Therapy is not one-size-fits-all, and is a much more complicated science than most people think. Therapists and researchers are forever trying to nail down the best evidence-based strategies for helping clients better manage their illnesses. According to Dr. Cliff Lazarus at Psychology Today, three strategies have proven the most widely effective for dealing with common psychiatric conditions.
It’s worth noting that this is not a list of coping strategies, but methods of therapy–meaning that they’re things to work through in concert with a therapist. The most important factor for the efficacy of therapy is how strong a relationship you have with your therapist. Though some of these principles may be applied to coping mechanisms you can try by yourself, this article is specifically talking about things for therapists and clients to work on together.
1. For Depression: Behavioral Action Therapy
Behavioral Action Therapy (BAT) is a very simple concept. It can also be described with two aphorisms: “where your feet go, your head and heart will follow” and “fake it ’til you make it.” People who suffer from depression are often unmotivated to do the things they ordinarily enjoy, or even the things they need to do. BAT is all about overcoming that amotivation and carrying on your activities as you would otherwise.
This may seem like crass advice, but it’s not just about doing things because you have to. In the medium-to-long-term, engaging in these sorts of activities is known to have a reliable positive effect on depressed client. Depression reinforces itself by making sufferers want to withdraw and isolate themselves from the world around them. Staying socially active, keeping up hobbies, and getting outdoors help counter and eventually reverse this spiral of behavior.
2. For Anxiety: Exposure Therapy
Just as depression reinforces itself through withdrawal and isolation, anxiety reinforces itself through avoidance. Many people with anxiety disorders go far out of the way to avoid certain stimuli, and may miss out on important opportunities rather than risk an anxiety attack. Rather than helping the client cope, avoidant behaviors often only strengthen and reinforce the underlying anxieties.
However, exposing oneself to triggering stimuli can also make anxiety worse, or just lead to unnecessary suffering. The help of a therapist, and a controlled environment of exposure, creates a much more supportive and a more effective environment. Not all exposure treatments are direct–many anxious clients are put through “imaginal” exposure, visualizing and thinking through scenarios that cause anxiety.
3. For Social Challenges: Assertiveness Training
Social and interpersonal challenges can be connected to either anxiety or depression, but sometimes just need to be worked on on their own. In this arena, the most appropriate behaviors are also emotionally reinforcing. Assertiveness is about finding a line between passivity–awkwardness or difficulty expressing your own needs and opinions–and aggression, where your needs and opinions trump everybody else’s. An assertive person is able to say what they want to say without belaboring the point or belittling others.
Assertive behaviors cause self-confidence and a higher estimation of yourself. Whether or not you “get what you want” through these behaviors, you are likely to receive an emotional reward for yourself. Working through social situations with a therapist can prove very helpful, even if your problems aren’t connected with other symptoms such as depression or anxiety.
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