A Practical Guide to Mental Disorders No. 6 —– What are the side effects and misconceptions of psychotherapy?

  What are the side effects of psychotherapy?  There are no therapies in the world that have only therapeutic effects without side effects, and psychotherapy is certainly no exception. The side effects of psychotherapy can be seen in three ways: first, it makes the patient stagnant, second, it makes the patient’s condition worse, and third, it adds new problems to the patient.   The most common side effect is to make the patient stagnant. For example, a dependent patient who transfers a pattern of dependency to a doctor who is not aware of it and is subconsciously satisfying and encouraging the patient’s pattern of dependency will lead to a difficult resolution of the patient’s pattern of dependency, and treatment will, of course, stagnate. If the patient happens to meet a therapist who is used to controlling others, the patient and the therapist will form a pathological alliance of “control-acceptance of control”, which seems to be a very comfortable relationship on the surface, but the patient’s fundamental problem is not solved, and the patient’s personality is not developed and matured. The patient’s personality does not develop and mature.  The second possible side effect is the exacerbation of the patient’s condition, which is very rare. This usually occurs in the psychotherapy of borderline personality disorder. Since the psychological defense mechanisms of these patients are weak, if the treatment is too intense, it can cause the patient’s defense mechanisms to collapse and make the condition worse in a transient manner. There are also individual patients who have a deep hidden self-masochistic psychology and regard psychotherapy as a tool for self-masochism. In such a person, the more successful the psychotherapy is on the surface, the more his masochistic psychology is satisfied and the heavier and more stubborn his condition becomes.  The third possible side effect is the creation of new problems. Such a situation would be very rare. It usually occurs between a very sick doctor and a very psychologically naive patient, and is based on a serious sadistic masochistic psychology of both the doctor and the patient. This situation seems to be only appreciated in Western psychological films.  The side effects of psychotherapy come mainly from the immaturity of the doctor. The good thing is that psychotherapy is a “self-correcting” process, and patients will instinctively withdraw from such treatment. Moreover, the creation of a supervisory system for psychologists can also avoid the side effects of psychotherapy to a certain extent. Therefore, psychotherapy is a relatively safe treatment compared to other treatments, and there is no need to worry too much about it.  Common misconceptions about psychological treatment In the process of treating psychological diseases, I found that many psychological diseases are not treated well because patients fall into certain misconceptions. The most common misconception is that the patient is bent on seeking special treatments, what special drugs, what advanced instruments, what foreign therapies, what has been advertised in the media, should be rushed to try, and each therapy is superficial, ignoring the mobilization of the patient’s own inner potential and motivation. The mobilization of the patient’s own inner potential and motivation is precisely the core of psychotherapy, and is also the fundamental reason for the effectiveness of the treatment, if the core and the fundamental is ignored, the treatment will not be successful. The second common misconception is that patients in the process of psychotherapy, reversing the primary and secondary relationship between the doctor and the patient. A significant difference between the treatment of psychological disorders and general diseases is that the patient is the main body of treatment and the doctor is the auxiliary body. If the treatment of psychological disease is compared to a spiritual surgery, then the most appropriate and ideal surgeon is not the psychiatrist, but the psychiatric patient himself, the psychiatrist is only the assistant and adviser of the operation, and must not overstep the bounds, otherwise, it will only help to grow. The third common misconception is that patients underestimate the difficulty and time required for treatment. According to research, any psychological disease, there is a pathological character as the basis, the foundation of character is not shaken, the symptoms of psychological disease will also be difficult to eradicate. And character is formed before the age of five years old cast role, after the age of five, the basic stereotypes, once set, lifelong difficult to change. In our proverb, there is also the saying “the mountains are easy to change, but the nature is difficult to change”, so it is clear that the diagnosis and treatment of psychological disorders is originally difficult and long. Lack of awareness and preparation for this, and fall into the misconception of rushing to success, treatment will easily fail.  There are many issues involved in the “Guide to the Treatment of Psychological Disorders”, which cannot be thoroughly explained in a few words, so this article can only be a slapdash introduction. Moreover, there are some questions that are not universally answered by the wise and the benevolent. The above views are for reference only, and I hope they can be of help to psychiatric patients.