In psychotherapy, what is a "cure"?

There is a conflict among psychotherapists about what constitutes a "cure". One group says that the patient is the final authority. Another group says that there is no such thing as a cure. A third group say that when symptoms of depression and/or anxiety have gone, the patient is cured. A fourth group says that until the underlying character defect that causes the patient to have symptoms is corrected, the symptoms will return under the pressures of life.

The problem with all these points of view is that they don't define clearly what the "illness" we psychotherapists treat actually is. When the patient complains of symptoms of various kinds to a physician, the physician doesn't just apply medications to relieve the symptoms. Instead, the physician looks for the cause of the symptoms, and attempts to address that. Are the symptoms of depression and anxiety like that? Do we need to look for some underlying cause to correct, lest the symptoms return?

I think reasoning by analogy is very risky business. We don't know what causes pathological anxiety or depression. We can make up plausible, but ultimately untestable fictions that account for the symptoms, but plausibility is not a sufficient foundation for any structure. The problem is, we don't know what causes anxiety or depression. We have no therapies that address "causes". However, when depression is treated as a symptom, and when the treatment is effective, as it is in 70% of the cases, the depression does NOT return. The same results apply to the effective treatments of anxiety. The patient doesn't feel bad any more. Is that not enough?

By the way, the two therapies that have currently demonstrated consistent effectiveness at symptom reduction are cognitive-behavioral therapy and interpersonal therapy. No other therapy has been demonstrated scientifically to be as effective for the reduction of symptoms. But people have problems that do not manifest themselves as clear-cut symptoms, and symptom-reduction therapies are ineffective for them.