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One of my earliest cognitive therapy patients asked if we’d spend time exploring his past. He thought we might find patterns that would explain his depression.
I was taken aback. I had just discovered a set of powerful, active techniques that helped people change how they felt in the here-and-now. As a psychiatric resident, I had seen that endless venting without specific techniques for change led to little or no relief.
So, I made him an offer.
I told him I’d be happy to explore his past for as long as he wanted—with just one catch. He’d have to work with me for a few sessions so I could cure his depression first. Then, if he was still interested, we could spend as many months as he wanted digging into his history.
He agreed, and he responded really well to CBT. His depression disappeared after just a few sessions. When I told him we could now begin exploring his past, he said he no longer needed that, and he felt ready to move on with his life.
Over the years, I made the same offer to many patients who had spent years in traditional talk therapy. And without exception, once they were feeling joyful and hopeful again, their interest in exploring the past suddenly evaporated.
That experience shaped what I now call TEAM CBT—a high-speed approach to treating depression and anxiety that focuses on what’s happening right now. Over the past 35 years, my goal has been to complete a full course of therapy in a single two-hour session. And 90% of the time, that’s been possible. I also offer unlimited free tune-ups for life if needed, but they rarely take me up on it.
That eventually led me to a troubling question.
If rapid change is possible when we focus on the present, why do so many therapists devote years to revisiting the past?
In my early career, I assumed that the past must matter deeply. After all, my own psychiatric training was steeped in the idea that the roots of emotional suffering lie in early experiences, and that therapy ignoring the past is superficial.
That’s why some new data greatly surprised me.
I was analyzing our 2023 beta test of our mental health app,1 which was based on the hypothesis that believing negative thoughts—“I’m not good enough,” “I’ll always fail”—directly causes depression and anxiety, and that the moment those beliefs change, your feelings will change too.
The data strongly confirmed that idea.
But we’d also collected something else: estimates of how depressed people felt over the previous two years. For the first time, I could test whether information about the past added anything once we already knew how someone felt in the present.
I expected it would. For example, I thought that people with a history of chronic severe depression would improve less, since many published studies have confirmed this.
That wasn’t the case, as you can see in Figure 1.
When we controlled for how people felt right now, their emotional history—months or even years of past suffering—added virtually nothing to predicting or explaining their current distress or their recovery.
At first, I thought there had to be a mistake.
But there wasn’t.
Then it suddenly clicked. The data were trying to shout something incredibly important. And once I listened, I “got it.”
I’ve often described effective psychotherapy as fractal. In nature, fractals are simple patterns that repeat themselves over and over again. The same thing happens emotionally. Every time you’re upset, the same pattern appears: a triggering event, distorted thoughts, and painful feelings. The details change, but the structure doesn’t.
That means your past isn’t something separate that lives behind you.
It’s embedded in you—right now.
When you change the way you think and feel in this moment, you aren’t ignoring the past. You’re transforming it at its core.
This insight also resolved a long-standing puzzle for me. Many clinicians believe trauma must be processed slowly over months or years. Yet in my experience, trauma patients often improve remarkably quickly when therapy:
Focuses on how they’re feeling in the present.
- Helps them challenge the beliefs that keep the trauma emotionally alive.
Of course, many thoughtful therapists would disagree. They argue, often convincingly, that early experiences shape core beliefs, emotional learning, and even the nervous system itself. From this perspective, ignoring the past risks missing the very origins of suffering. Influential approaches ranging from psychodynamic therapy to modern trauma-informed models emphasize the importance of understanding—and sometimes revisiting—what happened long ago. This concern is legitimate. The past does matter.
But here’s the crucial distinction.
Understanding how the past shaped you is not the same as needing to relive it in order to heal. The data I’ve been seeing suggest that the emotional impact of the past is already fully expressed in how you think and feel right now. When those present-moment patterns change, the grip of the past loosens automatically, without requiring prolonged excavation.
This doesn’t minimize trauma. It only helps explain why revisiting it endlessly isn’t always necessary.
The present moment already contains everything that matters.
And that may be why the fastest path to healing isn’t found by looking backward, but by learning how to change what you’re experiencing right now.
