If you Can't Make Decisions, Which Psychotherapy Should You Choose?

Gary: Our question this week: “A friend of mine, who is usually pretty level-headed about things, nevertheless thought about going to see a psychotherapist about a mild depression that she hasn’t been able to shake. However, she became so confused about the different therapies that were being recommended, she decided to simply ‘work her way through it.’

Some of the processes recommended to her were “cognitive behavioral therapy,” “neuro-linguistic programming,” “hypnotherapy,” and “eye-movement desensitization and reprocessing.” I’ve heard of hypnotherapy, but what can you tell me about the other three?”

Tom: One of the things that irks me about psychotherapy and its gaining inroads is that they come up with labels and titles for things that at the least sound intimidating, and they seem to separate “we ignorant” from the professionals. But what are these? How would you explain “cognitive behavioral therapy,” “neurolinguistic programming,” “eye-movement desensitization and reprocessing”?

Martin: Okay, now, you’re dealing with three whole different fields, and these three different fields aren’t really fields that we can really get in-depth about. Neuro-linguistic programming, I have to say to begin with, is a rather high-promising (and it’s also true of the others), it’s a very high-promising orientation as to how people can change. And I don’t want to go into the history of it, because…

Tom: No. Just basically, how does it…how do they say it works, if we can use that term?

Martin: Cognitive behavioral therapy, basically, came out of behaviorism, which is based on the idea that it’s our environment that causes us to have problems, and so basically, they have to change a person’s belief system. They believe that if you change the belief system, then you will change the behavior. And so, one of the main things one must change in regular (unless it’s been  “Christianized”) in regular cognitive behavior therapy is you’ve got to get rid of this idea of “God,” of the supernatural. You have got to understand that you are in control of your life. You are to have high self-esteem. You are to think well of yourself, and so, basically the whole thing rests on having a new belief system. That’s what the “cognitive” part is. You must switch your belief system to believe that you are a wonderful person, you are very capable, you don’t need God, and that you, yourself, can make things happen, can change things. In other words, it’s dealing with so-called “irrational beliefs,” and, of course, God, the Bible, and all of that, would be part of the irrational beliefs.

Now, they are…

Tom: Deidre, can I just interject this?

Deidre: Yeah.

Tom: Would I be off the mark if I looked at this and I said, “Cognitive behavioral therapy has to do with thinking. Has to do with your thinking and changing your behavior, and it’s put together in various forms, just as you stated.”  I mean, would that be …?

Deidre: Yeah, basically, it is…your behavior will change when you think differently.

Tom: Okay, what about neuro-linguistic programming? (It’s even hard to say!)

Deidre: Well, that kind of developed by people watching how some…well, there was a particular therapist who was very successful, and they watched how that person related in therapy, and if the person who was in therapy would say, “Oh, I see this!” or would use the sensory expression having to do with sight, then the therapist would reflect that. And if it had to do with the person always talking about auditory types of sensations or other sensations—in other words, the therapist would pick up the language, the sensory language, of the client, and that then would help the person relate. Now, that’s just part of the whole thing, but that’s where the linguistic part comes in.

Tom: What about eye-movement desensitization and reprocessing?

Martin: Well, EMDR is partly Freudian and it’s partly other systems, but the idea is that there are certain traumas that have occurred early in life that get locked into your system—that’s the way they would describe it—and then you have to go back to these so-called “frozen incidents” that have been frozen into your neurological system, and then the different ways they have of doing that are described in the EMDR book by Francine Shapiro, who originated it, and if you go back there, and if you have these memories, and you visualize these things, and so on and so forth, you’re going to have a cathartic experience in most all cases, and then you’re going to be delivered from whatever current “neurosis” that you have.

Tom: Martin, what would eye movement have to do with it? That sounds like it’s physiological.

Martin: Yeah, well, the eye movement—actually, the eye movement isn’t, in certain cases they say the eye movement isn’t necessary. But they have different eye movements that they try to initiate with the individual as the recollection is going on of these past events.

Tom: I think the point of concern of the person who wrote this is, “Well, this all sounds really scientific.” Is it scientific?

Martin: Well, there are two parts of it. One is scientific, and the other is the question, “Are they effective?” Now, scientific—these are ideas, opinions, or guesses. Scientific? No. As, you know, I’ve said many times, if you go to the philosophy of science and look at the standards of science, these things are certainly not science. As to effectiveness, all of these methods—they give you tremendous promises. NLP and EMDR and cognitive behavioral...they’ll all give you these wonderful promises and often accompanied by what they would call “short term curing,” but the fact is, we don’t have the research to back what they say.

Deidre: The research doesn’t exist.

Martin: Well, no, in many cases it does exist, but it’s not supportive of…  But with many of these therapies, if we had an FDA, a Federal Drug Administration for therapies, they would be put out of business. NLP, EMDR, Cognitive Behavioral, and a number of…just line ‘em up, because you don’t have the evidence to support their efficacy at a level sufficient to charge the kinds of fees that these individuals are charging.