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Abstract

My dissertation examines the sense in which psychotherapy’s effectiveness depends on truth. Specifically, it looks to the common factors hypothesis of psychotherapy, which suggests that therapy works not because of specific techniques, but because of features shared between all effective therapies. An implication of this view is that the content of therapy need not be true to work, which raises pressing questions about the relationship between therapy, self-knowledge, and truth. A sketch of the empirical and theoretical details of the common factors hypothesis is provided in the introduction, Chapter 1. In Chapter 2, co-authored with Garson Leder, we argue that acceptance of the hypothesis does not undermine core components of theories underlying specific approaches to therapy, and that the common factors hypothesis does not predict the equal efficacy findings. Appreciation of these facts alters the landscape of the debate and paves the way for a more productive agenda in psychotherapy research. Chapter 3 develops “psychotherapeutic fictionalism”, a framework for understanding therapeutic discourse without requiring literal belief in its contested, dubious, or false theoretical claims. On this view, patients and therapists may accept therapeutic narratives as useful conceptual tools, avoiding worries about deception or irrationality. In Chapter 4, I defend the importance of truth to mental health and healing in therapy against challenges posed by depressive realism and the common factors hypothesis itself. I argue that mental health centrally requires holding relevant true beliefs about oneself. Together, these chapter illuminate and uphold the sense in which psychotherapy involves not only healing practices, but the pursuit of self-knowledge and truth.