BBC Ideas｜心理治疗是如何起作用的?

How does therapy work?
Have you ever wondered how talking therapy works? Maybe you've suffered a bereavement, been feeling down or anxious or just overwhelmed and you're starting to think you should talk to someone. Perhaps you've tried talking to friends or family, but they don't seem to quite understand or they have too much on their plates. So you consider therapy, but you have doubts. What if you're not ill enough to see a professional? Will it feel awkward talking to a stranger? Will they make you lie down on a couch and reveal your innermost secrets?
你有没有想过谈话疗法是如何起作用的?也许你遭受了丧亲之痛，感到沮丧或焦虑，或者只是不知所措，你开始认为你应该和别人谈谈。也许你试着和朋友或家人谈谈，但他们似乎不太理解你，或者他们有太多事情要做。于是，你考虑接受治疗，但又心存疑虑。如果你的病情不足以让你去看专业人士呢？与陌生人交谈会不会感觉尴尬？他们会让你躺在沙发上说出你内心的秘密吗？

In the UK, you can get talking therapy free on the NHS, but waiting times can vary significantly. Private therapists can be expensive, although some do offer lower fees for those who can't afford to pay more. But let's say you've arranged your first session and you're wondering how exactly it might help.
在英国，你可以在国家医疗服务系统（NHS）中免费获得谈话治疗，但等待时间会有很大差异。私人治疗师的费用可能会很高，不过有些治疗师会为那些无力支付更多费用的人提供较低的费用。但是，假设你已经安排了你的第一次治疗，你想知道它到底会有什么帮助。

The good news is that therapy can actually change the way your brain functions in a positive way. Our brains are a little bit like Play-Doh, capable of adapting, reshaping and rebuilding. This is known as neural plasticity. Whilst in therapy, your brain circuits are able to remould and reconnect in different ways, meaning we're able to reframe negative or obsessive thinking. By shifting our thinking, we start to strengthen different pathways. So when you talk through stressful feelings and strong emotions in therapy, you're rewiring your brain, a bit like rewiring an electrical circuit.
好消息是，心理治疗实际上能以积极的方式改变你的大脑功能。我们的大脑有点像橡皮泥，能够适应、重塑和重建。这就是所谓的神经可塑性。在治疗过程中，你的大脑回路能够以不同的方式重塑和重新连接，这意味着我们能够重塑消极或强迫性思维。通过转换思维，我们开始强化不同的通路。因此，当你在心理治疗中倾诉压力感和强烈情绪时，你正在重新连接你的大脑，有点像重新连接电路。

Therapy also activates the hormone serotonin and can help improve our ability to cope with stress. Studies found the brains in people who've had therapy for depression and post-traumatic stress disorder showed improvements that were as good as SSRI antidepressant treatments. Even short courses of therapy can be beneficial. They often use techniques known as CBT, or cognitive behavioural therapy. This can be particularly useful in helping you change specific behaviours or negative thinking patterns because it focuses attention on your problems and helps you develop coping strategies.
治疗还能激活荷尔蒙血清素，有助于提高我们应对压力的能力。研究发现，接受过抑郁症和创伤后应激障碍治疗的人的大脑表现出的改善，这与SSRI抗抑郁治疗一样好。即使是短期的治疗也是有益的。他们经常使用认知行为疗法。

In 2020-21, over 630, 000 people completed the NHS Talking Therapy programme in England, averaging seven and a half sessions with a therapist. 51. 4% of those who completed the programme for anxiety or depression recovered. The most important factor determining whether therapy works for you is the quality of the relationship you have with your therapist. This is actually more important than the type of therapy you choose or the therapist's experience. So if you don't get on with the first therapist you meet, it's worth persevering and looking for a new one.  Your level of motivation is also important, as is the therapist's ability to recognise which type of support is best. Suggesting weekly homework might do wonders for some but be completely off-putting for others.


So why can therapy be better than talking to a friend? For starters, you get your therapist's undivided attention and you don't have to worry about what they think of you. You can cry your eyes out. They won't judge you. Unlike with a friend, you don't have to worry about hurting your therapist's feelings. Then there's confidentiality. Unless the therapist thinks you're at risk of harming yourself or others, whatever you say in the therapist's office stays in the therapist's office.


A friend might offer advice, which, even if well intended, might not be right for you. A good therapist usually won't offer advice, but instead listen, summarise what you said and reflect it back to you. This simple technique can help you see things from a different perspective. Unlike a friend who may be quick to agree with you, a therapist can challenge you in a supportive way, and without being challenged, you may not find new ways of thinking or behaving.


Of course, therapy doesn't work for everyone in every situation. Serious mental health conditions can require drug treatment or even an inpatient stay. Other people find self-help techniques such as meditation are enough for them. But overall, studies show that a typical client is better off for having gone through the process. In fact, according to the NHS, in 2022, over 66% of people who entered therapy found it beneficial. In the words of American writer Carlee J Hansen, "Therapy didn't fix me, therapy gave me the tools to help me fix myself, over and over again. For the rest of my life."

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