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Therapy Goes Bananas

March 4, 2014 | Rachel Ehmke

When most people hear the word "therapy" they still picture someone lying on a couch talking while their mostly silent therapist takes notes. While this kind of therapy still happens, the science and art of therapy has evolved a lot since the days of Freud. It's moved so far away, in fact, that one psychologist takes patients out to the street, where the task is to walk a banana on a leash.

In a piece for Scientific American Mind, that psychologist, Jerry Bubrick, who works at the Child Mind Institute, describes the kind of work he does with severely anxious children. It's a form of cognitive-behavior therapy, and Dr. Bubrick gives an interesting history of it, going back to the 1950s, when the first psychologist made the move away from psychoanalysis towards a more active and goal-oriented treatment.

Instead of trying to resolve past childhood issues—how traditional psychotherapists explained anxiety disorders—CBT therapists focus on changing the negative thoughts and behaviors that accompany anxiety. So while anxious kids want to avoid the things that make them anxious, Dr. Bubrick helps them learn to habituate to their anxiety. Enter the pet banana.

For the severely anxious boy Dr. Bubrick was working with, who had been paralyzed by fear of looking foolish around other people, such a thing would have been unimaginable before treatment. But he and Dr. Bubrick worked up to it, getting used to feeling anxious during more mundane things—asking strangers questions, asking strangers questions while in a ridiculous wig, ordering coffee at Starbucks in the wig, and so on.

Dr. Bubrick goes into more detail in the story, explaining how the therapy works and giving several patient case histories. It's a must-read for people who want to know more about what really great therapy—especially for kids—can look like. It's behind a pay wall at Scientific American Mind, but you can read it for free if you use this link

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