The Case for Long-Term Psychotherapy

"Mention long-term psychotherapy (think years, not months) and you will most likely hear skepticisms expressed such as too expensive, too time-consuming, or they don't really do that anymore, do they? For individuals with complex or comorbid conditions, and/or those who continue to struggle with deep-rooted problems that impair functioning, long-term psychotherapy can be effective when other shorter-term therapies fall short."

"Regardless of how many times I cycled through the four DBT modules of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance, though, this therapy was not effective for me. Sometimes, knowledge of the skills is not enough. Knowing the skills didn't abate my deep-seated self-loathing or my wish to be dead. The next two decades were filled with multiple inpatient psychiatric admissions for depression, for suicidal ideation accompanied by detailed plans, and for starving myself."

Long-term psychotherapy faces skepticism as too expensive, time-consuming, or outdated. An individual in their late twenties received diagnoses of anorexia, major depressive disorder with psychotic features, and borderline personality disorder; clinicians told the individual's parents that prognosis was poor. The individual experienced acute psychiatric hospitalization and transfer plans to a long-term DBT unit. Extensive engagement with DBT skills failed to reduce deep self-loathing or suicidal wishes. The subsequent two decades included repeated inpatient admissions for depression, suicidal ideation, and starvation, along with trials of multiple psychotropic medications often combined into multi-drug regimens. Twenty-five years after diagnosis the individual abruptly quit therapy and medications.

Read at Psychology Today