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Attitudes about psychotherapy have been changing dramatically. When I was a medical student and resident, psychiatry departments were staffed by analysts and analytically oriented psychiatrists. We learned that effective therapy required extensive examination of past trauma as the only way to achieve insight. Any treatment that avoided this lengthy and painful process, such as hypnosis, was believed to offer only temporary relief, since the underlying problems were not dealt with and would resurface at a later date. This concept of psychotherapy persists with many psychiatrists and the medical community at large.
However, in the past year or two I have read responsible studies on depression and anxiety in which cognitive-behavioral therapy was felt to be the most effective treatment. These studies agree with my personal experience using a cognitive-behavioral approach in the treatment of depression and many anxiety disorders, including PTSD. I found that through both individual and group therapy, remarkable insight was achieved without spending much time with past trauma. When patients feel better, they get spontaneous insights regarding past trauma without the usual strong emotional reactions.
There appears to be more than one road to achieving insight.
Merrill I. Lipton, M.D.
Belton, Tex.