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Myth: a psychologist tells you what you should do to get better

Myth: a psychologist tells you what you should do to get better

Photographer:Fotograaf: Joey Roberts

Myth busters

It is a misconception, in particular among people who have never had anything to do with a psychologist, says Lotte Lemmens, UM researcher and therapist at Virenze Riagg. “Anyone who asks for help, has often already looked into what the treatment entails. Nonetheless, you discuss the expectations and confer with the patient on the treatments that could prove successful.”

The myth partly comes from the traditional medical model, Lemmens suspects. A doctor makes a diagnosis and cures you with pills, an operation, or whatever. That same reasoning is extended to the psychologist. TV programmes such as Dr. Phil can also give people the wrong idea. “It is good that this programme shows people that they are not the only ones with a particular complaint. At the same time, you are given the impression that for every problem there is a tailor-made answer ready and waiting. And all within forty minutes, because that is how long a Dr. Phil episode lasts.”

So what is it that psychologists do? "With cognitive behavioural therapy, which is what I have specialised in, therapists and clients form a team. The former offers the tools and monitors the process, but the client provides the content,” says Lemmens. "The therapist teaches the client how to be aware of his or her own train of thought. In doing so, he asks a lot of questions and actually acts in fact like a researcher. How is it possible that...? How do you know that …? What would happen if...? This provides the client with new insights, and these form the core of the treatment. In actual fact, you help people to become their own therapists.”

In cognitive behavioural therapy, patients check whether their thoughts align with reality. “If someone suffers from social anxiety and thinks that passers-by on the street give them disapproving looks, then the client can test those ideas in practice. This is carried out with behavioural experiments. You can, for example, keep track of how many people actually even look; you can find out from friends and acquaintances, or actually ask people directly on the street. This is another area where the patient comes up with ideas, also because they are the ones who best feel what information they need.”

Despite the many psychotherapeutic treatments, not everyone benefits from them. In cases of depression, one third of the patients notices improvement after the first treatment, one third feels somewhat better, while another third experiences no change at all. The question is: What works for what person? “We would very much like to know beforehand what treatment is suitable for a patient. That is where we are now focusing our research.”

What complicates matters is the fact that a multitude of factors are involved, all of which can influence each other. “Most studies focus on one or two individual factors. Is therapy A or B better for serious depressions? And what about clients who have experienced depressions before? Or in men? It gets even more complicated when the factors that are being studied, point in opposite directions. Suppose that therapy A works better for serious depressions, and that people with recurring depressions benefit more from therapy B. What treatment would you then choose for patients with recurring serious depressions?”

Lemmens and her colleagues are now trying to find out whether a computer model that combines multiple factors, could help one choose the most appropriate treatment. This involves the individual client being matched with population data from an extensive database. “In that case, you would get tailor-made advice, which would be a great step in the development of personalised medicine.”

Mythbusters is a series in which academics shoot down popular myths on complex topics



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