This week a psychologist won the Nobel prize for medicine. He and the two physiologists with who he shared his prize made discoveries about the fundamental nature of spatial memory. This memory and processing is nonconscious and takes place in the area of the brain responsible for emotional processing. The underscores the need for psychologists to be scientists — even if they are primarily clinicians.
The somewhat over-rated genius Sigmund Freud proposed that anxiety is the result of sexual thoughts, that you unknowingly are keeping out of awareness. He proposed that your unconscious mind decides what memories you can or can not handle. If your unconscious decides that letting some memories or desires into consciousness would be too hard for you to manage it represses the memories. That is, without any input from you, your unconscious contains independent censors that laboriously work to keep offensive material from airing in your minds viewing screen. This censoring process, according to Freud, drains your life energy or libido. When it gets overburdened in the process of protecting your from your own impulses you will feel the weakening of the censoring mechanism as anxiety. Suppose your darkest wish is to make incestuous love to your mother – this maternal example, incidentally, is a key tenet of Freud’s theory. Suppose further that your incestuous impulse begins to grow increasingly strong. According to Freud the unconscious repression mechanisms will begin to strain under the pressure and this will be experienced in the conscious mind as increasingly intrusive anxiety.
In contrast, the more research based view of anxiety is quite different. In short, areas of the brain that regulate fear are exposed to thoughts, images, or other sensations that provoke feelings of dread. These largely originate in a brain region called the amygdala that is part of an evolutionary old brain region called the limbic system. It is responsible for most survival behaviors and emotions — including fear and anxiety. Indeed, anxiety can be triggered by a range of feared objects that might escape overt notice. Or it can result from irrational thinking that is so habitual that is goes unnoticed until pointed out.
It is conscious reasoning largely in the prefrontal cortex that can consciously attenuate anxiety arising from the more phylogenetically primitive limbic system. Albert Ellis proposed that many people are genetically prone to developing emotional vulnerabilities. He said:
I am still haunted by the reality, however, that humans . . . have a strong biological tendency to needlessly and severely disturb themselves, and that, to make matters much worse, they also are powerfully predisposed to unconsciously and habitually prolong their mental dysfunctioning and to fight like hell against giving it up.
Thus, anxiety may have unconscious causes but they are freely accessible and open to challenge if one’s attention is directed there. And the anxiety can be greatly lessened or eliminated by conscious effort.
The deceptive demon of psychotherapy is the persistent belief among many practitioners that it is essential to understand the life history of the client before he/she canhelp or her with his/her presenting problems. This is not only untrue, unsupported by research, but potentially harmful to the client. Psychotherapy cannot change the past, it cannot discharge unconscious conflicts, or magically change personality flaws. Instead, therapy can change the way you think, the way you view your life — both in the present and in the past. Therapy can also change the way one reacts to problems and behaves in the fact of adversity.
CBT or cognitive behavior therapy accomplishes the very essential goal of therapy — to help you change the way you think and behave. All negative emotions, ALL, stem from your attitudes, beliefs, and your personal philosophy. Change these, and your greatest terrors will become mundane. CBT in any of its modern incarnations REBT, CT, CBT, et al all require that the therapist actively seeking to find those aspects of your cognitions and behavior that are leading to your distress and underachievement. Having discovered those the therapist collaboratively helps you change them. Indeed, most of the human brain works non-consciously -BUT THESE NON CONSCIOUS PROCESSES CANNOT BE ADDRESSED IN THERAPY!
Psychotherapy must accept that the clients conscious constructs and view of the world is real and under his/her control. To pretend that the therapist’s presence in the room will magically heal through some magic called transference is simply not true. Naturally, it makes the therapist a regal shaman like figure if the client belies that his/her sitting and nodding will cure all ills. But this does nothing more than wax the ego of the therapist. If you want to change, it takes work on your part and the part of the person you are paying to help you effect this change.