Psychotherapy

There are numerous evidence-based psychological therapies that are effective in helping patient to alleviate symptoms, resolve conflict and enable effective functioning in relationships and the workforce.

Cognitive Behavioral Psychotherapy is based upon a theory of psychopathology, set of psychotherapeutic principles, and empirical investigation. It is based upon information-processing theory and social psychology. Aside from being effective with a wide range of disorders, it appears to enhance the impact of medications used to treat such disorders and has appeal in that it is active, structured and time-limited.

Pain, phobias, and mood disorders as well as psychophysiologic (psychosomatic) disorders have been treated successfully with this approach. Errors in thinking leading to self-defeating assumptions, incorrect interpretation of information, and lack of adequate problem solving or planning are often at the heart of problems. Treatment assists the patient in identifying, testing the reality of, and correcting dysfunctional beliefs, and in modifying the thoughts and behaviors that emerge.

In systematic desensitization, the patient can overcome disabling anxiety evoked by situations or objects by approaching the feared situations gradually and in a psychophysiologic state that inhibits the experience of anxiety. Deep muscle relaxation procedures and advanced EMDR induces a psychophysiological state that counterconditions the anxiety response. The patient approaches the deconditioning of anxiety by beginning, in fantasy (mental imagery), with the least anxiety-provoking scene and progressing up the hierarchy. The goal is to imagine the previously anxiety-evoking scene with equanimity. This capacity translates to real life situations but is most successful when real life situations are incorporated into the course of resolving each scene in the hierarchy.

Clinical biofeedback instrumentation provides information (data) to a patient about normally involuntary physical processes that are below threshold (outside of awareness). The patient adjusts behavioral, cognitive (mental) and affective (emotional) processes and learn to control these physical processes. (The term was first employed during WWII and the term behavioral medicine was first utilized in 1973 to describe integration of behavioral and biomedical sciences for the diagnosis, treatment, rehabilitation and prevention of illness as well as promotion of health. Not only can biobehavioral methods be effective in the management of specific symptoms and rehabilitation, but also these approaches are often useful for patients who are resistant to other forms of treatment.)

Marital and Sexual Psychotherapies deal with not only environmental, situational and phase of life problems that confront relationships but deal with concurrent problems in communication and conflict. Problems that occur within a relationship often emerge from interactional problems, the nature of feedback that couples provide each other, the difficulties in maintaining functional balance within the relationship, and the struggles for power and control that emerge. While interactional problems within a marital system may result in, and sometimes from, sexual conflicts, these are not the sole cause, nor even necessarily the primary cause. It is quite possible for a couple to have a functional sexual relationship and a dysfunctional emotional relationship. Relationship problems may emerge or worsen because of sexual dysfunction. By the time the couple consults a doctors, it is questionable as to whether sole resolution of the sexual problem, via medication for example, will make the marriage again functional unless other intervention (e.g. marital psychotherapy) also occurs.

Short-term dynamic psychotherapies (STDP) work well for nonresistant patients whose resolution of problems do not become steeped in long term transferential problems relating to the doctor and for whom problems are significant but not overwhelmingly complex. Such patients often have some beginning insight or awareness of potential causes of their problems. Treatment begins with a comprehensive diagnostic examination that determines whether a particular psychotherapeutic technique will address the problem. The doctor also determines whether the patient has the strength to confront the underlying causes for their problems and if there is the potential for positive response to short-term intervention.