Synchronicity and Rethinking 'Evidence-Based' Therapy

Healing often comes from what science can’t quite grasp.

Posted July 14, 2025 | Reviewed by Davia Sills

Touting something, including psychotherapy , as an “evidence-based treatment” can be reassuring because we think that means it works. Many believe that the descriptor signifies it is more scientific and trustworthy. The trouble is, digging into the empirical evidence for “evidence-based” psychotherapy reveals a different story. As Jonathan Shedler asserts from his research and clinical practice:

“One might assume, in light of the strong claims for ‘evidence-based’ therapies and the public denigration of other therapies, that there must be extremely strong scientific evidence for their benefits. There is not. There is a yawning chasm between what we are told research shows and what research actually shows. Empirical research actually shows that ‘evidence-based’ therapies are ineffective for most patients most of the time.” 1

However, evidence-based practices are not the problem. Rather, the misinformation, false assumptions, and projections placed on them are problematic. For example, many studies about evidence-based therapy show high drop-out rates, suggesting it was effective for some, yet ineffective for those who quit. The fact is, psychotherapy outcome research is complex and nuanced, making it difficult to conduct and measure. Randomized controlled trials are considered the gold standard, but their findings often do not generalize to clinical practice.

Moreover, when the patient’s experience does not conform to what the evidence claims should happen, the “evidence-based” approaches must be questioned for that individual. I have worked with people who did not respond to evidence-based approaches but did respond to “non-evidence-based” treatments. This highlights the need to individualize treatment, consider patient characteristics, and integrate clinical expertise and clinical experience to achieve effective outcomes, including improved mental health and symptom reduction.

Evidence-based therapy cannot capture all the issues that patients bring into the consulting room, especially some of the most complex and meaningful dimensions of their human experience. I’ve heard over 45,000 hours of human stories, and I can’t explain many things. Many of those things are synchronicities , which occur when an event in the external world coincides in a meaningful way with the internal world of thoughts, feelings, images, sensations, memories, and dreams , but not due to causal reasons (read more in my previous blog post ).

Synchronicities can create connections and relationships that foster healing. They can transcend the small self and break through defenses by getting the patient’s attention while providing a lens for psychotherapy. And in my professional experience, as well as many others’, many psychological treatments and therapies, including empirically supported and evidence-based practice, cannot account for these non-causal yet meaningful experiences.

When Evidence-Based Therapies Don’t Work but the “Irrational” Does

When a synchronicity occurred in a session with a stuck patient, Carl Jung remarked, “Evidently something quite irrational was needed, which was beyond my powers to produce.” When the irrational appears, it creates an experience for both patient and psychotherapist to explore, which can move the issue forward in a way they had not considered before.

Years ago, monarch butterflies arose in two different sessions with two different patients of mine—on the same day—as they each grappled with the traumatic loss of their spouses. One patient grieved his wife’s suicide . He struggled in his marriage , remaining with her out of fear she would kill herself. They stayed together, and she died by suicide anyway. Despite evidence-based and trauma-informed interventions that supported mentalization and affect regulation , he was wracked with guilt , particularly when recounting years of conflicts, including their last argument, hours before she ended her life. Such evidence-based treatments are recommended for mental health conditions such as mood disorders and post-traumatic stress disorder, but, as with this patient, they do not always lead to effective outcomes.

As an aside, the patient shared that monarch butterflies were randomly visiting him after his wife’s death. He felt like his wife was sending him a message, but figured he was “imagining things.” I noted how these experiences sparked curiosity. I invited him to explore what emerged inside him from these “silly events.” He shared how his life had changed so dramatically, and compared it to the change process from caterpillar to butterfly.

He associated butterflies with a sanctuary in Mexico that he visited with his wife. I amplified his associations, affirming how, collectively, butterflies represent change and transformation. On a cultural level, he was stunned to learn how the monarch butterfly is revered in Mexico as a symbol connecting the living and dead, guiding the souls of the departed back to Earth during their Day of the Dead celebration. This symbol’s meaning was even more special to him, given his connection with Mexico.

By discussing and integrating the personal, cultural, and archetypal levels of meaning, my patient eventually came to peace with the belief that death released his wife from her mental anguish. The monarch butterfly sightings partially felt like a message that her suicide opened him to transform. His guilt functioned to keep him from embracing his new life. My patient became freer and took steps to tangibly change his life. Working with this synchronicity helped break through and access material that helped him move forward.

Cultivating Receptivity and Imagination Through Synchronicities

On the same day, another patient brought up monarch butterflies. Her husband was diagnosed with a progressive, debilitating disease. Still functional, he volunteered for a community clean-up and disappeared. Exhaustive search and rescue operations were dispatched, but to no avail.

My patient found herself thrust into an unenviable reality: Her spouse was now a “missing person.” Her husband was never to be seen again. Her mind went into obsessive spirals about what happened and where to find him. She was wracked with guilt because, for once, she had not joined him at this event.

She, too, was visited by monarch butterflies and found their visitation comforting. As the realities of this tragedy became clearer, letting in that monarch butterflies could comfort and carry meaning felt traitorous towards her beloved husband. As I worked with her defenses, a key theme emerged: They did everything together, and her husband had been slowly fading before his literal disappearance.

She had started living more independently, which felt foreign, and was laden with grief . She wanted him to retain his dignity and not suffer through this progressive illness, and his tragic, surreal disappearance shockingly meant he would not suffer this fate. She was devastated that he was gone and not ready for him to die, yet found solace that this spared them from the ravages of his disease.

On a spiritual level, she wondered if this was his final gift to her. While pondering that idea, a monarch butterfly fluttered on a flower right before her, which stimulated awe and reflection. I further shared how, like the persevering monarch butterfly, whose long journey is guided by its internal compass, she was facing a long journey of life without him.

She liked to imagine that her husband affirmed these ideas and was saying, “I’m free now. You are on your own independent journey. Trust your inner compass and know I am flying with you.” This was meaningful, and shortly thereafter, a search worker, with no knowledge of the butterfly connection, called with discouraging news. To my patient’s amazement, the worker called back and shared that she had seen a monarch butterfly and was moved to call her, though she didn’t know why.

In our work, we cultivated connecting with presence, receptivity, and imagination , rather than dismissiveness, judgment, or preconceived knowing. We related with openness to the emerging synchronicity, which stimulated a process and comforted them in a way I could not do without the synchronicity. Commonly used modalities help resolve conflicts and support us when facing life stressors, but unique experiences like synchronicity may offer comfort and meaning that conventional practices cannot provide. By incorporating synchronicities into psychotherapy, in an approach I call “ synchronicity-informed psychotherapy ,” a patient can be impacted in a way that words alone cannot induce. 2

Shedler, Jonathan. 2018. “Where Is the Evidence for ‘Evidence-based’ Therapy?” Psychiatric Clinics of North America 41, no. 2: 319–329. https://doi.org/10.1016/j.psc.2018.02.001 .
Beitman, Bernard D. 2021. “Synchronicity-informed Psychotherapy.” Psychology Today, August 23. https://www.psychologytoday.com/us/blog/connecting-coincidence/202108/synchronicity-informed-psychotherapy

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Helen Marlo, Ph.D., is Dean of the School of Psychology at Notre Dame de Namur University, a licensed clinical psychologist, and a certified psychoanalyst (C.G. Jung Institute of San Francisco).

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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.