What's Changing? - Therapy

Please see below selected recent therapy-related change.

See also:

December 2023

Psychiatrist Bessel van der Kolk, author of The Body Keeps the Score, studied trauma for more than 50 years. Though we once considered trauma to be exclusive to veterans and people growing up in extreme circumstances, we now know it is widespread, and not only is it all over our society, trauma is all over our bodies too.
To an onlooker, one of the strangest aspects of therapy is the sheer length of time it requires. This is puzzling because an experienced therapist can typically diagnose the essentials of a person’s troubles in one session and yet a course of therapy can last years, at a rate of one appointment a week. As therapy sees it, the chief difficulty is not to identify someone’s problem, it is to help them see, feel and accept it properly, noted The School of Life.
Trends impacting person-centred counselling in the coming years are likely to include the following:
- The use of technology in counselling has continued to evolve. Online platforms, video conferencing, and mobile applications have become more prevalent, allowing individuals to access counselling remotely.
- There's been an increased emphasis on cultural competence and diversity within the field. Person-centred counsellors are striving to be more inclusive and aware of cultural differences to provide effective and relevant support to a diverse range of clients.
- The person-centred approach has seen ongoing research to establish its effectiveness and refine its application. Researchers and practitioners are exploring the integration of evidence-based practices into person-centred therapy.
- Some person-centred therapists have incorporated mindfulness and experiential techniques into their practice. These approaches aim to enhance self-awareness and focus on the present moment, aligning with the person-centred emphasis on the individual's subjective experience.
- There is a continued focus on training and professional development for person-centred counsellors. Ongoing education helps counsellors refine their skills, stay updated on the latest research, and adapt to the evolving needs of their clients.
- Person-centred therapy will be more often integrated with other therapeutic modalities, such as cognitive-behavioral therapy (CBT) or acceptance and commitment therapy (ACT), to create a more holistic and tailored approach for clients.

November 2023

Other-centred therapy seeks to restore our aliveness by rebuilding our connections to the world. The therapy focuses on our relatedness to others; human and other-than-human. It explores our inter-relatedness and recognises the fact that we live within a network of conditions that hold in place our beliefs and perceptions. Other-centred methodologies, which reflect a client-led relational model, explore the client’s world not only from their own perspective, but also, in imagination and reconstruction, through the eyes of some of the significant others who share it, inviting empathy and honesty as the process moves between the subjective and objective viewpoints. It explores both the minutiae of particular relationships, with the projections and the truth involved, and the wider systems within which they operate.

September 2023

30-40% of people do not benefit from psychotherapy, which is about the same as the proportion of patients for whom antidepressants do not help (but, fortunately, most people respond to one or the other or both).
Research suggests that successful exposure treatment leads to the formation of a new memory trace - i.e: ‘Even if I step very close to a precipice, I do not lose control of my body’ - in which the formerly feared stimulus (the precipice) is no longer associated with threat. This new learning can happen very quickly. In the 1980s/90s, Swedish psychologist Lars-Goran Öst showed that most phobic disorders could be treated just as well in one session of only a few hours as in multi-session formats, and just as effectively in small groups as in one-to-one therapy. Since then, positive effects of one-session treatments have also been demonstrated for other forms of excessive anxiety, for example panic attacks resulting from traumatic experiences.
For The School of Life, many tensions within relationships can usefully be looked at through the prism of a concept much used within psychotherapy: the idea of ‘rupture’ and ‘repair’. For psychotherapists, every relationship is at risk of moments of frustration or as the term has it, of ‘rupture’, when we suffer a loss of trust in another person as someone in whom we can safely deposit our love, and whom we believe can be kind and understanding of our needs.

August 2023

“Psychotherapy has become more and more popular,” claimed Irena Bezic, president of the European Association for Psychotherapy. “I think it’s the profession of this century.” Data from membership organisations showed new counsellor numbers rising fast, e.g. between April 2020 and April 2023, membership of the British Association of Counselling and Psychotherapy, increased by 27% to 66,000, and student membership rose by more than a third to 13,000. The surge followed a sharp increase in demand for mental health services. Figures also showed that between 2017 and 2022, the number of people in contact with NHS mental health services rose by 25% to 4.5m. Private providers reported more people seeking self-funded therapy, while charity Rethink Mental Illness said visits to its advice website increased 175% in a year.

July 2023

A study assessing randomised control trials of therapy sessions in the US and Norway found that of all the techniques counsellors attempted - including confrontation, questioning and offering support - the therapist listening carefully and reflecting back what the patient said was the most effective. The “listening carefully” part is vital. People know when you are only going through the motions.
According to Doreen Fleet, writing in Psyche, the emergence of sand-tray therapy is often associated with the British paediatrician and child therapist Margaret Lowenfeld in the early 20th century. In 1937, she presented what she called her ‘world technique’, suggesting it could help children in therapy if they were struggling to put their experiences into words. Today, sand-tray therapy is used not only with children but with adults too. Fleet's own experience as a psychotherapist is that sand-tray therapy can be a powerful and effective way of working with a wide range of adult clients.

June 2023

The mental health benefits of spending time outdoors are well documented, but nature immersion could be more important than previously acknowledged. According to one study, activity conducted outdoors produces more benefits to the brain than the same exercise conducted indoors. Brands encouraging people to get outside, with e.g. Hipcamp and REI partnering with Outdoor Journal Tour to sponsor weekly guided hike, while L.L.Bean encouraged people to get outside with others (an important consideration when concerns about loneliness are mounting, e.g. US Surgeon General Vivek Murthy declared loneliness a public health epidemic, and Google Trends reported that searches for 'how to make friends', 'where to make friends' and 'where to meet people' had reached an all-time high).
Some people have reported experimenting with the ChatGPT chatbot as an unofficial therapist. The technology has clear potential to provide a “listening service” that could expand the franchise of mental health apps, which are already booming, but the FT warned that unsupervised AI “self-medication” could also be very dangerous. It could, for example, convince users that delusions were real or low self-esteem was justified.
Aided by best-selling psychology books, such as Bessel van der Kolk’s The Body Keeps the Score, discussions about trauma and how to deal with it have entered popular public discourse. However, leading neuroscientist Lisa Feldman Barrett challenged the popular notion that trauma resides solely in the body, asserting that trauma is rooted in the brain’s predictions and the construction of our experiences. Rather than focusing on the body as the site of healing, she suggested that changing the brain’s models of prediction is what needs to be addressed to break free from the cycle of trauma.

May 2023

One of the cruellest aspects of mental illness is that it strips us of any ability to believe that other people might be suffering in the way we are. We are condemned to a feeling that, while everyone else is coping perfectly well, we alone are struggling. It's not always easy to share our innermost feelings, but when we express our anxieties out loud, we are better able to understand them and gain perspective on our situation. Yet this sense that our present difficulties are unique isn’t just unlikely, but impossible. Among the seven billion of our species, there are countless others who feel just like we do — but we have lost all confidence in our right to find them, notes The School of Life.
The Body Keeps the Score is the suggestive title of a book published in 2014 by a Dutch professor of psychiatry at Boston University, Bessel van der Kolk. The book has proved immensely significant because it emphasises an idea that has for too long escaped psychiatrists and psychotherapists. Van der Kolk stresses that people who are suffering emotionally are unlikely to do so just in their minds. Crucially, their symptoms almost always additionally show up in their bodies: in the way they sit or breathe; in how they hold their shoulders, in their sleep patterns, in their digestion processes and in their attitudes to exercise.

April 2023

Psyche noted that more and more people around the world are undergoing psychotherapy to help address their psychological and emotional difficulties. Research on its effectiveness is generally positive, but unfortunately there are many people whom it fails to help. A major obstacle to improving and refining therapy so that more people benefit is that how exactly therapy works remains unknown. Varied approaches to therapy have evolved from different philosophical positions, and each holds different theories about how their approach to therapy works and brings about change and some of these theories are not currently supported by empirical evidence.
Psychoanalysis suggests that many people will end up - without being aware of the fact - marrying either our mothers or our fathers. Indeed, psychoanalysis doesn’t merely insist that we will marry someone like our parent. It also proposes that what we really want to do is to give the story with a parent-type figure a different ending.
Some clients in therapy, are alexithymic, a term coined by the US psychoanalysts in the 1970s, from the Greek a (‘without’), lexis (‘words’) and thymos (‘emotions’). It refers to a cluster of features including difficulty identifying and describing subjective feelings, a limited fantasy life, and a style of thinking that focuses on external stimuli as opposed to internal states. Psychoanalysts often describe such clients who reach an impasse in treatment because of their concrete thinking, limited emotional awareness and dismissive attitude toward their inner lives. These people can be prone to developing so-called somatic symptoms (bodily complaints such as pain or fatigue) and using compulsive behaviours to regulate their feelings, such as binge eating and alcohol abuse.
The theory of bibliotherapy is that people engage with literature, not just to escape the familiar world and travel somewhere else, nor only for academic purposes, but to ease the pain of existence, of being human. Researchers investigating the concept have included Kelda Green, author of the thesis ‘When Literature Comes to Our Aid’ (2018), and practising bibliotherapists, such as Ella Berthoud and Susan Elderkin who wrote The Novel Cure (2013), noted Psyche.

March 2023

Mental illness is often thought to be a matter of individual disorder. Psychiatry looks to features of individual experience, behaviour and thoughts to diagnose mental illness, and focuses on individual remedies to treat it. If you are depressed, this is understood as your response to circumstances, based on features of your genetics, disordered patterns of thinking, or personal problems and emotional states. Western treatment of mental illness follows these same individualistic lines: an individual is provided with medicine and therapy. Yet such an emphasis on the individual can neglect communal approaches to treatment. Often overlooked are the ways in which social norms, cultural beliefs and communal attitudes contribute to mental illness.
Equally, the counselling and psychotherapy profession is embedded in a political system: such as who pays therapists to work, how they get to train, what work they do. A few counsellors might live in a "protective" domain of private practice, but even that is affected by political factors: for instance, who gets to come and pay the fees. If someone is unemployed, for instance, it might be much more difficult for them to have therapy with us than if they're in a highly-paid job.
Numerous companies offer virtual and on-site psychologists to help staff deal with problems both at work and in other parts of their lives. Support such as this can help employees deal with grief and loss, anxiety and depression. When work therapists are available, it means employees can access support more easily. The offer of counsellors and therapists can also help ease the pressure on managers, who themselves can be highly stressed.

February 2023

Psyche identified a number of new/emerging therapies, including:
- Acceptance and commitment therapy (ACT), which aims to develop and expand psychological flexibility, thereby improving one’s ability to adapt thoughts and behaviours to better align with one’s values and goals. Individuals who experience rigid thought processes, who have difficulty imagining alternative options, and who struggle to accept their thoughts may benefit from ACT.
- Internal family systems therapy (IFS) - an approach developed by the US psychotherapist Richard Schwartz that sees the different parts within each of us operating much like families interact. Sometimes, our different parts squabble; sometimes, they work together; and sometimes they’re fiercely protective of other members. Schwartz came to this realisation after listening to clients – really listening. He found they would say: "A part of me likes/hates this…" and he wondered what would happen if we recognised those parts as being real.
- Mindfulness-based stress reduction (MBSR), which incorporates mindfulness meditation, body awareness, yoga and explorations of one’s patterns of thinking, feeling and acting to cultivate attention and emotion regulation while reducing rumination and worry. Individuals who experience difficulties engaging with the present moment (due to fixations on the past or a potential future) and who are not in tune with their bodily sensations may benefit from MBSR.
- Rumination-focused cognitive behavioural therapy (RF-CBT), which involves identifying the causes of rumination and aims to foster more concrete, process-focused and specific thinking – as opposed to ruminative thoughts, which are often abstract, obsessive, and focused on numerous possible outcomes. Unlike traditional CBT, which focuses on modifying the content of thought processes, RF-CBT focuses on modifying the process of thinking. Thus, it may be particularly useful for individuals who perceive their thoughts as incessant and out of control, and who would like to change not only what they think, but also how they think.

January 2023

New Zealand’s prime minister Jacinda Ardern’s resignation led some experts to believe burnout will finally be recognised as a strategic priority by company leaders. However, studies show that many executives perceive burnt-out workers as less competent than those who do not go through the ordeal. Moreover, Ardern’s authenticity might even fuel gender bias towards high-profile women leaders.

December 2022

Further reading:

November 2022

In Men and barriers to help, psychotherapist Jeremy Sachs warned that men’s barriers to accessing health are planted early and built upon with every myth and stigma reinforced by family, society, and men’s internal voice, pushing them to ignore any pain they feel. But as the statistics show, for some men, this leads them to a place where the only viable option is to take their own life.
Humanity Crew, an organisation founded in 2015, has so far provided more than 32,000 hours of free mental health services to refugees in the Mediterranean. The organisation does its best to reframe traumatic experiences for people when it makes sense to do so - for example, helping a young refugee boy who survived a dangerous ocean journey to see himself as a strong and capable hero. This can nudge the mind to store memories as positive experiences instead of traumatic ones.
As “therapy speak” increasingly infiltrates the vernacular, Merriam-Webster took official note of the trend. The dictionary publisher chose “gaslighting” as its word of the year for 2022. A term that once referred to extended and severe “psychological manipulation,” it now means “something simpler and broader: the act or practice of grossly misleading someone”.

October 2022

BACP warned that mental health is in decline - 75% of therapists said that the public’s mental health had declined recently. 88% of therapists who said mental health had declined in 2022 listed cost of living concerns as a reason for this. 70% of therapists agreed that there had been a rise in referrals from first timers to therapy over the past two years. 50% of therapists said the demand for therapy is over capacity, this was up 11% compared to the previous year. 57% of therapists also reported an increase in clients presenting with relationship issues in the past year.
A study, led by University College London researchers, examined data from the NHS’s Improving Access to Psychological Therapies (IAPT) service for people with dementia who also had clinically significant anxiety or depression. The researchers found that among people with dementia, the treatment proved to be beneficial. Some 63% of them saw a reduction in symptoms of depression and anxiety, after completing treatment through IAPT. Around 40% recovered completely.
The School of Life noted that, to an onlooker, one of the strangest aspects of therapy is the sheer length of time it requires. This can be puzzling because an experienced therapist may diagnose the essentials of a person’s troubles in one session and yet a course of therapy can last years, at a rate of one appointment a week. As therapy sees it, the chief difficulty is not to identify someone’s problem, it is to help them see, feel and accept it properly. Were the truth to be laid out before clients, some might leave at once in a mood of fury: we have only limited strength to hear that, for example, our levels of confidence might be connected up a trauma that occurred before we were three.

September 2022

A clinical psychologist claimed that society is failing people by locating their problems within them as some kind of mental disorder or psychological issue, and thereby depoliticising their distress. Will e.g. CBT designed to target “unhelpful” thinking styles really be effective for someone who doesn’t know how they’re going to feed their family for another week? Antidepressants aren’t going to eradicate the relentless racial trauma in a hostile workplace, and branding people who are enduring sexual violence with a psychiatric disorder does nothing to keep them safe. Unsurprisingly, mindfulness isn’t helping children who are navigating poverty, peer pressure and competitive exam-driven school conditions, where bullying and social media harm are rife.
This relates to liberation psychology, founded in the 1980s by the Salvadorian activist and psychologist Ignacio Martín Baró, which argues that we cannot isolate “mental health problems” from our broader societal structures. Suffering emerges within people’s experiences and histories of oppression.
New therapies are on offer to people in Brussels suffering from depression, stress or anxiety. Psychiatrists in one of the city’s largest hospitals are now able to offer patients “museum prescriptions”, a free visit with a few friends or family members to discover one or more of Brussels’ cultural institutions. Such museum prescriptions are a voluntary addition to medication, psychotherapy, individual or group therapy, as well as exercise, healthy eating and other forms of relaxation.
SFBT stands for solution-focused brief therapy. This is a short-term, goal-directed form of therapy in which the purpose is to help the client discover, clarify and accomplish their own solutions to problems. SFBT is future-oriented, so it supports and motivates the client to move forward towards the desired outcome, rather than remaining stuck on the presenting issues. In Cognitive Behavioural Therapy (CBT), the focus is on eliminating or reducing a problem or symptom. In SFBT, the focus is on enhancing or amplifying a solution.

August 2022

Mirena Dimolareva, a lecturer in educational psychology, has claimed that the future for animal-assisted interventions looks promising. She has seen first-hand how children regulate their behaviour during lessons and playtime (often the most challenging time, due to the lack of structure) to make sure they are allowed to spend time with the therapy dogs. If we can teach children to regulate their behaviour in the classroom and potentially transfer this to their day-to-day life, it could have a groundbreaking impact on their ability to learn and their overall wellbeing. She believes that this is particularly exciting as animals may have the potential to elicit these benefits for those who do not currently respond to other interventions.

July 2022

A biographer of Carl Rogers, David Cohen, wrote that Rogers’s therapeutic philosophy ‘has become part of the fabric of therapy’. Today, in the West, many believe that going to therapy can be an empowering and positive move, rather than an indicator of crisis or sickness. This shift owes a great deal to Rogers, as does the expectation that a therapist will allow themselves to enter into our thinking, and express a careful but tangible empathy. Where Freud focused on the mind in isolation, Rogers valued more of a merging of minds - boundaried, but intimate.
Depression affects approximately 280 million people worldwide, and antidepressant medications – though they have offered relief for many – are not as effective as we need them to be. Furthermore, psychotherapy - an effective treatment for depression and other mood disorders - is simply not accessible enough for many people. One assessment found that the median time that a young person waited to access therapy in the UK was 60 days. Many people wait even longer. In a survey of therapists across the US, conducted by The New York Times at the end of 2021, a third said that it would take at least three months for an appointment to open up.
Psyche explained that exposure therapy refers to ‘repeated, systematic exposure to cues that are feared, avoided, or endured with dread’. Whether the therapy is delivered in vivo or in sensu, it can provide patients with new, anxiety-reducing and fear-relieving experiences that violate their fear-evoking expectancies - such as patients with a fear of heights (acrophobia) predicting that "If I step too close to a precipice, I am pulled into the depths". Research suggests that successful exposure treatment leads to the formation of a new memory trace – i.e: "Even if I step very close to a precipice, I do not lose control of my body" - in which the formerly feared stimulus (the precipice) is no longer associated with threat.
Whereas CBT emphasises using a set of tools to form new habits of thinking and behaving, psychoanalysis involves an ongoing, collaborative and transformative process involving therapist and patient. The therapist notes ways in which the patient might, in the here-and-now of the therapy unconsciously experience repetitions of past situations. These repetitions, known as ‘transference’, can indicate core psychological conflicts from childhood or adolescence - moments when needs went unmet while growing up. Unlike CBT, psychoanalytic therapy does not view all psychological problems as problems of thinking. There is no expectation that these problems can be resolved merely by helping the patient think more carefully and accurately.

June 2022

According to Eric Jannazzo, a licensed clinical psychologist working in private practice, the benefits of good therapy are often profound. Yet, for many people, finding one way or another to engage with the basic spiritual question - who they are, really, really - opens a doorway to the lived experience of being a natural phenomenon, inseparable from a world that otherwise, too often, leaves us with a vague sense of estrangement and loneliness.
For the School of Life, the steps we need to take in order to check in with ourselves are not especially complicated. We need to make time, as often as once a day, to lie very still on our own somewhere, to close our eyes and direct our attention towards one of many tangled or murky topics that deserve reflection: a partner, a work challenge, an invitation, an upcoming trip, a relationship with a child or a parent. We might need a moment to locate our actual concern. Then, disengaged from the ordinary static, we should circle the matter and ask ourselves with unusual guilelessness: "What is coming up for me here?"
The School of Life also believes that, nowadays, we’re used to thinking of travel as the ‘fun’ bit of life, but enjoyment isn’t a reason why it shouldn’t also do some very serious things for us. At its deepest level, travel can assist us with our psychological education. It can play a critical role in helping us to grow into better versions of our normal selves. When it corrects the imbalances and immaturities of our natures, travel reveals its full potential to function as a form of therapy in our lives.
For The Economist, it is no surprise that demand for psychotherapy is increasing in China. Take the residents of Shanghai, who suffered through months of lockdown and if the virus was not causing enough anguish, there was also the struggling economy. China’s youth-unemployment rate shot up to 18.4% in 2022, allied with censorship, surveillance and oppression. China’s collective mental health seemed to be declining even before the pandemic. In Shanghai the suicide rate had been rising since 2009, while suicides in Wuhan, the city where the COVID virus was first identified, were 79% higher in the first quarter of 2020 (when it was under lockdown) than in the same period a year earlier.
Further reading:

May 2022

Erik Erikson maintained that personality develops in a predetermined order through eight stages of psychosocial development, from infancy to adulthood. During each stage, the person experiences a psychosocial crisis which could have a positive or negative outcome for personality development. For Erikson, these crises are of a psychosocial nature because they involve psychological needs of the individual (i.e., psycho) conflicting with the needs of society (i.e., social).
COVID increased many people's awareness of their own mental health struggles. According to a 2021 report by Mind, over a third of Britons said they didn’t have the support or tools to deal with the ups and downs of life. At least 10 million people might need support for their mental health as a direct result of the pandemic, according to the Centre for Mental Health. Demand for therapy was however outstripping supply. A study by the New York Times in late 2021 December revealed that even therapists in the US, where it has always been more accepted, are turning away patients, while in the UK, demand for mental health advice soared since the start of the pandemic.

April 2022

Big Think pointed to data that suggesting that the stories we tell ourselves about our motives, beliefs, and values are not merely unreliable but entirely fictitious. Our brains are such master storytellers that they even are able to justify choices that we never made. Introspection is not some strange inner perception; it is the human imagination turned upon itself.
For many, a tendency to not ask for help has been strongly reinforced over time. Many have lived in cultures in which individual performance and independence were prized and in which vulnerability and dependence on others were to be avoided, and this was passed down through the generations. And yet, the ability to ask for and obtain help is a valuable life skill. Over time, carrying a heavy load without enough support can lead to exhaustion and disengagement, resulting from the chronic stress of having too many demands and not enough resources. A lack of perceived social support has been associated with poorer mental and physical health outcomes.
For The School of Life, we accept without shame that most organs in our bodies might at some point develop problems and could need a bit of help. We should not make an exception of our minds. Our lives are so complicated and so filled with burdens, we should be completely unsurprised if, at some point, we felt a need to pull up a white flag and ask for help with our minds.

March 2022

A leading counsellor noted that under-40s increasingly come to her before they have even got near a crisis point. They come, they say, because they value their mental health much in the same way that they value their physical health. They often come because they want to acquire communication tools, to head off conflict before it derails them. They are open to each other and genuinely curious. However, many older couples seem to find this playful curiosity more difficult and some long-term married couples who seem to know very little about each other.
Hotels have long offered gyms to help guests stay physically fit while traveling, but what about their mental health? Remedying that omission, Kimpton Hotels & Restaurants partnered with Talkspace to provide free access to online therapy sessions. When booking a stay at one of the boutique hotel chain's 60 participating properties, guests could claim a complimentary video therapy call with Talkspace.
In London, Self Space opened a storefront location to provide anyone with flexible and on-demand mental health care, allowing people to pop in for a session like they would for a haircut. The startup's goal was to remove any perceived barriers to seeing a clinical psychologist or psychotherapist. Clients could usually book a same-day appointment, with the shop open seven days a week. Options include one-on-one therapy, couples therapy, student sessions and executive coaching, or just "a good conversation with a qualified person".

February 2022

Mild to moderate depression and anxiety are often treated with cognitive behavioural therapy (CBT) or some other evidence-based, structured psychotherapy, such as interpersonal therapy (IPT). CBT tends to focus on ways to address patterns of negative thinking, whereas IPT focuses more on difficulties with other people. In England in 2021, the National Institute for Health and Care Excellence, which provides independent, evidence-based guidance to the government, issued a renewed draft guideline for treating depression in adults, which stressed that talking-based treatments should be the first choice for addressing mild to moderate depression.
However, Psyche warned that 30-40% of people may not benefit from psychotherapy, which is about the same as the proportion of patients for whom antidepressants do not help (but, fortunately, most people respond to one or the other or both). As with any intervention, talking treatments can do harm as well as good. Data from a study of hundreds of people who received therapy for depression or anxiety via the NHS in England found that just over 14% of clients reported that they had been made worse in the long term. The risk of harm has long been recognised in the psychodynamic community. Simply put, there are some unfortunate people who have been too damaged by traumatic upbringings to be able to tolerate, let alone benefit from, talking about it.
Acceptance and commitment therapy, or ACT, which is infused with mindfulness concepts, acknowledges that suffering is part of the human condition and guides people in becoming “psychologically flexible” to navigate life’s ups and downs and keep moving forward. ACT encourages "psychological flexibility" - i.e. people being able to live their lives meaningfully and effectively, regardless of what they’re thinking or feeling, regardless of what memories are coming up, regardless of how they’re thinking of themselves, regardless of how much anxiety they may be experiencing, or sadness or hopelessness.

January 2022

According to Psyche, while most people learn how to regulate their emotions when they’re growing up, for some, the strategies they adopt are unhealthy or unhelpful. One theory about why this happens is the biosocial theory, from a treatment called dialectical behaviour therapy (DBT), which posits that some people are born with a higher level of emotional sensitivity: they have stronger reactions to things, take longer to get over those intense feelings, and generally deal with a higher level of emotional pain (eg, they experience more anger, sadness, shame or anxiety). While this emotional sensitivity (the ‘bio’ part of the theory) isn’t uncommon and isn’t a problem in and of itself, when combined with a problematic environment (the ‘social’ part), things can become difficult.

December 2021

While Stoicism promises to help us build an “inner citadel,” a fortress of power and resilience that prepares us for the difficulties of the world, it makes no promises to make us superhuman. A Stoic isn't someone invincible.. A Stoic is someone who puts themselves back together so they can do what needs to be done, for themselves and for others. The Stoics would have liked the Japanese art form known as Kintsugi, which dates back to the 15th century. In it, masters repair broken plates and cups and bowls, but instead of simply fixing them back to their original state, they make them better, noted The Daily Stoic.

November 2021

The Financial Times reported on psychoanalyst Adam Phillips' book, On Getting Better, which asks one of the more amorphous questions of psychoanalysis: what draws us to the psychoanalytic couch? A desire to change, which is always a desire to change for the better. On Getting Better considers not simply how we might get better, but whether “self-improvement’” is a productive framework to construct one’s life around. Phillips suggests that our idea of how we want to get better can also be a “way of narrowing our minds, and deferring our desires”, and the question of “what we actually value and why we value it” can too easily be usurped by the desire to improve. Accordingly, he asks what might it look like to “get better at talking about what it is to get better”.
In the late 1950s, psychologist Carl Rogers first introduced the concept of empathy for invoking positive change. Over 60 years on, Nir Eyal explored the concept of unconditional positive regard and how it facilitates improved self-confidence to help us live out our values without fear of judgement.
An article in Psyche argued that targeting underlying risk factors such as neuroticism represents an efficient approach to addressing common mental health conditions. Given the enormous public health significance of neuroticism in particular, directly addressing this trait has the potential to help ease the burden of mental illness on a global scale.
Psychodynamic therapy differs from other talk therapies in using the patient-therapist relationship to explore the patient’s unconscious thoughts and fears, and in allowing the therapist to interject, feeding back how they feel about what the patient is and isn’t saying. A psychodynamic therapist enables the patient to renegotiate their relationships using the therapeutic dynamic as a safe testing ground, noted Psyche.

October 2021

French president Emmanuel Macron announced that the government will cover the cost of therapy sessions for any citizen aged three and older, as part of a broader initiative starting in 2022 to address mental health concerns. “Mental health is a major issue that is insufficiently addressed in our country,” Macron said at a conference for psychology professionals. The president said he sees the new measure as a way to address a “historic demand” for therapy, and help citizens whose mental health is suffering “as soon as possible.”

September 2021

There has been a boom in psychedelics research to treat various conditions ranging from PTSD to depression. The use of psychedelics like psilocybin, the psychoactive ingredient in magic mushrooms, has been particularly effective in limiting anxiety in studies with terminally ill patients at Johns Hopkins University and New York University. Given the state of the world and the liberalization of drug laws in the United States, people are returning to plant medicine to ease the ills of modern life, noted South Africa writer Joseph Dana.
The FT noted that, since the pioneering work of Sigmund Freud, psychotherapists have known that our early childhood experiences have a significant effect on our perceptions and character traits, which we then bring into our working lives. Compulsions such as perfectionism, workaholism, controlling behaviour and even people pleasing, habits which can undermine our careers, can be understood best by examining our past. Our earliest relationships reside deep in our minds and, consciously or not, create a template for how we relate to others, respond to conflict and deal with authority.
When we’re young, all of us draw; as we grow older, most of us stop. We come to see drawing not as a type of play, but as a craft or skill; one that we can do either well or badly. But to see drawing in this way is to deny ourselves one of life’s great pleasures, and to miss out on its profound psychological benefits. By allowing us to express ourselves creatively, and capture our thoughts and ideas on paper, drawing can be a form of therapy, argues The School of Life.
The Guardian asked: could you spot the signs of poor mental health in a friend, relation or colleague? Mental health first aid is an idea that is taking hold, at a time when record numbers of people have been seeking help for mental health conditions. It’s not as straightforward as treating, for instance, a cut or a burn. Signs of depression and anxiety can be tricky to spot, says Stuart Payne, a mental health first aid trainer for St John Ambulance, which runs courses in workplaces.

July 2021

Although many mental health treatments are available today, they continue to involve a great deal of guesswork. For instance, if someone is feeling down and sad every day or has lost all interest in the things they usually like (the symptoms of major depression), their GP will usually either offer them an antidepressant drug or put them on a waiting list for psychological therapy. These treatments are somewhat effective: each treats depression successfully in about half of cases. The problem is, there is currently no way to tell whether someone would be more likely to get better after therapy or after drugs (or a combination of the two).
HBR pointed to an op-ed in the New York Times Sunday Review affirming that expressive writing can heal us. A certain kind of guided, detailed writing can not only help us process what we’ve been through and assist us as we envision a path forward; it can lower our blood pressure, strengthen our immune systems, and increase our general well-being. Expressive writing can result in a reduction in stress, anxiety, and depression; improve our sleep and performance; and bring us greater focus and clarity.
Carl Jung died 60 years ago this month. In the spring of 1957, at the age of 84, Jung set out to tell his life’s story. He embarked upon a series of conversations with his colleague and friend, Aniela Jaffe, which he used as the basis for the text. At times, so powerful was his drive for expression that he wrote entire chapters by hand. He continued to work on the manuscript until shortly before his death in 1961. The result was Memories, Dreams, Reflections - a peek behind the curtain of Jung’s mind, revealing his wisdom, experience, and self-reflection.
The Future Today noted that psychedelic therapy is becoming more visible in mainstream media and culture, e.g.
- How to Change Your Mind, a 2018 book by Michael Pollan, was a watershed moment, a serious journalist talking openly about the benefits of psychedelics in major media outlets, from the New Yorker to Time to The Late Show.
- The Psychedelic Trial was a BBC documentary that explored the implications of a major study at Imperial College.
- Lamar Odom Reborn was a documentary detailing the former NBA player’s recovery from addiction using psychedelic medicine.

May 2021

The modern world can present the body as a machine that just needs to be regularly exercised. However, it is a remarkably sensitive organ in which a lot of our pain and hope is stored and that we need to interpret and handle with subtlety. This impact of our body upon our mind is something that needs to be explored as it is easy to pay attention to one more than the other and to ignore the crucial balance between the two.

April 2021

During anxious times, it perhaps makes sense that companies offering therapy to the masses would receive a a lot of interest and headlines. But as noted in The Cut, the apps’ patient-as-consumer approach means they often don’t live up to their promises, for therapists or users.
According to Psyche, most people learn how to regulate their emotions when they’re growing up. But for some, the strategies they adopt are unhealthy or unhelpful. One theory about why this happens is the biosocial theory, from a treatment called dialectical behaviour therapy (DBT), which argues that some people are born with a higher level of emotional sensitivity: they have stronger emotional reactions to things, take longer to get over those intense feelings, and generally deal with a higher level of emotional pain (eg, they experience more anger, sadness, shame or anxiety). While this emotional sensitivity (the ‘bio’ part of the theory) isn’t uncommon and isn’t a problem in and of itself, when we combine this with a problematic environment (ie, the ‘social’ part), things can become difficult.
Covid transformed the way many people work, including those who look after our mental health. For much of lockdown, psychotherapists, counsellors, psychologists and psychiatrists had to venture into the world of online therapy, tackling their clients’ issues via a computer screen, and often the experience has felt less than ideal for all those involved. But throughout much of lockdown, another option has become increasingly popular: combining therapy with the benefits of the great outdoors. The British Psychological Society (BPS) issued guidance on this, advising its members on how best to take their work outside, addressing issues such as confidentiality and the absence of a boundaried space. Yet many therapists ditched the four walls and a couch approach a long time ago and have been working out in nature for years. For example, psychotherapist Beth Collier is founder of the Nature Therapy School, which offers training to psychotherapists who want to practise outside.

February 2021

Mental health often isn't addressed until someone reaches a state of crisis, much like someone not eating well or exercising until they've had a heart attack. California-based startup Coa aims to flip that convention and get people to take a proactive approach to mental health through regular maintenance and tune-ups. The company launched inearly 2021 after its founders first trialled the concept by hosting mental health pop-ups across the U, offering one-off emotional fitness classes for USD 25, and three themed eight-week series for USD 240. While classes are led by licensed therapists, Coa stresses they aren't for clinical needs.

December 2020

Psychotherapist Megan Devine, creator of Refuge in Grief and author of its portable counterpart, It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand found that, when studying how people navigate intense grief - the loss of loved ones to violent crime, suicide, disaster, infant death, and other abrupt catastrophic traumas - our most intuitive impulses about helping those whose suffering we yearn to allay - by cheering them up, by reorienting them toward the lighthouses in their lives amid the darkness - tend to only deepen their helpless anguish and broaden the abyss between us and them.

September 2020

While an esimated 173 million people, or 12% of the population of China, live with a mental health disorder, the lingering stigma of treatment means that only one in 10 of them end up seeking it. The country also lacks a robust infrastructure for mental health services: China has four times fewer trained mental health professionals than the global average, and most are concentrated in major cities.
However, China’s top health body said it planned to roll out counselling to people who have recovered from Covid-19.According to the official China Daily, social workers, volunteers and therapists will be made available to former patients, to help understand any physical, mental or financial help they might need. Their data will be held on local medical databases, under a system that “emphasises the importance of protecting their privacy”. Local health centres will also offer mental health assessments “based on informed consent and voluntary participation”. In China, more than 80,000 people have recovered from Covid-19 since the beginning of the year. Mental health hotlines have been open since as early as January. But mental health is a major concern in China. The official Xinhua news agency estimated last year that one in 10 Chinese people had mental health problems. That is 140 million people.
Medium reported on Denice Clark, PhD, a therapist based in Atlanta, who has been providing walk-and-talk therapy professionally since 2008. She’s well known as Dr. Walk and Talk (her company is called Sole to Soul Therapy), and a few months after the pandemic hit, therapists started contacting her about how best to offer this kind of therapy to their clients. “Therapists and clients alike are getting tired of online therapy,” she says, “so walk-and-talk seems to be the one way they can meet in person while feeling safe in the midst of the pandemic.” It makes sense that this type of therapy is on the rise: There’s strong evidence that spending time with other people outdoors is relatively safe, plus research shows that eye contact can increase anxiety levels, which suggests that walking side by side with a therapist (with masks and appropriate distancing, of course) could feel more comfortable for some people.
Recent decades have seen an increasing interest in the healing and therapeutic potential of nature and interest in the potential of "greencare" interventions for the benefit of mental health. The field of nature based therapies is expanding in line with this interest. A 2020 book, Nature and Therapy, outlined the specific processes involved in conducting counselling and psychotherapy sessions in outdoor natural environments.

August 2020

According to the Financial Times, the highest value for money comes from treating mental illness. There are many reasons for this. Empirically, mental illness accounts for more of the misery in our society than any other factor, including poverty. Under Covid, mental illness, became on average nearly 10 per cent worse for those already mentally ill, especially for women and young people. Excellent psychological treatments exist for most mental illness, and they are not expensive. But they reach fewer than one in five of those who need them. Finally, the economics. Mental illness is the main illness of working age, accounting for half working-age morbidity, and half of all disability and absenteeism. When people recover, they go back to work, come off benefits and pay more taxes.
The emerging field of financial therapy may have little to do with a particular money problem, but is instead often concerned with more subconscious issues that is causing stress. The root of a person’s relationship with money is very deep. “Money is a window to early trauma,” according to psychotherapist Judith Barr, in Connecticut, who focused on finance after recognising the deep effect that financial stress was having on her clients. “There have been very few times that I have worked with anyone on their money relationship where that hasn’t shown up.”

July 2020

An app can track mental health via your phone usage. It gauges users’ emotions by analysing factors such as voice, keystrokes, and amount of sleep. The hope is it will give mental health professionals a way to know how their patients are doing outside of a clinical setting so they can provide specialised treatment options.

June 2020

At Seattle’s Gottman Institute, relationship therapists attach wires to couples to assess their interactions. Now, the institute’s co-founders are spinning off this tech set-up into a startup, Affective Software, Inc. The new company offers an app-based, DIY solution, reports GeekWire. Couples upload videos of themselves (or their therapist does, with permission) to the app, which uses machine learning to assess the couple’s verbal and nonverbal behaviour. Couples can also choose to use fingertip sensors in conjunction with the app, to add additional data.
A chatbot called Woebot provides an AI-fuelled version of cognitive behavioural therapy. The makers of Woebot say it offers a powerful new form of self-care to those dealing with anxiety, depression and other mental health issues. The app free to use, and is working its way towards full FDA approval; a randomised, controlled trial by Woebot and Stanford University found the app could help people with depression. By mid 2020, Woebot exchanged 4.7 million messages with people every week. Woebot and apps like it have been a crucial aid for millions during the pandemic. But even before lockdowns began, psychiatry and talking therapy services in most affluent countries were stretched beyond their limit.

May 2020

Big Think wrote about how ecotherapy (also referred to as nature therapy) has been proven to be effective and is used in various practices and cultures around the world. While we stroll around the forest, breathing in the fresh air, airborne chemicals like phytoncides (a chemical many plants give off to fight disease) are also entering our system. When this happens, the human body responds by increasing the number of natural killer blood cells (a type of white blood cell) which attack virus-infected cells. In one 2009 study, participants spent 3 days/2 nights in a forested area. Their blood and urine were sampled before, during, and after the trip. Natural killer cell activity measured significantly higher during the days spent in the forest and the effect lasted up to 30 days after the trip. The results of a 10-study analysis proved that both men and women have similar self-esteem improvements after experiencing time spent in nature, and the boost in mood particularly impacted men.

April 2020

CB Insights analysed how chatbots can transform the mental health industry — specifically, in supplementing cognitive behavioral therapy. These bots largely fell short of expectations during their initial hype thanks to their stilted responses, but as companies strive for efficiency via automation and deploy more advanced neural network algorithms, chatbots are now able to generate more empathetic responses than ever.
Further reading:
- Coronavirus: how to make sure our relationships survive - Financial Times

March 2020

Further reading:

February 2020

Further reading:
- I’m a psychotherapist, but therapy didn’t ease my grief - The Guardian
- Why Extremists Need Therapy - The Atlantic

January 2020

Further reading:
- Grief in the age of the Internet - Prospect Magazine

November 2019

Further reading:
- A Therapeutic Approach to Art - The School of Life
- Esther Perel on surviving (and thriving) at work - Financial Times

October 2019

Further reading:
- 5 Signs of Emotional Immaturity - The Book of LifeThe Book of Life
- The therapy business - File on 4, BBC Sounds

September 2019

Further reading:
- Transform Your Therapy Sessions by Mastering These 6 Listening Skills - Thrive Global

July 2019

A mental therapy program using virtual reality, the Yes I Can project, was trialled in Hong Kong. Launched by AXA insurance, the Chinese University of Hong Kong and Oxford VR, the program aims to help patients overcome their social fears. 250 people were recruited to traverse VR environments that reflect everyday scenarios like going to a cafe, a convenience store or a doctor’s waiting room. In those spaces they will confront and safely engage in social situations.

June 2019

Further reading:
- How to Overcome Trauma - The School of Life

May 2019

Woebot was developed a mobile app, giving one-on-one therapy and getting millions of messages a week. But Woebot isn’t a person – it’s a chatbot. It was invented and developed by a psychologist Alison Darcy and uses AI to guide users through a session, anytime, anywhere. The developers hope that Woebot will help break down the stigma of therapy and help provide services to underserved communities, though it is not clear what might happen when we remove the human therapist from therapy.
For The School of Life, most of us have many vague feelings of hurt, envy, anxiety and regret, but for the most part we never stop to make sense of them. It’s too uncomfortable and especially difficult because we are so often busy and frazzled, hyper-connected yet a bit lonely. To really understand what we feel and think, we must turn away from distractions, common sense, and other people’s opinions. We need to develop intimacy with ourselves. Our un-thought thoughts contain clues as to our needs and our longer-term direction. Writing them out is key. Through writing, we recognise patterns to observe and, perhaps, outgrow.

April 2019

A founding idea of psychotherapy is that we get mentally unwell, have a breakdown or develop phobias because we are not sufficiently aware of the difficulties we have been through. Somewhere in the past, we have endured certain situations that were so troubling or sad, they outstripped our rational faculties and had to be pushed out of day-to-day awareness. Victims of our unconscious, we can’t grasp what we long for or are terrified by. Therapy is a tool for correcting our self-ignorance in the most profound ways, argued The School of Life. It provides us with a space in which we can, in safety, say whatever comes into our heads. The therapist won’t be disgusted or surprised or bored. They have seen everything already. In their company, we can feel acceptable and our secrets sympathetically unpacked. As a result, crucial ideas and feelings bubble up from the unconscious and are healed through exposure, interpretation and contextualisation. We cry about incidents we didn’t even know, before the session started, we’d been through or felt so strongly about.
A huge amount of suspicion still surrounds the business of seeking psychotherapy. To go to therapy is routinely associated with being somehow ‘disturbed’ or ‘ill’, self-indulgent or ‘weak’. And yet having therapy, far from evidence of mental immaturity or sickness, is perhaps a good sign of sanity, for it indicates that one possesses an unusual capacity for introspection and openness to vulnerability.

February 2019

Some 45 million people live with mental illness in the US alone, but only 43% get the treatment they need. Now there’s an app for that, although it’s not yet clear if chatting online delivers the same life-changing benefits as traditional therapy. Quartz noted that talk therapy has its limits, but that for many people, including those with conditions like depression and anxiety, it can help. As the number of people who suffer from mental illness has risen starkly, virtual therapy might be a way to bring the benefits of talk therapy to those who find the face-to-face version cost-prohibitive or simply inconvenient.

December 2018

The School of Life believes that self-analysis can work because, as we reflect, we let our sadness take its natural, due shape. We dwell at length on the wounds. We give space to our nostalgia. There may not be an immediate solution to the sorrows, but it helps immeasurably to know their contours and give ourselves a chance to square up to them. Our pains need a hearing. The more we think, the more our fears, resentments and hopes may become easier to name. We may become less scared of the contents of our minds. We may grow calmer, less resentful and clearer about our direction.
Further reading:
- Freshwater swimming as exploration and therapy - The Economist

October 2018

Modern life can keep us so busy that we forget (or avoid) the essential need to stop and check in with ourselves in order to take care of our own emotional lives. The School of Life believex that consulting a psychotherapist should be as accessible and as normal as developing a career, getting help for a physical problem, or going to the gym to get healthy. Just as we take care of our bodies and physical health, a vital element of self-care is devoting focused time and energy to exploring and understanding our thoughts and feelings.
Quartz argued that good design can help ameliorate the stigma around going to therapy. Chic lighting and furniture create an environment patients want to return to.

September 2018

For The School of Life (TSOL), what is distinctive about therapy is what it is a tool for: it is an invention to help improve the way our emotions operate. It has been devised to correct the otherwise substantial difficulties we face understanding ourselves, trusting others, communicating successfully, honouring our potential and feeling adequately serene, confident, authentic, direct and unashamed.
Therapists know, adds TSOL, that inside every adult there remains a child who is confused, angry, hurt and longing to have their say and their reality recognised. They appreciate that this child has to get to know itself again and will want to be heard, perhaps through tears or near-incomprehensible mutterings, which might be at odds with the surface maturity and self-command normally associated with the grown-up sitting in the therapeutic chair.

August 2018

Mexican healthcare company Docademic launched Cool Emotions, a free app that uses AI and cognitive behavioral methodology to provide therapy, noted Trend-Watching. Launched in July 2018, Cool Emotions is designed to support young Latin Americans with issues such as depression, teen pregnancy and bullying. The app helps patients identify their problems, as well as educate them, propose solutions and motivate them to act. Therapy sessions on the app, with live therapists, last approximately 15 minutes. Patients that keep up with their sessions are rewarded with Docademic’s MTC cryptocurrency, which can then be exchanged for anything from medicines to concert tickets.

July 2018

Psychotherapy is one of the most valuable inventions of the last hundred years, argued The School of Life (TSOL), with an exceptional power to raise our levels of emotional well-being, improve our relationships, redeem the atmosphere in our families and assist us in mining our professional potential. But it is also profoundly misunderstood and the subject of a host of unhelpful fantasies, hopes and suspicions. Its logic is rarely explained and its voice seldom heard with sufficient directness. TSOL shared 20 small essays on its key concepts.
Psychotherapy won’t work for everyone, adds TSOL: one has to be in the right place in one’s mind, one has to stumble on a good therapist and be in a position to give the process due time and care. But that said, it believes that, with a fair wind, psychotherapy also has the chance to be the best thing we ever get around to doing.

Pre 2018

In 2016, Adam Phillips, one of Britain's most renowned psychoanalysts and literary figures, joined RSA Chief Executive Matthew Taylor for a conversation about life, the universe, and everything (and maybe a little Freud as well). See also:
- For more information about the event go to the RSA event page.
- Listen to the podcast of the full event including audience Q&A.
- Watch Adam Phillips on the RSA's YouTube Channel
- Watch Adam Phillips on the RSA's Vimeo Channel
Having some psychotherapy is for The School of Life just about the most significant and interesting thing one could do to improve your chances of contentment - in relationships, at work, and with friends and family.

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