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Psychotherapy may be the most tested form of health intervention and also one of the most mysterious. Clinical trials, and meta-analyses of these trials, have repeatedly demonstrated the effectiveness of psychotherapy, while also failing to uncover any clear-cut and consistent understanding of how psychotherapy works. This lack of understanding has driven the field to develop 500 supposedly distinct, yet equivalently effective “theories.” The field suffers from barriers to scientific discovery, barriers to therapist training, and barriers to people seeking help for their psychosocial problems. This chapter tackles the mystery of how therapy works by examining the shortcomings of modern medical science, most notably reductionism. By grounding the substance of psychotherapy in a more holistic and logical foundation rather than a fruitless search for active and common ingredients, the question of how therapy works becomes much simpler to answer. It is well understood that each of the approaches to psychotherapy targets one or more “channels” of human experience: emotion, cognition, behavior, and self- and interpersonal relations. When one applies a nonlinear dynamical systems perspective to these experiential domains, it becomes clear that psychotherapy works by increasing the flexibility and the structural integrity of experience, leading to improved experiential balance and resilience.



Publication Date





New York, NY


Cognition and Perception | Other Psychiatry and Psychology | Other Psychology


In Kanako Taku and Todd K. Shackelford (Eds.), The Routledge International Handbook of Changes in Human Perceptions and Behaviors.


The author

Integrity, Flexibility, and Balance: How Change Works in Psychotherapy