Increased Depression and Anxiety amongst Young Adults

by Judy Koven, WTRS Coordinator

The last few years, I’ve noticed an increase in young adults seeking therapy for anxiety and depression. These college students, as well as recent graduates newly in the work world, are overwhelmed by both internal pressure and external stresses. For many there’s an underlying paralyzing perfectionism–a need to excel to do the best and the most. Clients come in noting, among other symptoms, sleeplessness, difficulty concentrating, distorted body image and unhealthy eating, a sense of hopelessness, and crippling negative self-talk.

The 6/7/17 New York Times special section on Higher Education included pieces on how some universities are responding to their students’ mental and emotional health problems. These articles provide an overview of the complex issues and challenges students face, and detail strategies for responding to their struggles.

Colleges Get Proactive in Addressing Depression on Campus

A Climb Out of Depression, Doubt and Academic Failure

The On-Demand Culture and Therapy

by Judy Koven, WTRS Coordinator

We in Seattle live in a busy city, with its strong economy, burgeoning population, changing demographic, and the many challenges these bring. The corporate technology culture that’s become predominant in central Puget Sound exerts a powerful influence on our sensibility, values, and priorities. I call it the “on-demand culture”.

Want to buy something? Order it from Amazon Prime and it shows up in a few hours. Hungry? Find something that looks good on your restaurant app and a delivery person is at your door with an insulated bag, dinner at the ready. Need to get somewhere quickly? Get on your smart phone and Lyft will be there.

As someone who educates and matches clients looking for a therapist, I often see the ripple effect from this on-demand worldview. People now come to the search for a therapist with similar expectations, foregrounding convenience and immediate results. These are understandable requests but not necessarily realistic, nor are they reliable determinants for successful therapy.

Therapy entails a different mindset. Research has repeatedly shown that a good match in a therapist is essential for a positive outcome. When we’re in distress, it’s understandable that we want relief now, and it takes courage to reach out for assistance. But convenience doesn’t guarantee productive and successful therapist-client collaboration over time.

An on-demand culture may work efficiently for meeting practical needs but doesn’t translate well for our deeper well being. In fact, it is a significant source of stress. Therapy provides an opportunity to slow down, reflect, and create new ways of understanding and interacting with the self and the world. The result is deeper, more lasting transformation.

Johnson and Tronick: Love Sense

by Karen Lucas

Attachment theory has influenced the field of psychology and has become the primary undercurrent for many theoretical approaches. This video is about Emotionally Focused Therapy (EFT), which was created by Dr. Susan Johnson. The video incorporates the “Stillface” video that was created during Dr. Edward Tronick’s studies of attachment with infants and their mothers.

Dr. Johnson labels both infant and adult behaviors initiated when the emotional connection has been lost during the bonding dance. The same patterns we learn as infants and children often carry over into our adult lives and relationships. As Dr. Johnson puts it, “The drama of romantic bonding is an adult version of the bond between parent and child.”

Watching the video, many of my clients have been able to identify with one or both of the adults. Hearing the behaviors named and seeing the dance of bonding from disconnect to a conclusion of repair has helped my clients identify their own core moves. Discussing patterns of rupture that developed in their family of origin helps clients understand why they are repeating old childhood behaviors in their adult relationships.

It is what you do with the rupture that impacts the relationship. The repair between infant and mother and between adults defines the health of the relationship. This video shows the moments of repair and the reconnection as the mother and partner respond on an emotional level.  Bringing mindfulness to behaviors that cause rupture and reconnection can help create healthy change, especially when a therapist is present to facilitate the repair. Watching couples reconnect is like watching them soften and breathe deeply. As Dr. Tronick said, “ We need loving connection like oxygen.”

“Therapy Wars”: Some thoughts about current psychotherapies

by Judy Koven

In Therapy Wars: the Revenge of Freud (theguardian.com, January 7, 2016), Oliver Burkeman details the shake-up caused by recent research challenging the assumption of the superiority of cognitive behavior therapy (CBT). He cites several examples, including Norwegian research that found that the effects of CBT wore off over time, a large British National Health Service study that found an 18-month course of psychoanalysis more effective than CBT, and a Swedish media report that auditors there revealed expensive investment in a CBT methodology to be ineffective.

For the first time in years, the primacy of this modality is being questioned. Neuroscience discoveries support the idea that the brain processes and integrates information more quickly than we’re consciously aware of; this suggests that not everything can be known and measured quantitatively.

Because CBT is a quantitative approach that treats symptoms, it’s easily measurable. For example, you can keep a journal of your negative thoughts and episodes of physical symptoms of anxiety and measure your progress by looking at changes after you’ve cognitively reframed a thought or applied a behavioral technique. It’s much harder to assess changes such as an increase in one’s internal experience of self-satisfaction or healthy engagement with the world.

It would seem that fewer psychoanalysts, at least here in the western US, still practice in a classic Freudian mode. Analysis has blossomed in many directions, and the emphasis has shifted to other ways of understanding our psyches. The psychodynamic therapists I know focus on the connection between mind and body, “relational” work using the therapy relationship as a framework for exploring our experience of self and other, and the various ways our early life experiences impact our attachment styles. I don’t hear anyone talking about penis envy or such.

We live in a culture that values quick fixes, easy results, and action, and we are more comfortable doing than being. I think CBT speaks to that habit. Exploring and understanding the underpinnings of what makes us tick seems a more lasting approach to how we express our difficulties, but it’s work that can unfold slowly. That being said, I think CBT and related approaches have a real place in the healing modalities. For some people, it’s all they want or can tolerate. And what’s wrong with finding tools to manage or alleviate emotional distress? I just don’t think it’s the panacea that our medical, academic and health insurance systems seem to think it is.

Here’s what psychiatrist Jerome Frank (“Case Study”, Psychotherapy Networker November/December 2015) lists as the essentials for therapeutic success:
• Confiding relationship with a helping person
• Healing setting
• A rationale or mythology that accounts for the client’s symptoms
• Plan that both client and therapist believe can work

These ring true to me and I think argue for no one method being the magic pill. That’s why Women’s Therapy Referral Service emphasizes goodness of fit and congruence of values.

Niche Market Therapy?

A story in the February 7 New York Times Style section highlights the relatively recent phenomenon of therapists gearing their practice to a specialized, and sometimes narrow, demographic, e.g. LGBTQ clients, newly married clients, or those in the tech industry, the last especially prevalent in urban centers such as Silicon Valley and metro Seattle.

The piece concludes, though, with what we in the therapy field have long known, that the crux of successful therapy is the power of the healing relationship between therapist and client.