In this blog we explore how the power of treatment is not so much in the technique itself (like EMDR or antidepressants) but in the relationship of, and the way that practitioner and client give meaning to the situation together, and look for ways to change the situation. And yes, this also applies to medication like antidepressants – because the drug needs to fit into the world and experience of the person that uses it.

Treatment: What makes it efficient?

Let’s take a look at four essential pillars: presence, perspective, your relation to what is torturing you in your mental capacity, and motivation to change.

1. Presence: The art of really being present

It all starts with a counsellor that is present and available. No fast solutions or diagnostic ‘jumps’ – but someone who will stand by you, takes their time, and not just offers a solution. This presence is more than just listening; it’s about really feeling your pain and suffering. The therapist takes a part of that burden and makes that heaviness more bearable, even if it’s just temporarily. It’s about a relationship in which you can approach the suffering together, to find the words to describe it, and find out what it means. Eventually this commitment creates a secure foundation from which you can continue to work together.

2. Perspective: A story of hope

After that, you create a story together, something that contains hope and perspective. This story is not a straightforward diagnosis, but a framework that helps you understand what is happening and what ways forward there are. By painting a picture of the future together, you’re creating something to work towards, a direction of a possible recovery. This can help with feelings of uselessness, and create space for the belief that change is possible, even if it’s difficult.

3. Relating to the thing that is tormenting you

One of the most important aspects of recovery is learning how to handle what is tormenting you in your mental space – whether it’s fear, sadness, or another obstructive emotion. Instead of letting these feelings take control of you, you need to learn how to take charge. This could mean that you learn to face your fear by doing things you’re anxious about, or that you pick up small activities, despite the heavy feeling of sadness. It’s a process that involves learning who’s in charge, and experimenting with this in a playful manner.

4. Change: Building a new context together

And finally, an effective treatment is all about making meaningful changes in your life. Psychological suffering is often a sign of something not being right in the world around you. This may mean you need to work on your resilience to the pressure to be perfect that exists in our society, or that you need to reconsider your relationships. Sometimes it’s about really basic things, like a healthier lifestyle, or processing traumas that are stuck deep within you. What this change consists of can change, but the aim is always  the same: to discover together which context supports you the best on your journey.

Medication as a part of the ritual

Also medication, like antidepressants, needs to fit into this process. It’s not just a technical solution that can ‘fix’ you – it only actually works when you can find out how this contributes to your process.

Medication can be a great support, but it needs to complement the way you see your recovery. If you’re in doubt about your medication, or when the effect it has on you changes, you need to talk about it. This is part of the continuous alignment. Sometimes it’s sensible to consider lowering your dose, or to try and use the minimum dose that’s effective, maybe using tapering strips.

As well as that, there are things like ‘oppositional tolerance’ (oppositional tolerance means the body becomes desensitised to an antipsychotic or antidepressant after taking it for a longer period of time, due to the body becoming used to the medication) and withdrawal symptoms to take into consideration, especially if you have been using the medication for a while.

Tune and coordinate together

Using this approach, you will be constantly aligning with each other. How are you finding the treatment? Do you feel like it’s helping? What do you think of your counsellor and vice versa? Treatment is a creative and dynamic process, during which the counsellor and client keep being aware of each others’ perspectives. You could say that you work in some sort of triangle (I like to call it the ‘treatment triangle’): You as the creator of your own life, the therapist as co-creator that supports you, and the chosen technique (or ‘the ritual’) that brings you together. And this alignment is crucial, because only then you can walk the path that really suits you.

So, treatment in the healthcare sector doesn’t follow one set formula. It’s a lively process, in which you search for what works for you together. It requires flexibility, creativity, and the willingness to explore together. This way, treatment doesn’t become a rigid protocol, but a humane process of growth and signification, a process that focuses on you, rather than on the technique.

Translated from Dutch by SGM Taplin