What Works in Counseling, Psychotherapy, and Psychoanalysis: People are Resilient (Antifragile) and Adaptive

For years, I have studied human trauma and psychological stamina, learning from those who strove to effectively manage challenging and/or traumatic circumstances without developing psychological or psychiatric symptoms. I resonate with the current trend in psychology to focus on adaptation, grit, and how to find personal happiness, prosperity, and vitality rather than view problems principally from the lens of disease and defect. Specifically, I find it effective and personally rewarding to conceptualize much so-called psychopathology as relatively ineffective adaptations to complex biopsychosocial stressors and continually ask myself “why does it make sense that this patient is having these sets of problems with these people in those situations right now, and how can I assist in increasing his or her relational satisfaction?” When approached with this inquiry in mind and wrapped in Carl Rogers’ core attitudes for therapeutic change of empathy, genuineness, and unconditional caring coupled with a gentle and consistent “spirit of inquiry”, patients report heightened trust that comes from experiencing themselves de-pathologized. The treatment alliance strengthens, which increases the likelihood that they can break the shackles of self-contempt, pessimism, and cynicism learned over a lifetime from negative interactions with significant others. The more patients incorporate this interpersonal experience of appropriate levels of understanding, acceptance, attachment, and nurturance, they become more amenable to working together to help them experience greater relational competence and personal agency in the world generally, and with significant others in particular.