Post No.: 0515
Furrywisepuppy says:
We’ve taken a little peep at various forms of help available for those with mental health and psychiatric disorders before, but let’s take a more specific look at some common forms of therapies – some of which we’ve not yet explored…
Psychodynamic therapies aim to uncover ‘repressed’ and unconscious thoughts, anxieties and motives through dream interpretations and free associations. Examples include Rorschach ink blot or word association tests. But whether these techniques are truly beneficial is debateable.
Low self-esteem can be said to be a mismatch between one’s perceived real self and one’s perceived ideal self. A humanistic therapy approach would offer empathic listening and unconditional positive regard – that is to accept a person as they are, no matter how they are or what they may have said or done, so much that they begin to like who they are and accept who they are, thus building their self-confidence and the conditions for optimal personal furry growth.
A behavioural therapy approach to something like ADHD or drug addiction could be to use rewards and reinforcement (or the opposite – punishment and extinction) to shape and change behaviours. There’s classical conditioning e.g. a dog sees food (an unconditioned stimulus) and salivates (an unconditioned response), but the dog also hears a bell (a conditioned stimulus) during the process, and now the dog salivates whenever just hearing the bell (a conditioned response). And there’s operant conditioning where we reward or punish voluntary behaviours in order to increase or decrease their frequency. Tokens, such as stars, could be used as rewards whenever a desired behaviour is performed – these tokens can then be exchanged for practical rewards. The value of the tokens could increase for every consecutive token earned to encourage staying ‘on the wagon’ or keeping up the desired habit.
Aversion therapies are used to reduce the attractiveness of something by pairing it with an adverse stimulus e.g. treating those addicted to nicotine or those who have paedophilic sexual thoughts by using something that induces nausea whenever they’re exposed to cigarettes or inappropriate material.
Some phobias can be formed after just a single bad experience. (Although not necessarily a phobia, one rotten experience with a new foodstuff can put us off from wanting to try it ever again.) For someone who has a phobia, one could use systematic desensitisation/graded exposure therapy, where one pairs the anxiety-triggering event with a stimulus that elicits a more desirable response such as relaxation e.g. getting the person to name the source of anxiety whilst teaching them relaxation techniques. This therapy gradually builds up until they can actually face firsthand, or build towards a closer proximity to or a greater quantity of, the source of anxiety. This must be done under trained supervision.
An extreme technique would be flooding/prolonged exposure therapy, where there is no slow and gradual exposure but a massive and sudden exposure to the anxiety-triggering event. But this is risky for it could actually make a phobia worse.
At the other extreme end of the scale would be to try to totally avoid one’s psychological triggers altogether. But this again isn’t usually the best way to process traumatic events or overcome phobias or PTSD symptoms that negatively affect one’s day-to-day life, such as a phobia of stepping outside of the house. Avoiding something that causes us fear tends to just reinforce the belief that it’s something to be feared and avoided. The safer and best kind of therapy is normally therefore systematic desensitisation to retrain the brain. It’s best to face our fears than to avoid them – but with the right kind of support and compassion. (Post No.: 0449 focused on understanding anxiety disorders better.)
For some people with OCD though, it has been reported that ‘over-correction’ – where one is exposed to an extreme form of what one is anxious about so that one can settle back to a healthier middle ground, like a pendulum – has worked for them e.g. a person is overly petrified of germs so (with trained supervision) is encouraged to put their hands in (safe) toilet water (which most regular people wouldn’t even find comfortable doing), and they learn that they didn’t get ill. This will hopefully make them feel more comfortable about behaviours that are relatively less extreme, such as touching toilet seats in a regular manner.
Early intensive behavioural intervention (EIBI) and applied behaviour analysis (ABA) are both very effective in treating autism. These therapies involve a range of behavioural techniques for improving communication skills and so forth. But these therapies are controversial for being intensive, and some criticise whether autism needs to be treated at all or whether we should accept more neurodiversity?
‘Conversion therapy’ is a clearer example of something that’s unnecessary, for homosexuality is not considered a disorder and these practices are regarded more as pseudoscience too. But proponents argue that it’s down to the individual’s choice, and if gender identity is fluid and can change then sexual identity is fluid and can change too, hence conversion therapies can help convert those who wish to convert.
Cognitive therapies are any type of psychotherapies that don’t involve drugs or surgical, electrical or magnetic forms of therapy. They’re often referred to as ‘talk’ therapies, and they work by attempting to restructure irrational thought patterns and emotions. The therapist will attempt to identify these irrational thoughts then challenge the client on those thoughts with critical questioning and logic e.g. if someone believes that no one loves them, the therapist could point out the many people who’ve helped or tried to help them during this time – things often just need a change of perspective.
Cognitive behavioural therapy (CBT) essentially combines cognitive therapy (which attempts to change maladaptive thoughts) and behavioural therapy (which attempts to change maladaptive behaviours) approaches, in order to restructure irrational thought patterns with classical and operant conditioning techniques, and via reappraisal, to reshape and incentivise or encourage more adaptive behaviours and responses to one’s thoughts. It is a structured way to help change the way one thinks, feels and behaves.
CBT has become quite a common form of therapy and can be done in dyads, groups, online or even alone with the aid of a book. Our situations, thoughts, emotions, physical feelings and actions are all interconnected with each other, and so it’s about helping one to recognise one’s unhelpful thought cycles that result in difficult emotions, shining new lights upon them and changing one’s perspectives or responses towards them to more helpful ones. This is a skill, and as such can be improved with daily practice. Specific problems are identified and addressed, and pragmatic goals and actions are set to solve them. Your therapist won’t tell you what to do but will work with you to find solutions to your current difficulties. It’s not about changing the past but about how you think and behave now. Woof!
Group therapies involve groups of people who share a common problem, along with a therapist, and they all try to help each other out. These are usually structured and may involve CBT, training and practice in overcoming social anxieties, or 12-step programs for addiction recovery, for example. Support groups are less structured. These groups help show that people are not alone with what affects them.
All of these psychotherapy techniques, plus pharmacological treatments, meditation practices such as mindfulness meditation, physical exercise, spending more time amongst nature, and other techniques and therapies, can be combined and tailored to treat a client.
For example, mindfulness-based cognitive therapy (MBCT) combines CBT with mindfulness meditation – this aims to restructure one’s thoughts in a non-judgemental way (we’re neither bound nor defined by our thoughts) and tries to help one become fully aware of and in the present with our thoughts and feelings so that we can detect potential symptoms before they become a problem. This can be used to treat relapses of schizophrenia or depression – to change the voice or ‘voice’ inside one’s head rather than try to remove it, and to help one learn to live with it. Dialectical behaviour therapy (DBT) is similar and helps clients learn to accept themselves and their actions and emotions, which reduces the risk of self-harm and drug abuse.
Charitable volunteering is also good for our well-being. When you’re thinking of others then you’re not thinking self-absorbedly or of your own, often relatively superficial, problems. It raises self-esteem, belonging and meaning. (It also increases one’s attractiveness!) It’s not a sacrifice because it’s good for you. Trying to help those less fortunate than us shows us how lucky we are in comparison and stops our own troubles getting magnified out of all proportions. We have to find the right causes and activities to personally volunteer for but when we find one that engages us, it’s also a great feeling to know that we’re wanted and we make a meaningful and positive difference to others. It gives us purpose.
Keeping busy or taking up a new hobby such as gardening, painting or learning to play a new musical instrument can be beneficial. But don’t bury your head in the sand, don’t reach burnout, and do maintain a healthy balance between work, rest, play and social interactions.
Types of therapies or ‘therapies’ that are not effective or sustainable for the long-term include retail therapy, comfort eating, drug abuse or other forms of such self-gratifications that offer a bit of pleasure for a fleeting moment each time but don’t bring lasting benefits; and might instead bring lasting costs, harms or regrets. When our self-esteem is low, we might attempt to mask or escape our (perception of) reality that we’re unsatisfied with by using such strategies that never really solve our issues at their root(s). Our instincts to seek temporary forms of pleasure when we feel down can lead some to addictions, so rather than always helping us to get out of trouble, they can sometimes exacerbate matters and cause vicious cycles. Often what we want or desire, just for that temporary moment of joy or escapism, isn’t what we need. Excessive vanity or conspicuous consumption are insecurities too – not feeling worthy or rich enough (regardless of the true nature of one’s reality) thus overcompensating to appear so because one is too bothered about what other people think. We need longer-lasting and sustainable sources of contentment to overcome our (perceived) deficiencies.
As friends of the community, the rest of us should try to raise the confidence of those who succumb to retail therapy, comfort eating, drug abuse, excessive vanity or similar, rather than vilify them for their behaviours, because they only do these things precisely because they feel low or insecure. If one knocks them further down or makes them feel defensive, one will be aggravating the social problem rather than solving it. Another poor instinct is therefore thinking that one can discourage all deviant or harmful behaviours by simply mocking the people who do them(!) Being a human doesn’t mean one will automatically understand how humans work and work best, so humans (and dogs why not?!) are better off conscientiously learning more about others before judging others.
And – although this post has presented a quick flavour of some common therapies and practices that can help treat various mental health and psychiatric conditions for the purpose of showing what support is available – that’s why we’re also better off seeking the advice and guidance of relevantly qualified experts, such as one’s GP/PCP or a mental health specialist, before undertaking any kind of therapy. So please do so in your local area if you need to for yourself or for someone you care about.
New therapies are also being researched and developed all of the time e.g. virtual reality has been recently trialled to help enhance graded exposure therapies for tackling some phobias, such as the fear of heights.
Woof! So there are lots of options to try and therefore lots of hope, if not already then on the horizon…
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