Psychotherapy

Psychotherapy is a critical aspect of psychiatric treatment, often a part of first-line treatment for most psychiatric conditions. Sometimes, this is recommended before even considering medication. Other times, medications are often paired with psychotherapy to achieve some of the best results. To understand this, let’s first look at what medications do and then see where psychotherapy comes in.

First, Let’s Think About Medications.

It is helpful to think of psychiatric medications in 4 ways:

1. They Help with Symptoms. Psychiatric medication helps to manage symptoms. If you have an infection, you will likely have a fever. Psychiatric medication may relieve symptoms like Tylenol or Ibuprofen may relieve the fever.

2. They Buy Time. With the psychiatric symptoms under a little more control, we have time to investigate the underlying cause. Just like Tylenol does not cure the infection, psychiatric medication does not cure the underlying cause of symptoms. Rather, it buys us some time.

3. They Give Us Space. With psychiatric symptoms under a little more control, we achieve more space. This is a space between our symptoms and our experiences. It’s difficult to function optimally when you have a fever. Likewise, it’s difficult to function when psychiatric symptoms smother you.

4. They Fertilize the Brain. Psychiatric medications all impact neurotransmitter activity. Neurotransmitters are communication molecules. They are the messengers! What’s the message? To communicate more with other regions of the brain. At a subcellular level, what happens is an upregulation of brain-derived neurotrophic factor (BDNF). This is aptly referred to as “brain fertilizer.” So, ultimately the purpose of all this is to increase brain fertilizer that works to sprout new neuronal (brain cell) connections. The big picture goal is to achieve neural integration, which is healthy communication between brain regions. When this occurs, you can more effectively navigate through situations without the burden of psychiatric symptoms.

Now, What About Psychotherapy?

When you pair psychotherapy with medications, you take advantage of what medications do! With symptoms under a little better control (so you can function more optimally), you create space and buy time. In this space, you have the time to develop therapy techniques and strategies to work on symptoms AND explore underlying causes. This reminds me of a famous quote:

“Between stimulus and response, there is a space. In this space, you’ll find growth and freedom.”

— Viktor Frankl

Moreover, combining all of this does some impressive things in the brain. If a psychiatric medication is like “brain fertilizer,” how do neurons (brain cells) know how to communicate? We need neurons to communicate with the appropriate brain regions along a network effectively. This is where psychotherapy comes in! Like caring for a garden, you may benefit from fertilizer (i.e., medications), but you also need other ingredients! Psychotherapy is the water and sunlight. Psychotherapy shines a light on areas where you can use techniques and strategies while nourishing the roots and directing growth. Now all you need is time.

In Integrative Psychiatry, we also use this time to take a deeper look at underlying causes that may be rooted in the body. If your plant (i.e., your brain) is deficient in several vitamins and micronutrients, there are other parts of the system carrying disease, or if weeds are crowding out the growth and development of your plant (again, the brain) … then these things all need to be taken care of. This investigation goes down to the roots (i.e., looking for the root causes) to tailor appropriate treatment. Your Integrative Psychiatry specialist knows that treating the whole person is crucial to mental health and wellness and will incorporate medications, nutraceuticals, therapy, and lifestyle adjustments personalized to your unique situation.

While I mentioned psychiatric medications in this post, please note that you do not always need them to help with this process. The cool thing is that therapy and lifestyle adjustments have also been shown to increase brain-derived neurotrophic factor (BDNF, “brain fertilizer”)!

Examples of Psychotherapy Modalities.

There are several psychotherapy modalities. When dealing with something so abstract as psychospiritual experiences, there is bound to be a lot of variety in the way these concepts are interpreted, considered, and approached. Here are some of the psychotherapy modalities that have gained significant traction:

• Psychoanalysis (Ego psychology, object relations, Jungian, Lacanian, and Horneian, to name a few)

• Cognitive behavioral therapy (CBT)

• Dialectical behavioral therapy (DBT)

• Acceptance and commitment therapy (ACT)

• Eye movement desensitization and reprocessing (EMDR)

• Accelerated resolution therapy (ART)

• Internal family systems (IFS)

• Somatic experiencing (SE)

• Polyvagal theory and therapy (PVT)

• Hakomi

• Compassionate Inquiry (CI)

• Emotion-focused therapy (EFT)
  

Common Themes in Psychotherapy.

Although many psychotherapy modalities use different frameworks, languages, and techniques; they do converge around key themes. These commonalities reflect core truths about human experience, healing, and transformation. Here are some of the unifying themes that run across common psychotherapy modalities:

1. Parts of the Self / Multiplicity of Mind: The mind is not monolithic. Healing often involves identifying, understanding, and integrating various internal parts, voices, or self-states—especially those formed in response to trauma or developmental needs.

2. Relationship Between Cognition, Emotion, and Behavior: Thoughts, emotions, and behaviors are interlinked. Changing one can influence the others. Awareness and restructuring (cognitive or emotional) can lead to change.

3. Present-Moment Awareness / Mindfulness: Healing arises from cultivating awareness of what is happening right now—internally and externally—without immediately reacting. This presence allows integration and change.

4. Safety and Regulation: Emotional and physiological safety is essential. Dysregulation—especially from trauma—must be addressed before deeper work can proceed. Techniques often aim to restore a felt sense of safety and regulation.

5. Trauma and the Body: Trauma is not only psychological but also somatic. The body holds and expresses unresolved experiences. Healing often involves accessing and releasing stored energy or patterns from the body.

6. Acceptance and Compassion: Transformation often begins not with forceful change, but with acceptance. Compassion—toward self and others—is a key agent of integration and healing.

7. Narrative and Meaning-Making: Humans are meaning-making beings. Shifts in our stories, beliefs, and sense of self allow healing. Therapy helps us revise the internal narratives that define our identity and possibilities.

8. Relational Healing / Attachment: Wounding often occurs in relationship; so does healing. The therapeutic relationship itself becomes a space where new relational patterns and secure attachment can be experienced.

9. Agency and Empowerment: Clients are not passive recipients. Empowerment—through skill-building, insight, emotional mastery, or spiritual connection—enables clients to reclaim agency and direction in their lives.

10. Integration Across Systems (Mind, Body, Spirit, Society): The self is a system within systems. Healing often involves aligning internal systems (thought, emotion, body, spirit) and relating them more healthily to external systems (family, culture, environment).

Make an appointment now to see how the Integrative (holistic) approach that includes therapy can make a difference in your daily life!