance companies just
want to spend as little coin as possible
but here's the harsh truth health is not
Eternal just like we will all eventually
experience a decline in health and
ultimately die either due to acute or
chronic illness we will all also
experience moments of mental anguish
sort of emotional death as it were and
the case of mental illness it's a little
bit different from physical illness
because most people won't meet our end
because of it you know it's not actually
going to end us and instead of
clustering towards the end of our Lives
mental anguish usually tends to cycle
throughout our lives we have periods of
up and down the problem is that we in
modern society want a quick fix to
problems that cannot be fixed and a
quick end to pain that we will have to
endure no matter what there's a
difference between pain and suffering
pain is inevitable suffering is when we
augment our Pain by resisting it by
resisting the inevitability of it and I
think so much of what is wrong with the
way people approach therapy these days
is they're approaching it with
resistance they're approaching it with
avoidance of their struggles they say
cure me now I want to get rid of these
symptoms I want to feel better now in
taking that attitude you are ironically
transforming your pain into suffering
not distancing yourself from the pain a
few months ago I read this book forged
in darkness by Dr Joanna leade
fascinating five-star jungian book all
about how experiencing these periods of
Darkness can be analogous to traveling
into the underworld of your ssy and it
uses a lot of Mythology and symbolism to
exemplify that point I'd like to read a
couple of sentences from this book that
illustrate my point the modern
preoccupation with consistency and
containment teaches us to regard
contradiction as negative we sanitize
Darkness covering it for the sake of
control we think psychology is a way to
be saved from the messiness of suffering
really the messiness of life but
suffering is a part of what makes us
human if we put energy into avoiding the
underworld we miss the fecundity that
can help us heal and grow we banish the
ineffable in service of clarity avoid
the unexplainable in favor of what we
can engage with tangibly and neglect the
symbolic for the concrete a psychology
of depth sits uneasily in the western
mind mainstream psychology deals with
the surface treating symptoms without
diving deeply to discover their source
yet despite repression neglect or quick
fixes the demand of the inner World
insinuate their way into our lives
expressed as symptoms compulsions
depression and Neurosis surface
techniques often ignore the deeper
unknown parts of ourselves the realm of
meaning spirituality imagination emotion
Soul dreams and darkness none of this is
to say that symptoms of mental illness
cannot be reduced whether you choose to
go to therapy taking the connection
course buying the mental health bundle
using my journaling workbooks or any
other other resource there are ways to
reduce your distress and improve the
impairment and functioning caused by
mental illness or just mental struggles
but you have to remember that some forms
of mental distress are incurable for
example the grief that you feel When
Somebody Loved dies nothing is going to
cure that except time and processing
also you have to remember that seeking a
quick fix will only augment your
distress because remember pain times
resistance equals suffering and thirdly
mental health is more than just the
absence of mental illness let's break
this all down seeking a quick fix will
only augment your distress what do I
mean by this again anytime we want a
quick fix for something we are
practicing resistance of reality and
resistance of reality is what transforms
pain into suffering for example look at
panic disorder disorder on the surface
is a person who experiences panic
attacks but that's not what it is panic
disorder is a person who is afraid of
experiencing panic attacks and in doing
so triggers more panic attacks panic
disorder is basically fear about fear
resistance to fear what about OCD OCD is
basically a fear of discomfort and a
fear of uncertainty practicing
resistance towards those things if
people with OCD could acknowledge that
sometimes they're going to be
uncomfortable or sometimes there's going
to be uncertainty about safety they
might not meet criteria for OCD anymore
narcissistic personality disorder is the
resistance of One's Own imperfection
boardline personality disorder can be
conceptualized as the resistance of the
possibility of being abandoned of being
alone you see almost every mental health
disorder an issue is not caused by the
darkness that it consists of it's caused
by the resistance to the darkness most
disorders are disorders of resistance
not of pain but how do we Define what is
successful therapy and what is good
mental health one perspective is that
it's the absence of mental illness and
this is kind of equivalent with the
medical View that you're healthy when
you go into remission from cancer or
when you bounce back from a cold the
problem with this way of defining health
is that it doesn't account for incurable
illnesses like autoimmune disorders
cancer that can't be beat chronic
illness so is a person unhealthy just
because they have endometriosis are they
unhealthier than a person who has no
illnesses that we know of but also
doesn't do anything to let their body
and mind flourish that doesn't quite
make sense to me what do you think
alternative perspective is that mental
health is not just the absence of
illness but rather a life filled with
meaning with joy gratitude flow Beauty
that's why all of the prompts in a
season of Life are meant to evoke more
of these things because it's not just
about surviving it's about flourishing
mental health is also about having
quality relationships healthy
interpersonal patterns a life filled
with connection also about having
self-compassion having compassion for
other people having a sense of
self-efficacy like you can accomplish
the things you set out to do having the
ability to get back up after period of
hardship you know resilience having
authenticity feeling aligned with your
values having self-awareness treating
yourself and others kindly in this way
of defining mental health a person could
still meet criteria for a mental health
diagnosis or have symptoms of something
and they would still be healthy just
because they struggle with a mental
illness doesn't mean they're unhealthy
viewing things in this way can be
inclusive of the person living with
bipolar disorder who may always need to
keep an eye out for periods of
depression or Mania their whole life or
the person who experienced trauma and
still manages to have a fulfilling life
or people with a diagnosis that can't be
cured like something neurodevelopmental
something neurod degenerative after all
which of these two people are healthier
a person with ADHD who's trying to live
a full life or someone who doesn't meet
criteria for any disorder but has none
of the characteristics I just mentioned
of somebody who flourishes this is why
most therapists don't aim to cure
clients anymore because curing symptoms
no longer meeting criteria for a
diagnosis is not the whole point it's
not what health is and here's another
way that physical health is different
from mental health and why we can't
really take a purely quantitative
medical approach with it a physician can
to some degree manipulate the elements
of the body the muscles the bones the
skin the blood vessels the organs
including the brain but a therapist
cannot directly manipulate the elements
of the psyche the thoughts the feelings
the behaviors the motivations attention
perception defense mechanisms a
neurologist works on the tangible
aspects of the brain but a therapist
works on the abstract aspects of the
Mind the brain and the mind are two
different things the only person who can
directly control and manipulate their
mind is the person to who the Mind
belongs a therapist can only use certain
interventions that maybe indirectly help
a person to do that but at the end of
the day it's up to the sufferer the
patient themselves to take actions that
will change the way their Mental Health
Works that will change the way their
mind works all it will power call it
personal responsibility call it
Consciousness the spirit the soul
whatever you want to call it only that
person can really heal their mind let me
give you an example what do you think
this person's chances of healing are
somebody with depression goes to a
therapist they smirk at the
interventions they don't do the homework
they don't reflect on the insights
gleaned they don't try to pay attention
to new things they don't try to take
part in new behaviors or new ways of
thinking or responding to their feelings
do you think their chances are very
strong no because the onus is on them to
directly change the way their Mental
Health Works and in refusing to do so
and saying well my therapist is going to
fix me it's not going to fix anything
you have to fix you does this mean the
therapy is pointless absolutely not
studies show that all of the main
accepted therapies all of the types of
therapy I described are better than
Placebo and have similar Effectiveness
overall though some are effective for
different things the common feature of
what works in therapy is the
relationship between the patient and the
therapist somebody who walks with you in
your underworld cares about what happens
to you who makes you feel like you
matter who teaches you better relational
patterns who you can trust even with the
darkest parts of you this is different
from any other relationship because it's
a one-sided focus on you accompanied by
evidence-based interventions and
psychoeducation and skills that can help
you and emotional processing by somebody
who's trained to be sensitive with very
specific boundaries that they're willing
to uphold who's somewhat objective
because they don't know anybody in your
life doesn't feel like you're being
burdensome because it's literally their
job they get Fair compensation for the
work that they do so this is a very
special relationship that you can't just
get anywhere else therapy can be very
valuable all I'm trying to say here is
that you cannot go into therapy
expecting a quick fix you cannot expect
to never experience mental anguish in
your life some types of mental anguish
are here to stay and you can live with
them and manage them and even flourish
despite them everything in life is about
polarity and Cycles everything in life
is going to be about about cycling
between light and darkness cycling
between moments of flourishing and
moments of distress of Underworld of
diving into the unconscious and into the
dark parts of you and that is normal and
the more you will resist those dark
parts of you the stronger they will get
because the more you're turning your
pain into suffering I hope this made
sense let me know what you thought don't
forget to check out the mental health
bundle while you still can and I'll see
you soon
[Music]
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