Help me understand how a therapist is going to do more than medicine.

So here's some useful info.

First, in case you didn't bother to read my prior post, EMDR is not hypnosis and has no connection to hypnosis. (However, hypnosis can, separately from EMDR, be extremely helpful for anxiety.) Properly used, by someone well trained, both are powerful tools that can be very effective as part of an overall strategy.

As for medications, they are making a biochemical change in the neurotransmitter pathways. They have no impact on the actual memories, experiences, and events that generally form the underlying basis for the anxiety. So in a way, medication is a band-aid that covers up the symptoms but doesn't really deal with the underlying issues that are driving the anxiety.

Additionally, good psychotherapy is about helping you to understand the filters and experiences that color your view of the world in a negative way. No pill is going to do that. Basically, good therapy helps you understand the context of experiences in a way you can't do by yourself, because you can only see the experiences you've had through the distortions you (and everyone else) deals with on a day-to-day basis.

And finally, in your case, there's almost certainly a lot of deep-down shame, self-loathing, and self-sabotage. Good therapy will help you to get at these difficult issues and help you to process and resolve them so that their impact on your day-to-day life is either significantly lessened or taken away entirely.

I think the challenge for you might be finding the right therapist since you've had several misfires. Depending on where you are, I might know someone and be able to make recommendations if you want to PM me.

 

Hypnosis is a process that involves calming down the conscious mind, essentially to get it to step back a couple of steps so that it is easier to address the unconscious mind. It is the unconscious where the triggers, filters, perceptions, thoughts, and memories are that impact your current mood, behavior, and interpretation of present-day experiences. What hypnosis (good hypnosis) does is help to create deeper understanding and context, working directly with the unconscious, that allow the conscious mind to reframe earlier-in-life experiences so that they don't impact your day-to-day mood and experience as much.

On the other hand, EMDR is more in the class of a brain biochemistry alteration. It isn't directly doing anything with filters, reframing perceptions, or altering context. Instead, what it is doing is, essentially, breaking the connection between the memory of a traumatic event itself, and the strong emotions associated stored with that memory. So, EMDR, when correctly and successfully used, changes your recall process so that you will still remember a traumatic event, but will no longer find it triggering or upsetting or otherwise causing strong emotions to come up. The mechanism by which EMDR disrupts this association is not fully understood, but it has been tested and documented for more than 20 years in numerous studies, the largest of which is with veterans suffering from PTSD treated by the Veterans Administration, where EMDR has been found to have long-term effectiveness in something like 80% of the cases where it has been used.

Interestingly, EMDR is now more commonly practiced with exposure to sounds in earphones rather than with eye movement, though both methodologies are effective. As I said in my earlier post, there are no "magic words" (or, for that matter, really any words) used with EMDR as it is properly used. I suspect that your practitioner may have been using that s/he simply made up, or thought was EMDR, but without actually receiving training in it. There are a lot of people out there claiming to use it who have never actually been trained in it.

No, there's no rewriting (nor would that be possible.) What it does is help to provide context that enables you to understand and reframe. For example, someone can say something to you that you take huge offense to... but then, you talk to them, and you realize that either you misheard them, or you completely misunderstood their intentions. Once you understand that what you perceived was one thing, but what a neutral, third-party might have observed was completely different, and no malice was intended, your entire perception of that interaction changes. Nearly all of the filters and negative biases we carry in life are a result of these sorts of things that happened early in life, and our child-brain did its best to make sense of them, but without the understanding of adult context and cues. Insight-based psychotherapy helps us to gain understanding of context from an adult perspective.

CBT and DBT work from the perspective of directly changing behavior, essentially teaching us to recognize when we're about to react in a certain way (or when we're feeling something), and changing our reaction to it.

And all types of good psychotherapy eventually alter and rewire neurotransmitter pathways in much the same ways that drugs (anti-anxiety or antidepressant medications, in particular) do, except that the change takes place over a longer period of time and is permanent, unlike the drugs which must be taken for a lifetime if other steps are not taken to effect change in the pathways.

Nor would any ethical therapist seek to do that. All of us are a product of our memories and experiences, and nearly all experiences, no matter how terrible, can, through the right lens, give us compassion, understanding, motivation, and quite a variety of other positive attributes. Therapy helps us to gain better access to these positive aspects of the experiences we've had.

That isn't even possible.

Here I'm a little out of my depth since my knowledge of neurotransmitter pathology and biochemistry is limited.

But one way I can describe it is this: We know, without question, that early childhood experiences deeply impact the way neurotransmitter pathways develop in the brain. Gabor Maté explains in one of his books that if a child (or, for that matter, animal) is born into complete and total darkness, and spends his first four or five years of life in total darkness and is never exposed to any light whatsoever, then the brain's ability to process the signals that come from our eyes never develops. Even if the child is later exposed to light, s/he will not be able to see because those pathways haven't developed. In similar fashion, the child connects deeply with, and mimics, the emotional mood of his caretaker parent (usually the mother.) If the child's environment, or the mother's mood or life situation does not provide for stability, what the child learns is that his environment is not safe; consequently, the neurotransmitter pathways associated with fight-or-flight (basic survival and protection) are hyper-developed; we've evolved to self-protect even at an early age. By contrast, the pathways associated with calming and relaxation do not get developed when the child constantly (or near-constantly) feels insecurity or stress in either his environment or his caretaker. This is a very well-documented phenomena (see the reference section of Gabor's "In The Realm of Hungry Ghosts), and gives rise to a predisposition toward anxiety (along with many other conditions.)

We used to believe that these neurotransmitter pathways were fixed by early adulthood; we now know that this is not true, that over time, those pathways that weren't properly developed can be developed, and there is considerable evidence of this from looking at long-term changes in neurotransmitter availability among people exposed to various interventions, from psychotherapy to group therapy or other group social interaction. The citations for this work can be found in Candace Pert's "Molecules of Emotion" and in Philip Flores' "Addiction as an Attachment Disorder".

Unfortunately, you can't assume that anyone in your regular medical healthcare network is going to be a good referral source to a psychotherapist. Psychiatrists on the whole have a very different view of mental health from psychologists and clinical social workers, by virtue of their completely different training. Most psychiatrists do not have the depth of training in, or knowledge of, psychotherapy methods, and unless they have deep interaction with psychotherapists (in the US, many -- if not most -- do not), they will probably not be the best source of referrals. It is true that most US health plans don't provide much in the way of benefits for therapy, but, realizing that, many excellent therapists work on a sliding scale and will do their best to accommodate what you can afford.

I completely understand why this is a scary proposition to you, especially given your history of really horrific experiences. And I applaud you for being willing to at least explore it as a possibility. Once you find the right one, though... it is a truly transformational experience.

 

It never hurts to ask, but as I said above, unless your psychiatrist spends a lot of time with a given therapist, it may be hard for him or her to form an informed judgment.

You make it sound like the only choices are Freudian and Jungian. That's not true at all. You also have some misconceptions about Freud. Nearly all therapists (including Jung) make some use of psychodynamic theory, which arises from Freud's work. While a lot of Freud's work hasn't stood the test of time, some of the most basic aspects (the separation between conscious and unconscious, and the different aspects of self) remain an important influence on pretty much all modern psychotherapy.

That said, there are very few therapists that practice pure Jungian psychology, and even if you found one, that would probably not be what you'd want. There are even fewer that practice even neo-Freudian (the evolved version of Freudian work), so again, I don't think you need to worry about that.

The reason a pure Jungian (or neo-Freudian) would not likely be your best bet is because those schools of thought are both almost entirely insight-based. Given your anxiety issues, you're going to need someone who is skilled with modern CBT (it's changed substantially in the past 10 years), and who integrates that with an insight-based approach to allow you to put your previous experiences in context.

That sounds like an excellent idea. There aren't a whole lot of them, but you might want to try and find someone who is transpersonal/eclectic or (easier to find) existential/eclectic. The transpersonal school of thought is lnfluenced by Jung, but incorporates a deeper understanding of the role of spirituality. The existential school focuses on meaning in daily existence. And as I said above, the CBT piece will also be important.

We all have coping mechanisms. They are a necessary part of life because we all have situations where something shitty gets thrown at us. Some coping mechanisms (meditation, gratitude practices, exercise, journaling, dozens of others) are healthy and promote long-term healing; some (drinking/drugs, binge eating, avoidance, raging) not so much. A good therapist will help you find your strengths in coping strategies and encourage you to work toward those that help you grow.

 

There are a few. Most are older therapists likely getting close to retirement. It's definitely a dying school of tbought, though as I said, nearly every modern psychotherapy methodology draws from the part of Freud's original work that has stood the test of time.

Nope. If anything, CBT is probably the methodology that draws least on Freud. It's a lot more behaviorally centered.

While I'm sure there are a good number of therapists who are atheist, most schools of thought in psychotherapy are at least somewhat influenced by existentialism, which looks at life and meaning, and that tends to lead to some introspection into why we are here, and the idea that we all share common understandings and connection. For those who have spiritual beliefs, that, in turn, leads to a deeper understanding of their personal spirituality, whatever it may be. Psychotherapy, unless you go to a crappy therapist, will neither impose any set of spiritual beliefs, nor will it devalue any set of spiritual beliefs you have.

You have a lot of misconceptions about Psychology Today. They publish a lot of articles on the value of spiritual beliefs in creating meaning in our lives, they have a lot of articles by deeply religious authors (as well as authors who are atheistic or agnostic), and they take no editorial position one way or another on spirituality. If they did, it would likely not be atheistic, because nearly all schools of thought in psychotherapy recognize the value of some form of spiritual belief in creating meaning in our lives.

Additionally, they certainly don't hold Freud (or Dawkins) on a pedestal because, as I said earlier, practically everyone recognizes that many of Freud's theories have not stood the test of tine.

 

You might find life a little more enjoyable if you didn't make a sweeping judgement based on a single data point

You had a really shitty, and probably incompetent, therapist. First, no competent therapist would devalue any client experience or scoff at him. It's completely unprofessional and unethical to do so. Second, a competent therapist wouldn't offer his opinion of dream analysis unless there were a specific therapeutic value in doing so, particularly if the client had indicated that dreams are meaningful.

What you describe is appalling. I don't know who exactly it is that respects him, but no competent therapist who heard him say the above would have respect for that sort of exchange. It's completely inappropriate and unprofessional to have such an interaction with a client. My guess is that he didn't have any real training in dream analysis. It is Jung, not Freud, who is the primary dream analysis guy, and unless a therapist has separately and independently gone to the effort of studying dream analysis (which is a very, very complex, particularly Jungian dream analysis), they aren't qualified to do it, as very few schools include much dream analysis in their curricula. Jungian approaches are also not widely taught; there are a small handful of schools that specialize in it, but most others give passing discussion to Jung's work if it is discussed at all.

The more I hear, the more I understand why you're so against therapy. You've never had a good therapist. And that's really unfortunate. There are lots of good ones out there, and the problem is, if you don't know what you're looking for -- and most people don't -- it's really hard to find a good one, so it's often luck of the draw.