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Therapy as a Biological Treatment

I was reading on the Psychology Today website about a recent study that measured the effectiveness of therapy with clients.

PET (positive emission tomography) scans can differentiate the alterations in brain function between clients struggling with Obsessive Compulsive Disorder (OCD) and control subjects, who do not have OCD.  Scientists measured the changes in PET scans with people struggling with OCD after treatment .  Some were treated only by medication (Prozac), and some were treated only by “talk therapy”.  Dr. Aboujaoude reported in his blog that on follow up PET scans:

The results were essentially identical: both interventions decreased the rate of glucose metabolism to levels seen in healthy people without OCD, and the rate of the decrease seemed proportional to the degree of improvement in their OCD symptoms.

This doesn’t means that medication and counselling are interchangeable.  In some cases, medication is necessary for a particular symptom or diagnosis.  

However, it is compelling that counselling actually has a biological effect on a person’s brain.  Counselling changes brain chemistry as people learn new tools and strategies to cope with issues they struggle with.

Reminds me of a time I can recall a time when, after a significant “light bulb moment”, a client was quiet and contemplative for some minutes, quietly staring out in the distance.  Quiet uncharacteristic.  I asked quietly:  What’s happening?  And the response:  “I feel peaceful when I understand that.  I feel like I just took a Valium.”

Even after all these years of being a therapist, I am still humbled by the incredible power of meaningful connection and effective dialogue in the counseling room.  

Compassion for the unfaithful??

When there has been an unfaithfulness in a relationship, it signifies a break in the covenant made on the wedding day to remain faithful to each other…that is a problem.  Not a little one, either.  A big problem.

However, it is often a symptom of something else.  Seeing it as a symptom doesn’t make the problem acceptable, but it does help with understanding—always an important step in moving forward.  And if a relationship is going to be repaired after an affair, understanding is an important ingredient in the mix.

A powerful politician has a need to find a place where he can let go of the responsibility and heaviness that life places on him.  He feels there is no safe place in his life where he can escape from the pressures and expectations.  He places pressure on himself to be strong and brave for all—including his wife.

A woman who has had fathers, brothers, and husband be rough on her, minimizing her throughout her life, and generally has felt "pushed around" by men. When a younger, sensitive, very gentle man comes along, she gets sucked in.

These aren’t “good reasons” to have an affair, but along with the powerful reaction that anybody has when newly attracted to the opposite sex , the pull is incredible, and can feel, at the time, overpowering. (The sexual pull of a new relationship is compared to drug use for good reason—the brain is bathed in the same neurotransmitters as occurs when one might with street drugs).

Think about how attractive it is…an affair is a dream of what “might be”.  That will always win over “what is”—including work deadlines, mortgage payments, teething babies, and bad breath.  A relationship when the other looks at you with stars in the eyes and utter trust and wonder, rather than disappointment and a spirit of criticism because of how you didn’t follow through on getting the basement done, cutting back on your work hours or your drinking habits.  

It’s difficult for someone to understand (in the heady, drunk-with-the-attraction moment) this powerful feeling of being loved, understood and accepted isn’t something that will last indefinitely, but is part of the inevitable infatuation of a new relationship that is unemcumbered by the daily realities of a real life.

It can seem so clear when the guilt takes over, when the secret is found out, and reality hits…something like, “I could lose all the years of history with someone, the parent of my children, the sharer of my dreams, the one who not only causes me stress and grief, but has loved me through thick and thin-unlike any other.”  

It might be difficult for a spouse who has been cheated on to hear me say:  in amongst the anger, outrage, betrayal and fear, it is important to find a place of curiousity to find out the circumstances that existed that allowed an environment where the affair occurred…to allow the offending individual to understand themselves and be understood, to have room for growth in new way, and to recognize the patterns in the relationship that made it vulnerable to infidelity.  The curiosity can develop into a sense of compassion and understanding which paves the way to reconciliation…it doesn’t replace the anger and sadness, but co-exists with it in a way that allows for the relationship to be rebuilt.

Curiosity, (followed by empathy and understanding) allows infidelity to be seen as not only a problem of something unacceptable, but also a symptom of something else—and the door is opened to restoration.

Changes

Change comes in many packages and sizes. 

Many of us despise change.  Much of the work that is done with clients is discovering the part of them that will resist the very change they seek help for.

-A client who asks for help with procrastinating on homework, and on further investigation, really doesn't like the course she is taking.  If the procrastination is reduced, she'll be doing homework she doesn't want to do and isn't really interested in--why kind of fix is that!

-A couple wants help reducing the conflict in their marriage.  But as tensions decrease, they find themselves sharing more deeply and intimately--which has its own terror.  Suddenly, the conflict seems attractive--it's connecting at a safe level.

Suffice to say, resistance to change isn't just about wanting to stay stuck in an ugly place.  It's about difficulty letting go of the underlying adaptive process that has something that looks like it's not working actually serve a valuable purpose.

All this thought about change comes up because I have been learning more about how websites work, and I "took the plunge" and transferred my blog to the same web address as my website.  I really liked the look of the other blog, the usability of the features of blogspot.  But I'm working at being open to the change, and finding ways to embrace it.  I think it will be a good decision in the long run. 

How will you make your change decisions that you are facing?