What is Therapy Anyway?

By Amy Rauch, PsyD

When people find out that I am a therapist, I get some awesome questions and comments. One of my "favorites" is..."so are you reading my mind right now?" Or they tell me about their crazy mother/ brother /sister / friend, and I then wish I had changed the subject prior to answering their question about what I do for a living!

I have had enough people genuinely ask me what therapy is to think that some explanation might be helpful. I would imagine that images of the client lying on their back on a couch and an elderly, serious male therapist with glasses talking gently with the client about long repressed memories comes to mind.  We can thank Sigmund Freud for that one. Ah yes, that brilliant, cocaine-addicted mind that taught us that everything we do is motivated by sex and aggression. Or, the ever classic, “How does that make you feel?” question coming after each statement that the client makes.  Or perhaps you are more “informed” about modern therapy after watching the movie, “50/50,” and think that therapists could be potential dates that show up at your house for pizza when you are having an off day? Ay-yay-yay, that one killed me.

I attended a conference recently with psychotherapy / psychological and psychiatric experts from all across the world....it was quite an experience to be in the midst of those that had crafted the theories that I had been studying for the last 13 years. These people had such incredible minds and expertise and I sat next to therapists from Australia, Europe, Canada, and South America, to name a few...all sharing the common goal of becoming better at our respective profession and better learning how to help others. And one surprising thing that I took away is that we all define "therapy" differently. One thought leader interviewed noteworthy psychologists around the world and there was very little consensus. As such, you likely already guessed that I will not be attempting to define therapy explicitly, rather I will attempt to clarify what therapy is NOT by addressing myths about today's therapy.

Myth 1: The client is at the therapist's mercy.

There has been a huge shift in this area, both in medicine and in mental health...a shift from teacher / student, guru / naive, expert / novice to more of a collaborative relationship.  It's about time we figured out that just merely telling adults what to do does not work! If type 2 diabetic patients took their medications as prescribed, meaning along with diet and exercise!, how many borderline diabetic patients could get back into a normal A1C range?! If every overweight /obese patient who was told to lose weight actually did, then over 2/3 of Americans wouldn't be overweight! Simply telling independent adults what to do is ineffective....glad most of us finally figured that out!!

Clearly you still pay therapists / psychologists and physicians because they are knowledgeable in their respective areas and expertise and have something to offer, but the shift has been away from a "one size fits all" approach.  Effective therapy sometimes takes a problem solving approach to figure out a solution that gets them closer to their goal. Not all problems stem back to our repressed need for affirmation and the lack of warmth in our childhood...sometimes it can take the form of a nudge / push / lift / encouragement from a neutral source to get you where you need to go.

Countdown to Red Cups

What foods do you fantasize about? Is it that juicy steak, with cheesy mashed potatoes? A hot fudge sundae with cookies and cream ice cream, topped with whipped cream, nuts and a cherry?  The garlic fries at your favorite baseball stadium (AT&T Park for me, GO GIANTS!) Or how about the Starbucks holiday drinks, like the gingerbread or eggnog lattes?  You fill in the blanks.  I would be willing to bet that our favorite daydream food items share a common theme, though. I would venture to guess that these foods are out of reach most of the time.... that for whatever reason, you don’t eat these items daily, or even weekly.  Starbucks, for example, with all their marketing genius, knows that some of the secret to the success of their holiday drinks is that they are only offered during a specified period of time. 

You can almost set your clock by the first social media posts with Starbucks red cups housing their seasonal holiday beverages. Would you believe there is a website dedicated to the count down to said red cups? www.countdowntoredcups.com At the writing of this post, 294 days, 4 hours and 50 minutes stand between all of us and those red cups.  That’s right, according to the rumors, November 6th, 2015 is when they will unveil the new drinks. #firstworldproblems

In my last post, we all felt a little smarter as we learned about the science behind habituation and how we can use it to our benefit, or at least stop being a slave to our neuronal impulses and desire for neurological stimulation.  Let’s put habituation to work to help us stop obsessing about our favorite foods.  If we were to stop saving our favorite foods for special occasions and instead eat them on a more regular basis, we would be doing ourselves a favor by allowing our brains to adapt to these foods, instead of throwing an internal party when we finally allow ourselves to eat them!   I put this to the test recently, as I thought my appetite for ice cream was insatiable, meaning that no matter how much or how often I ate it, I would want it just as much.  So.... I ate it daily, sometimes twice a day. I ate that delectable Trader Joe’s Mint Chip for snacks or meals when I was hungry. And wouldn’t you know? It lost its allure for me.  I still enjoy it, but I am able to stop when I am full and not finish the carton each and every time.

Eating Intuitively* encourages applying this approach one by one to your favorite foods. As these foods lose their hold on you, be prepared for a bit of the emotional let down as these items become less exciting and tantalizing. What will you daydream about now, if not about that amazing dessert or scrumptious treat?  The possibilities are endless!

*Tribole, E, & Resch, E. Intuitive Eating: A Revolutionary Program that Works. St. Martin’s Griffin. 2012.

Learning at its finest….

Have you ever wondered why “new” things typically seem more appealing than “old” things? Aside from the vintage obsession, of course...but, even then, the vintage items are still new to you.  Even babies prefer the novel and pay more attention to items they have not seen before, as opposed to items that have been in the toy room for a while.  Does this same principle also apply to love and attraction?  What is it about a first kiss that is so intoxicating......yet kissing the same person feels routine after a while?

Science can lend us a hand as we try to explain this.  Habituation is generally known as diminished responsiveness over recurrent stimulation.  It occurs at the neurotransmitter level.  For those of you that are thinking.....”neurotransmitter....? You think I was listening in Biology 101 or Psychology 101 when that was discussed?  I had so many more important things on my mind!  Like if that guy/girl I went on a date with last night is going to return my text....or playing that addictive game on my phone!”  I don’t blame you. Such is life.  Simply speaking, neurotransmitters are chemicals in the brain that communicate information throughout our brain and body.  At this chemical level, our body responds less when it becomes accustomed to something.....when this something becomes a habit, hence HABIT-uation.

Habituation is the most simple form of learning*.  If everything were new to us every day, we wouldn’t get anything done! We would be so distracted by the novelty of everything around us, that our minds would be exhausted attempting to process it all.  Habituation allows us to mindlessly drive our car without thinking about every little step involved.  Think back to when you first got your license....how much longer did it take you to start the car then as compared with now?

So what do we do about this? Do we keep constantly keep buying new clothes, new toys, and starting new relationships??  We can, but then we may end up on “Hoarders” and date lots of different people because we decide our current partners just don’t give us “butterflies” anymore. 

We have other options. How can we use our knowledge of this to our benefit?  Let’s think about this.......When you have been away from your partner for a period of time, does that first kiss taste sweeter?  When you magically find that long-forgotten favorite toy underneath the driver’s seat, does your child find it more exciting?  Are you one of those really organized folks that rotate seasonal items in and out of your closet? Then you are already on your way to getting this! By reducing exposure to the particular stimulus for a period of time, it will likely feel new and excited again!   With your partner, expect that that kiss will likely feel less exciting over time, so switch things up regularly. Rotate your little one’s toys every few weeks or alternate toys with a friend who has a similar-aged child.  With your clothes, save that special shirt/dress/tie for special occasions and it will maintain its excitement or novelty for longer.

*Neurobiol Learn Mem. 2009 September ; 92(2): 135–138. doi:10.1016/j.nlm.2008.09.012.