* what the problem is: whether it is purely emotional or it has affected your capacity to think coherently and realistically
* whether there have been fortunate or unfortunate events in your life before and during therapy
What the future holds in store for you after therapy relies greatly on many of these same factors and on many of the personality qualities that helped you, or hindered you, as a client in therapy (see Chapter 21).
SO, DOES PSYCHOTHERAPY WORK?
Yes, for certain clients and under certain circumstances. The main changes that psychotherapies aim for are either to eliminate destructive habits of thought, attitude, or behavior or to establish new, constructive habits. Neither one can be accomplished by means of a medically effective treatment that is applied to the patient until a cure occurs.
A few emotional problems fall under the heading of true psychiatric disorders and result from physical causes. They include, for example, epilepsy, drug addiction, and Alzheimer's disease. But these conditions are in the minority; most emotional "disorders" have not been traced to underlying organic causes. There are several currently competing hypotheses relating to possible biochemical bases of schizophrenia, mania, depression, and anxiety disorders. As time goes by and medical research progresses, more emotional conditions will very likely be tied to underlying physical problems.
Until that time, however, they remain medically incurable conditions. At present, the possibility of overcoming them depends heavily on clients themselves, their ability to find an approach to therapy that is appropriate for their personality and their goals or problems, and their good fortune in locating a therapist who is able to help them to summon the faith, energy, determination, and courage necessary to overcome their sense of demoralization.
21
LIFE AFTER THERAPY