Psychotherapy for mental illness

Psychotherapy is form of "talking therapy" treatment for mental disorders, and not a treatment used to directly treat myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, multiple chemical sensitivity, or any other physical illnesses. Psychotherapists are trained in the working of the mind, and do not have medical training.

Psychiatrists rather than psychotherapists are medical doctors trained in mental illness, and prescribe psychiatric medications or treatments.

Purpose
Psychotherapy is designed to treat mental illness, whether it impacts or occurs in people with physical illnesses or not.

A person with ME/CFS might see a psychotherapist to treat either a pre-existing mental disorder, one caused as a reaction to the effects of living with ME/CFS, or an unrelated mental disorder that begins later, for example:
 * serious phobia
 * depression resulting from a bereavement
 * reactive depression, which is depression resulting from the effects of an illness, such as the loss of friends or career
 * post-traumatic stress disorder due to abuse from medical professionals, childhood abuse, and car accident or another psychological trauma

Difference from counselling
Psychotherapy is different from counseling because:
 * psychotherapists have more extensive training
 * psychotherapists typically offer longer term work, counseling is often brief
 * counseling is sometimes delivered by people who aren't mental health professionals but have training in a particular method of counseling, this means that their understanding of more serious or long term difficulties in particular may be limited, and these "paraprofessionals" may not be registered with any counseling or psychotherapy professional body, and they may not work under a clear ethics framework or by licensed by a regulatory body for counseling or psychotherapy
 * counseling is often sought for issues unrelated to mental health, to allow someone to be able to work through feelings or difficult decisions, for example family matters or pregnancy counseling and life transitions

Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a form of talking therapy that was developed initially to treat depression, then later models were developed for anxiety, post-traumatic stress disorder and other mental illnesses. CBT is an extremely popular form of therapy that can be delivered in either psychotherapy or counseling. In CBT, "homework" such as worksheets completed between sessions is often expected, which may mean that it is more demanding in terms of energy than some other types of therapy.

Many people who deliver CBT counseling are not registered mental health professionals and do not work primarily in counseling or psychotherapy. Acceptance and Commitment Therapy is also a form of CBT.

CBT for ME/CFS
Cognitive behavioral therapy has also been developed for ME/CFS based on a highly controversial biopsychosocial model of ME/CFS that does not accept that it has an underlying biological disease process, and views psychological factors such as fear of exercise as a key part of the disease, something which has been found to be incorrect. This form of CBT, which is often delivered by the UK's Improving Access to Psychological Therapies (IATP) but may be delivered by any counselor in any country, aims to cure or significantly improve physical symptoms through encouraging the person to change their thoughts and behaviors. In this model of CBT the person assumed to have an "unhelpful" (irrational) beliefs that exercise is harmful or to be engaging in a viscous circle of thoughts and behaviors that are claimed to make the illness worse. This extremely controversial model of CBT, which is typically delivered by nurses, occupational therapists and sometimes counselors, treats ME/CFS as medically unexplained physical symptoms (MUS) and may be treat symptoms as "bothersome" or as if they can be "reversed" by altered behaviors rather than acknowledging ME/CFS as a serious, neurological disease with a very low recovery rate; this cognitive behavioral and biopsychosocial model of ME/CFS was abandoned by the CDC in 2017, and by the UK's NHS guidelines in 2021 due to the evidence that is was ineffective and often harmful,  Some people experiencing this form of CBT have reported that they felt like they were experiencing gaslighting, which is a form of emotional abuse, and that their experiences of illness were not believed, and that medical facts were disputed by their counselor: in the UK, a significant minority of people found that CBT for ME/CFS made their mental health worse.

Forms of therapy
Many different types of therapy exist, including:
 * EMDR, which is mostly used for post-traumatic stress disorder after abuse or trauma, and is based on a mixture of eye movements and addressing distressing and intrusive memories and feelings
 * Person-centered therapy, which is based on fully accepting you as you are, and does not attempt to challenge your thoughts or beliefs, developing self-compassion and self-acceptance is encouraged. Typically not a fixed number of sessions.
 * Dialectic behavioral therapy - while this is derived from CBT and is very structured rather led by the patient it is based on the principle that you/the patient are doing the best you can, and is very focused on skills training and coping strategies
 * Interpersonal therapy, which is based on how you interact with others and how other people's actions affect you, and vice-versa, and icreasing support from others
 * Mindfulness-based therapies - based around stress reduction, increased self-awareness, and regular practice of mindfulness
 * Art therapy, in which feelings or difficulties are expressed creatively, and the value is on emotional benefits with no need for artistic skills
 * Solution-focused - a short term therapy where you work towards a particular goal you have
 * Group therapy - attending regular sessions with others who have similar difficulties to share problems and thoughts, with a therapist acting as a facilitator

Somatization and Somatic Symptom Disorder or Bodily Distress Disorder
These are a group of mental disorders in which emotional problems are converted into physical symptoms in place of emotions, sometimes called Conversion Disorder. For example, a child might have abdominal pain whenever they are sad but not be able to recognize their sadness, or an adult survivor of rape may experience chronic pain in their genitals which is not caused by physical illness, and that resolves or improves with psychological support to work through the emotional consequences of the rape.

The symptoms of ME/CFS, fibromyalgia and irritable bowel syndrome are not caused by this somatization process but some professionals may view the symptoms as "unexplained" or "having no medical cause" and assume that psychotherapy for a somatization disorder and/or antidepressants might help. Historically, this approach has been used for many illnesses that medicine was not able to recognise properly or not able to understand at the time, for example multiple sclerosis was treated under this model as a "hysterical paralysis". Jennifer Brea was misdiagnosed with conversion disorder, and as a result tried to push through her symptoms, causing her physical to decline dramatically.

Learn more

 * Guide to psychiatry and counseling - WebMD
 * What Therapy Can Help With - British Association of Counselling Professionals
 * Chronic Illness - Sources of Stress and How to Cope - Cleveland Clinic


 * Overview - Cognitive Behavioural Therapy - NHS