Why does therapy work and can the dodo help?

There’s a principle in therapy, derived from Alice in Wonderland, called the “Dodo Bird Verdict”. In the story, the dodo announces that all participants in a race are winners and therefore must have prizes. In therapy, this idea translates to “all modalities are equally effective”. The impact of this idea is twofold: 1) whichever type of therapy your counsellor practices makes no real difference, it’s the relationship between you which matters, and 2) there’s something unscientific about the whole business.

For some people, the dodo verdict is a positive - get the right therapist who can offer you strong, authentic empathy and listen without judgement and you’ll benefit. In essence, this must be true, because anyone who’s sat with the wrong therapist knows that without that connection, the whole enterprise is pointless. It also encourages clients to be discerning. You should focus on that relationship - feel comfortable with the therapist, recognise the connection, appreciate that they “get” you and are willing to work with you without prejudice. In my view, this is exactly what you should do at Shared Mile. And it’s why we offer an extended trial session for free. Choosing the right therapist is important and there should be no pressure to accept a relationship that doesn’t feel right.

But therapy also struggles to shake off the sense that if the modality - the type of therapy - doesn’t matter, then there’s something unserious about the work. Why can’t we prove which therapy actually works best? As a recent article (sub) in the New York Times explains, this is partly because it’s impossible to run double-blind trials in therapy - the relationship aspect cannot be removed from the study. And the measures aren’t helpful if they’re always tied to depression scores, or anxiety ratings. Lots of clients aren’t in therapy for diagnosed maladies. Measuring therapy is, by its nature, incredibly difficult.

As the New York Times article suggests, it may be that we need a better sense of why people seek therapy and how the brain works before we can fully assess the effectiveness of different therapies. For my part, I think we must maintain that focus on the relationship - nothing good will happen without it. And then we can work flexibly in whatever style we decide is best. Fixed ideas don’t tend to work. What modality I think might work best could be wrong and what you think suits you might turn out to be unhelpful. We’ll learn this together, in a spirit of curiosity.

So, while the dodo hands out prizes to all, there’s only one result that matters: your confidence in the relationship and a sense that the work is working. The proof of the value of therapy is down to you and your personal, unique experience.