The Place for Psychotherapy

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Author: Ron Cridland, MD

The cognitive-behavioral approach to managing insomnia (CBTi) is very effective for reconditioning good sleep.  However, there is no one therapy that is going to work for everyone.  There are people who will continue to have problems with their insomnia.  Often there are other psychological issues that are aggravating the insomnia such as depression or anxiety.  These conditions may also be aggravated by social circumstances that you feel unable to change. 

In today’s medical system, typically depression and anxiety are managed with medication.  Although medications may help relieve the suffering and enable people to function in difficult situations, they unfortunately do not address the underlying causes.  Some doctors talk about patients having a “chemical imbalance”.  While it is true that some people may have genetic predispositions for psychological illness, that is not what causes it to manifest.   There may by other physical, dietary, and environmental factors contributing to the manifestation of psychological illness.  Although circumstances from the past may have triggered a psychological illness, dysfunctional thoughts and behaviors along with conditioning often perpetuate it.  Some patients will have the insight to address these issues in therapy.  For those, CBT can be an effective way of managing psychological illness.

Some people are concerned that psychotherapy has to dredge up feelings from the past.  A psychologist will take a history about your past to help you both understand the present.  However, CBT takes place in the present and is focused on specific current issues, not the past.  It is usually short-term, although if there are more than one issue, it may take some time to deal with all the issues.

There are other forms of psychotherapy as well.  A good psychologist, like a good physician, will be able to tailor your therapy to your specific needs.  If you continue to suffer from thoughts, feelings, or behaviors that you have been unable to change to a satisfactory degree despite your best intentions with the CBTi and stress management strategies discussed on this website, then a psychologist could help you take things to the next level.


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