What Is Therapy? — The Complete Definition of Psychotherapy

Therapy [psychotherapy] is the process of working with a licensed therapist to develop positive thinking and coping skills and treat mental health issues such as mental illness and trauma. Answering the question of “What Is Therapy?,” however, goes far beyond this basic definition.

The definition of psychotherapy depends on the therapist, type of therapy and time period. By exploring these three factors and their combinations, we defined what therapy was, what it is and what it might become. These pieces form the complete definition.

By reading a thorough answer of “What is Therapy?,” you should be able to pick which part of therapy and which kind of therapist is most appealing to you. Understanding what therapy is could be the first step toward trying something that will help you live a happier life.

How Do Therapists Define What Therapy Is?

Every therapist defines therapy in at least a slightly different way. By looking at the aspects they stress, you can see a more detailed picture of what therapy is and whether the therapist’s approach aligns with your goals.

Here are some definitions we gathered by surveying our therapists at Talkspace and reaching outside our network:

  • A commitment to yourself and to opening yourself up to someone else; being willing to trust someone enough to let them into your life and learn from each other — Alaina Brubaker, Talkspace Therapist
  • A way of changing your perspective on how to handle a situation — Noor Pinna, Talkspace Therapist
  • A communication process of increasing clarification and understanding pertinent to specific experiences related to such terms as discomfort, dissatisfaction, disappointment, discontent, disenchantment, and other dispositions that are perceived as problematic — Ken Fields, Talkspace Therapist
  • A dynamic process that occurs in a safe and contained relational frame wherein destructive patterns of being are identified and replaced with healthy and productive ones — Paul Hokemeyer, Marriage and Family Therapist
  • Empathy, a nonjudgmental attitude and the creation of a safe space in which nothing the client wants to explore is off-limits and everything is on the metaphorical table — Kristen Martinez, LGBT Therapist
  • Learning how to overcome your personal or relational struggles by developing long-term tools — Jennine Estes, Marriage and Family Therapist
  • The art and science of engineering self-improvement and growth in clients via a strong therapeutic relationship and evidenced-based therapies — Michael Zito, Therapist, Ph.D.
  • Helping clients break free of old ideas, patterns and wounds that are restricting their happiness and contentment; coaching them through life passages, teaching skills and techniques for self-awareness, relationships and success — Tina B. Tessina, Therapist, Ph.D.

What Is Therapy (Based on Each Type)?

If you asked a psychoanalytic therapist to define psychotherapy, the answer would be a far cry from one a cognitive behavioral therapist would offer.

All forms of psychotherapy exist to improve clients’ mental health, but the definition for each type stresses a different primary purpose. The best type for you will be the definition that most closely resembles your reasons for considering going to therapy.

If there isn’t any one type that appeals to you or seems like enough to help you, consider a therapist who uses multiple approaches or does not identify with a single approach.

Note: The following list includes the most widely practiced types of therapy. A complete list would be too long.

Client-Centered Therapy: you determine the course of the session; the therapist helps build self-esteem and problem-solving abilities but does not guide the session

Cognitive Behavioral Therapy [CBT]: challenging negative patterns about yourself and the world to alter unwanted behaviors or treat disorders such as depression

Dialectical Behavior Therapy [DBT]: stressing acceptance and change while learning behavioral skills (mindfulness, distress tolerance, interpersonal effectiveness, emotion regulation) that help clients enhance motivation, overcome challenges, improve mental health or treat a disorder (often borderline personality disorder)

Existential Therapy: working with a therapist to find meaning in life and confront the “givens” of human existence: isolation, meaninglessness, mortality and freedom

Family-Focused Therapy [FFT]: working with family members and a therapist to understand how their behavior impacts your bipolar disorder or overall mental health

Gestalt Therapy: gaining an awareness of emotions and behaviors in the present rather than focusing on the past; improving self-awareness and personal responsibility

Interpersonal Therapy [IPT]: improving communication patterns, relational abilities and the way you see yourself to better manage and express emotions, treat mental illnesses such as depression and improve mental health

Psychodynamic Therapy: understanding the influence of the past and subconscious processes on present behavior

What Was Therapy Before Freud?

To fully understand what something is, you need to explore its past, present and possible future. This timeline will give you a richer understanding of what psychotherapy is and how it evolved.

Before Freud and other early psychologists such as Wilhelm Wundt, philosophy was the closest thing to therapy. It was the only field that explored human behavior and mental health.

“Psychology is an offshoot of philosophy,” psychologist Bart Rossi told Talkspace.

Rossi cited schools of philosophy such as rationalism and empiricism. He also said philosophers including Immanuel Kant contributed to the development of therapy.

One of the best examples of philosophy informing psychotherapy is existential therapy, which is derived from existential philosophy. Existential psychotherapist Irvin Yalom, who shaped the field of modern existential therapy, said existential philosophers such as Nietzsche inspired his work.

What Was Therapy During Freud’s Time and the 20th Century?

Because Freud was a psychiatrist, early psychotherapy was mostly about reducing symptoms. It followed a medical model rather than the wellness/medical model we see today. Therapy was for “patients” with diagnosable mental illnesses, not “clients” who see a therapist for various reasons.

“I think in the past, therapy was centered around ‘fixing’ what was ‘wrong’ with people,” said therapist Kristen Martinez. “Certain people thought they were the healthy ones, and psychotherapy focused on getting ‘unhealthy’ people to be healthy like them.”

What Is Therapy Now?

Modern psychotherapy tends to balance a wellness and medical model. Therapists want to reduce symptoms in people dealing with mental illness, but they focus more on the person.

CBT changed the definition of therapy, according to Rossi. It is now more behavior-focused and does not use the dynamic approach as often.

The advent of online therapy has also appended what therapy is. Although earlier definitions of therapy did not explicitly describe it as occurring only in-person, it needed to happen in an office because the Internet did not exist.

Earlier definitions also implied therapy could only take place in “sessions” where the therapist and client scheduled a meeting or phone call. Because of technology and approaches such as the asynchronous texting Talkspace offers, therapy does not require sessions.

What Will Therapy Become?

The basic definition of therapy seems here to stay, but there are trends that will expand the answer to the question of what therapy is.

Read: 3 Trends in Therapy You Need to Watch For

Here are some trends that might evolve the definition of psychotherapy:

  • More technological advances in online therapy
  • Virtual reality
  • Integration of medical care
  • More focus on the therapeutic relationship
  • More cultural consideration
  • New CBT approaches

Now that we’ve discussed what therapy is, take a moment to think about what it can do for you. The titular question is also an opportunity to improve your mental health and live a happier life.

-Joseph Rauch, Staff Writer at Talkspace

Quote: Unconditional Love

Spend your time with people who love you unconditionally, not with people who want you to fulfill all their conditions.

MegAnne Duke, LCSW

When changing careers isn’t a realistic option

  • Try to find some value in what you do. Even in some mundane jobs, you can often focus on how what you do helps others, for example, or provides a much needed product or service. Focus on aspects of the job that you do enjoy—even if it’s just chatting with your coworkers at lunch. Changing your attitude towards your job can help you regain a sense of purpose and control.
  • Find balance in your life. If your job or career isn’t what you want, find meaning and satisfaction elsewhere: in your family, hobbies, or after work interests, for example. Try to be grateful for having work that pays the bills and focus on the parts of your life that bring you joy. Having a vacation or fun weekend activities to look forward to can make a real difference to your working day.
  • Volunteer—at work and outside of work. Every boss appreciates an employee who volunteers for a new project. Undertaking new tasks and learning new skills at work can help prevent boredom and improve your resume. Volunteering outside of work can improve your self-confidence, stave off depression, and even provide you with valuable work experience and contacts in your area of interest.
  • Make friends at work. Having strong ties in the workplace can help reduce monotony and avoid burnout. Having friends to chat and joke with during the day can help relieve the stress of an unfulfilling job, improve your job performance, or simply get you through a rough day.
  • Consider the following steps to planning a career change. Even if it’s something that you’re unable to act on at present, having a plan for someday in the future (when the economy picks up, the kids have grown up, or after you’ve retired, for example) can help you feel energized and hopeful, and better able to cope with the difficulties of the present. Simply sending out resumes and networking can make you feel empowered. Also, making a career change can seem far more attainable when there’s no time pressure and you break down the process into smaller, manageable steps.

-Talkspace

How Therapy Can Help in the Golden Years

Marvin Tolkin was 83 when he decided that the unexamined life wasn’t worth living. Until then, it had never occurred to him that there might be emotional “issues” he wanted to explore with a counselor.

“I don’t think I ever needed therapy,” said Mr. Tolkin, a retired manufacturer of women’s undergarments who lives in Manhattan and Hewlett Harbor, N.Y.

Though he wasn’t clinically depressed, Mr. Tolkin did suffer from migraines and “struggled through a lot of things in my life” — the demise of a long-term business partnership, the sudden death of his first wife 18 years ago. He worried about his children and grandchildren, and his relationship with his current wife, Carole.

“When I hit my 80s I thought, ‘The hell with this.’ I don’t know how long I’m going to live, I want to make it easier,” said Mr. Tolkin, now 86. “Everybody needs help, and everybody makes mistakes. I needed to reach outside my own capabilities.”

So Mr. Tolkin began seeing Dr. Robert C. Abrams, a professor of clinical psychiatry at Weill Cornell Medical College in Manhattan. They meet once a month for 45 minutes, exploring the problems that were weighing on Mr. Tolkin. “Dr. Abrams is giving me a perspective that I didn’t think about,” he said. “It’s been making the transition of living at this age in relation to my family very doable and very livable.”

Mr. Tolkin is one of many seniors who are seeking psychological help late in life. Most never set foot near an analyst’s couch in their younger years. But now, as people are living longer, and the stigma of psychological counseling has diminished, they are recognizing that their golden years might be easier if they alleviate the problems they have been carrying around for decades. It also helps that Medicare pays for psychiatric assessments and therapy.

“We’ve been seeing more people in their 80s and older over the past five years, many who have never done therapy before,” said Dolores Gallagher-Thompson, a professor of research in the department of psychiatry at Stanford. “Usually, they’ve tried other resources like their church, or talked to family. They’re realizing that they’re living longer, and if you’ve got another 10 or 15 years, why be miserable if there’s something that can help you?”

Some of these older patients are clinically depressed. The National Alliance on Mental Illness reports that more than 6.5 million Americans over age 65 suffer from depression. But many are grappling with mental health issues unaddressed for decades, as well as contemporary concerns about new living arrangements, finances, chronic health problems, the loss of loved ones and their own mortality.

“It’s never too late, if someone has never dealt with issues,” said Judith Repetur, a clinical social worker in New York who works almost exclusively with older patients, many of whom are seeking help for the first time. “A combination of stresses late in life can bring up problems that weren’t resolved.”

That members of the Greatest Generation would feel comfortable talking to a therapist, or acknowledging psychological distress, is a significant change. Many grew up in an era when only “crazy” people sought psychiatric help. They would never admit to themselves — and certainly not others — that anything might be wrong.

“For people in their 80s and 90s now, depression was considered almost a moral weakness,” said Dr. Gallagher-Thompson. “Fifty years ago, when they were in their 20s and 30s, people were locked up and someone threw away the key. They had a terrible fear that if they said they were depressed, they were going to end up in an institution. So they learned to look good and cover their problems as best they could.”

But those attitudes have shifted over time, along with the medical community’s understanding of mental illness among seniors. In the past, the assumption was that if older people were acting strangely or having problems, it was probably dementia. But now, “the awareness of depression, anxiety disorders and substance abuse as possible problems has grown,” said Bob G. Knight, a professor of gerontology and psychology at the University of Southern California, and the author of “Psychotherapy With Older Adults.”

A report by the Substance Abuse and Mental Health Services Administration found that about half of all Americans ages 50 to 70 will be at high risk for alcohol and marijuana abuse by 2020, compared with less than 9 percent in 1999.

In years past, too, there was a sense among medical professionals that a patient often could not be helped after a certain age unless he had received treatment earlier in life. Freud noted that around age 50, “the elasticity of the mental process on which treatment depends is, as a rule, lacking,” adding, “Old people are no longer educable.” (Never mind that he continued working until he died at 83.)

“That’s been totally turned around by what we’ve learned about cognitive psychology and cognitive approach — changing the way you think about things, redirecting your emotions in more positive ways,” said Karl Pillemer, a gerontologist and professor of human development at Cornell, and author of “30 Lessons for Living.”

Treatment regimens can be difficult in this population. Antidepressants, for instance, can have unpleasant side effects and only add to the pile of pills many elderly patients take daily. Older patients may feel that they don’t have the time necessary to explore psychotherapy, or that it’s too late to change.

But many eagerly embrace talk therapy, particularly cognitive behavioral techniques that focus on altering thought patterns and behaviors affecting their quality of life now. Experts say that seniors generally have a higher satisfaction rate in therapy than younger people because they are usually more serious about it. Time is critical, and their goals usually are well defined.

“Older patients realize that time is limited and precious and not to be wasted,” said Dr. Abrams. “They tend to be serious about the discussion and less tolerant of wasted time. They make great patients.”

After her husband died two years ago, Miriam Zatinsky, a retired social worker who is now 87, moved into an independent living facility at Miami Jewish Health Systems. It was a difficult transition to make late in life.

“It was really strange to me, and I couldn’t seem to make any friends here,” Ms. Zatinsky said. “I really couldn’t find my way. I was having a terrible time.”

The medical director for mental health at the facility, Dr. Marc E. Agronin, a geriatric psychiatrist and the author of “How We Age,” told her that her problems were not unusual for someone in her situation, and encouraged her to make some friends. He prescribed Xanax to help with anxiety, which she said she rarely takes, and he put her in touch with a social worker, Shyla Ford, whom Ms. Zatinsky saw once a week until Ms. Ford moved (Ms. Zatinsky now has a new social worker she talks to). They strategized on how she could reach out. And slowly, she did.

“Sitting at the table for dinner, you talk to people,” said Ms. Zatinsky, who has become president of her building.

Typically, 15 to 20 sessions of talk therapy are enough to help an older patient, unless he or she is struggling with a lifetime’s worth of significant problems. Still, even long-term issues can be overcome.

After a debilitating depression in which she spent three months unable to get out of bed, Judita Grosz, 69, of Pembroke Pines, Fla., decided to see Dr. Agronin, who prescribed medication. (She also tried group therapy but didn’t like it.) He also practiced some cognitive behavioral techniques with her — for instance, requiring her to get dressed every day for a minimum of 15 minutes.

Eventually, she began to feel better. “I learned to adjust my thinking, and I don’t get as anxious as I used to,” said Ms. Grosz, who has since begun making and selling jewelry. “I found out at this age that I am artistic and creative and innovative and smart. I just woke up to the fact that I have a mind of my own. Talk about a late bloomer.”

Dr. Agronin, who still meets with Ms. Grosz monthly, said, “You might not be able to gain a magical insight and wrap up their entire life in therapy, but you might be able to accomplish one or two small but meaningful goals.”

Sometimes, what older patients really need is help putting a lifetime in perspective.

“Things can be seen differently from the perspective of old age that relieve some guilt and challenge assumptions that you’ve had for decades,” Dr. Abrams said. “ ‘Maybe it wasn’t too terrible after all; maybe I shouldn’t blame myself.’ Maybe some of your worst mistakes weren’t so egregious, and maybe there were unavoidable circumstances you couldn’t control.”

Mr. Tolkin still stops by Dr. Abrams’s office for a monthly checkup.

“Everybody has a certain amount of heartache in life — it’s how you handle the heartache that is the essential core of your life,” Mr. Tolkin said. “I found that my attitude was important, and I had to reinforce positive things all the time.”

He said he wishes he had tried therapy years ago. But he adds: “I can’t go back. I can only go forward.”

-Abby Ellin

Self-Esteem versus Narcissism

The distinction between self-esteem and narcissism is of great significance on a personal and societal level. Self-esteem differs from narcissism in that it represents an attitude built on accomplishments we’ve mastered, values we’ve adhered to, and care we’ve shown toward others. Narcissism, conversely, is often based on a fear of failure or weakness, a focus on one’s self, an unhealthy drive to be seen as the best, and a deep-seated insecurity and underlying feeling of inadequacy.

-HelpGuide.org

Psychologists Reveal One Of The Best Ways To Boost Your Mood

It’s not what you may think.

When we’re having a rough day, many of us tend to treat ourselves to some form of retail therapy, a favorite dessert or going out with friends in hopes of feeling better.

But a new study published in the journal Emotion last week suggests that treating ourselves is no more likely to boost our mood than doing nothing.

Rather, the research found that giving to others or practicing acts of kindness can improve our mood and overall well-being, Dr. Katherine Nelson, assistant professor of psychology at the University of the South in Sewanee, Tennessee, and lead author of the study, told The Huffington Post on Saturday.

“I was not surprised that prosocial behavior led people to feel greater positive emotions, and in turn, greater flourishing,” Nelson said about the study.

thing that I found very interesting, however, was that when we direct these actions towards ourselves, we see no improvement in positive or negative emotions, nor do we see improvement in psychological flourishing,” she added. “I think this is important because people are often encouraged to ‘treat themselves’ as a way to feel good, yet our findings suggest that the best way to feel happy is to treat someone else instead.”

The study involved 473 volunteers who were separated into four groups. Each group had to complete different tasks over a six-week period.

One group was asked to complete acts of kindness to improve the world, such as picking up litter. The second group performed acts of kindness for other people, such as buying a friend a cup of coffee or helping a family member cook dinner.

The third group was instructed to perform acts of kindness for themselves, such as exercising more or taking a day off from work. Finally, the fourth group was the control group that did nothing out of their ordinary activities.

Before and after the six weeks, all participants filled out a questionnaire to assess their psychological, emotional, and social well-being. They also self-reported their positive and negative emotions weekly throughout the study.

I think this is important because people are often encouraged to ‘treat themselves’ as a way to feel good, yet our findings suggest that the best way to feel happy is to treat someone else instead.

Psychologist Dr Katherine Nelson

The researchers found that participants who performed acts of kindness, whether those acts were for the world or specific people, were more likely to report feeling happy or experience an improvement in mood than those who did the self-focused and neutral behavior.
In fact, those assigned to engage in self-focused behavior did not report any improved well-being or positive emotions, according to the study.

“Doing things for others offers people opportunities to feel greater positive emotions, such as joy, contentment and love,” Nelson said. “People could feel greater positive emotions, and in turn psychological health, because by being kind to others, they are nurturing social relationships, or they could feel greater pride in themselves for doing a good deed.”

Previous studies have shown that acts of kindness may not only boost your mental health, but also your physical well-being. For instance, separate research suggests that being altruistic can lower your blood pressure and reduce stress.

Dr. Dacher Keltner, professor of psychology at the University of California, Berkeley, who was not involved in the new study, told The Huffington Post that performing acts of kindness can activate the release of dopamine, a feel-good neurotransmitter, in the brain — and it can lead to us feeling like we’re serving something larger than the self.

“This is a really important study,” said Keltner, author of the forthcoming book The Power Paradox: How We Gain and Lose Influence, “for it adds to the mounting evidence showing that focusing on enhancing others’ welfare boosts our own well-being, countering a widespread myth that the path to the good life is to look after number one, the self.”

Jacqueline Howard, HuffPost

Confusing Non-Verbal Signals

Use nonverbal signals that match up with your words. Nonverbal communication should reinforce what is being said, not contradict it. If you say one thing, but your body language says something else, your listener will likely feel you’re being dishonest or the emotion is not very intense for you. For example, you saying “yes” while shaking your head no. OR, smiling when you are trying to talk about something that hurts you deeply…to protect others from feeling pain. What does it feel like when you see others words contradict their body language?

-Regina Tate, LPC

Boredom Leads to Unhealthy Food Choices

Bored? Then you are more likely to reach for fatty and sugary foods.

That’s something that we’ve all known for years, but now there is scientific data that proves it.

That data was recently presented at the annual conference of the British Psychological Society by Dr. Sandi Mann from the University of Central Lancashire in England.

To gather the data, Mann and her colleagues, Faye Ibbitson and Ben Edwards, conducted two studies of boredom and food choices.

In the first study, the researchers asked 52 people to complete a questionnaire on their food preferences before and after completing the boredom-inducing task of repeatedly copying the same group of letters.

The researchers report that people were more likely to express a preference for unhealthy foods like potato chips, sweets and fast food after completing the boring task.

In a second study they divided 45 people into two groups. One watched a boring video, while the other watched a funny video.

At the same time, there were bowls of healthy and unhealthy snacks available for the video watchers to munch on.

The scientists, who weighed each bowl before and after each trial of the experiment to see how much had actually been eaten, found that people who watched the boring video ate significantly more unhealthy food.

“These results are in line with previous research suggesting that we crave fatty and sugary foods when we are bored,” Mann said. “This strengthens the theory that boredom is related to low levels of the stimulating brain chemical dopamine and that people try to boost this by eating fat and sugar if they cannot alleviate their boredom in some other way.”

“People designing health education campaigns to encourage us to make healthier food choices need to take boredom, including boredom in the workplace, into account,” she continued. “Bored people do not eat nuts.”

-Janice Wood

Changing (Stages of Change)

If you are struggling with an active addiction, you know what the shame feels like when you are not meeting other peoples’ expectations, you are losing relationships and jobs and health. Often, you feel extreme pressure to be changed but you may feel like you are drowning, instead. How do I get from here to there, you ask?

It is important to know how people change because then you can have realistic expectations, start to communicate better with those around you and start making changes in your addictions and other areas of your life!!!

There are various “stages of change:”

The first stage is Pre-Contemplation: this is the stage where a person doesn’t think he/she has a problem. Other people around them may think they have a HUGE problem but don’t see it. In this stage of change it isn’t going to help to push or pull the person and there can be a lot of conflict with those around you.

Contemplation stage of change comes next and is an important turning point. You start to think, “maybe they are right. Maybe something is wrong here.” “ Why have I lost all these things?” This is when the door opens for the possibility of change.

Preparation stage of change is when you have accepted there is a problem and start to think about how you want to go about changing it. At this point, you start to take other people’s suggestions into consideration.

Action stage of change is when you are actively involved in recovery activities, you are no longer alone, fighting to keep it all out. You start to go to 12-step groups maybe, or a church recovery group, engage with a Talkspace therapist, the options are many.

Maintenance stage of change is when you have reaped some of the reward of your difficult road. You have clean and sober friends, clean places to go, ways to celebrate that don’t include substances. Relationships are mended. Is it still difficult at times, absolutely, but you have resources and supports to get you through!

Relapse can come at any point. It is important to know it is often part of the cycle of change. If you relapse, you don’t lose all the wisdom you gained down your road of change. You need to hop back in and do what works, call out every supportive person and resource you have.

-Marie Turco, LCSW, CCPD_D

Five Ways to Overcome Feelings of Neediness

The biggest challenge needy people face is figuring out what they need.

We’re only as needy as our unmet needs                                                                                  Founder of Attachment Theory, John Bowlby

Have you ever felt needy? What comes to mind when you hear the word? Most of us consider it one of the worst possible invectives to hurl at another human being, conjuring stark images of pitiable panic and desperation. We imagine tearful pleas (“give me another chance!”), angry accusations (“you’ve never really cared!”), and late night calls and text messages demanding an immediate response (“where are you?”). When we’re gripped by the terror of neediness, we feel completely out of control. When we bear witness to it, we feel confused and overwhelmed, wondering if any amount of reassurance will ever be enough. How can we understand these moments? More importantly, how can the needy find relief?

As ill-defined as the experience of neediness seems to be, psychologists have made great strides in unpacking this complex state of mind. One line of research, which emerged from an attempt to better understand depression, sheds a good deal of light on what makes neediness so incredibly painful. Defining neediness, rather inelegantly, as “a generalized, undifferentiated dependence on others and feelings of helplessness and fears of desertion and abandonment, ” the investigators discovered that it has an important relationship to depression. The needy often feel hopeless and unhappy.  But that’s the least surprising finding in these studies.

You’ll notice that the diffuse, inchoate nature of neediness is woven into its definition. That turns out to be extremely important, because there’s a related factor, connectedness—“a valuing of relationships and sensitivity to the effects of our actions on others”— that has relatively little to do with depression. Both items are part of the same scale, dependency, but neediness, it seems, is the unhealthy version of our craving for contact, marked more by helplessness, fear, and passivity than any clear emotional request. The connected are open about what they want from relationships. The same can’t be said for the needy.

To be sure, the needy want something—insatiably, in fact—but short of instant attention and constant reassurance, it isn’t terribly clear to themselves or anyone around them what exactly they’re looking for. This is perhaps the most vexing thing about neediness. It gnaws at us, driving us to chase after contact, advice, signs of love, but none of these actions seem to quell its fury. And now we know why. When researchers put neediness under the microscope, they find overwhelming fear, not need, at its unseemly core. Neediness is the formless shadow of healthy dependency.

Attachment researchers, who also examine needy behavior, have arrived at a similar conclusion. At the heart of attachment theory is the assumption that we all—all of us—have a basic, primal drive to connect. It’s wired into us, after millions of years of evolution, because on our own, we humans are weak, relatively defenseless creatures. That’s why emotional isolation registers in one of the most primitive areas of our brain—the amygdala—as a life and death situation (scientists call this the “primal panic”). The anxiously attached lack any faith that emotional closeness will endure because they were often abandoned or neglected as children,  and now, as adults, they frantically attempt to silence the “primal panic” in their brain by doing anything it takes to keep connection. In short, they become needy. (The avoidantly attached shut their dependency needs and feelings off altogether, to escape the pain of having their longings ignored or rejected.)

It’s not need, then, that engenders neediness.  It’s fear— fear of our own needs for connection and the possibility that they won’t ever be met. That’s what hurtles us into the abject despair of neediness.  The only way to get rid of a need is to satisfy it, and the more anxious we are about having it, the more quickly we want it met.  Overcoming neediness therefore demands that we disentangle the need from the fear, and there a number of ways to do this:

1)     Breathe.  If you recognize that fear is the problem, not loneliness or a desire for contact, you can escape the suffocating grasp of the neediness by using stress management skills. Go for a run, meditate, do diaphragmatic breathing—all of these will reduce your anxiety,  along with your impulse to act out of neediness

2)     Get connected. The researchers discovered a healthy version of dependency, one that involves a valuing of relationships. It’s not just more active, it’s more direct. Make clear requests. Neediness is all about blindly reaching when you don’t even know what you’re reaching for. Connectedness is about effectively depending on others.

3)     Practice emotional mindfulness. Rather than acting on what you think you need, sit down and write about the feelings you’re having. Are you afraid of being alone? What’s it like to simply focus on that without trying to flee it by seeking contact? Instead of trying to get rid of the feeling,  try to understand it. Not only does that make it easier for you to recognize and express your needs more clearly, it teaches you how to tolerate them.

4)     Take stock of your relationships. Needy people often attract dates or friends who reinforce their neediness— people who crave connection, just like everybody else, but seem loathe to express the desire (they’re often avoidant). If your fear is the phone will stop ringing if you don’t call, ask yourself, am I the one who always seeks contact or reassurance? Am I OK with that?

5)     Make room for your needs. When we hate or fear our needs it only makes them more intense because we’re tempted to hide or disguise them. That not only makes them confusing for others, but harder to satisfy. How you express your needs—whether for closeness, reassurance, contact, or love—will change dramatically once you start taking them seriously because you’ll have a far better understanding of what they are and where they come from.

When all is said and done, the key to overcoming neediness is to respect your needs for connection instead of fearing them. When you do, the chaos of neediness gives way to the clarity of intimacy. And everyone’s happier for it.

-Craig Malkin, PhD, Romance Redux