Just finished How Psychotherapy Heals

Just finished How Psychotherapy Heals by Chessick. It seems like mental illness has creeped into many of my friends and family’s life lately. I have always been a bit skeptical about psychotherapy as a “soft science”. While there is quite a bit of research behind how and to treat mental illnesses both chemically and through talk therapy, I have always been skeptical of the talk therapy part. It seems like there are so many factors that can influence the disease and the symptoms can manifest themselves in so many different ways that it seemed just talking about your childhood couldn’t do much. But Chessick changed all that for me. (wow, google is great, here is the guy’s whole address and e-mail Richard D. Chessick, M.D., Ph.D., 9400 Drake Avenue, Evanston, IL 60203-1106, U.S.A., r-chessick@northwestern.edu).

The book is written for psychotherapy students so you have to slog through quite a bit of jargon, but here are the salient points:

1. You are today are result of all your past experiences, especially the formative emotional years of 13-18.
2. Most depression and mental illness can be traced to some form of transference neurosis. Basically the living the present in terms of the past (rather than maturing emotionally).
“The basic definition of transference is given by Fenichel (1945). “The patient misunderstands the present in terms of the past; and then instead of remembering the past, he strives, without recognizing the nature of his action, to relive the past and to live it more satisfactorily than he did in his childhood. He “transfers” the past attitudes to the present.“
3. The psychotherapy process goal it to identify the specifics of a patient’s transference neurosis that is causing the current negative effects. By bringing it to the surface of the patient’s consciousness (out of the darkness), there a high likeliehood of getting the patient past it and to integrate the knowledge and change behavior.

“any procedure that works by undoing resistances and interpreting transferences may be called psychoanalysis..”
“A certain time lag takes place from the time the therapist begins interpreting resistances and conflicts to the time they are “assimilated,” that is, made use of by the patient in changing himself or his situation.“
“…THE crutial factor in psychotherapy is the experience by the patient of the difference in reaction of the therapist from the reaction of the parents.”

So the process has been a bit de-mystified for me. I heard on NPR yesterday that China has around 50M people with some form of mental illness. Society has such a stigma on it that most aren’t getting treatment. With today’s combination of psychopharmacology and psychotherapy, there is a 95% success rate with your average depression. Untreated depression is estimated to cost over $30B to the US each year. It is time we realized that depression is an illness that is treatable just like any other and it is not “all in your mind”. Typically the patient can’t just “buck up”.

On the book review scale, I rate this a 4 of 5. If you are interested in the process it is a must read. If you have friends or family battling with depression it is a very informative read that will give you more perspective.