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Psychotherapy: A Series of Thoughts

Posted Jul 22 2008 8:21pm


Many books have been written in hope of defining psychotherapy. Here’s a very short attempt (has appeared as part 1, part 2, on the ‘psychotherapy?’ page):

Psychotherapy is a conversation between two people — where one person predominantly talks and the other predominantly listens. The goal of the conversation that develops is to foster insight into the nature of the person doing most of the talking, as well as insight into that person’s problems. But insight is not enough. The important work is somehow getting that insight to stick. To incorporate it into that person’s life in meaningful ways that in turn helps that person better adjust to her or his life.

Even such a simple definition leaves so much that is important out, and there are so many questions it raises, and statements that beg qualification.

Not a blame game.

Psychotherapy is not about complaining endlessly about past injuries. It is not about painting family members as the cause of all our problems. It can be about understanding one’s perceptions of past and present events and how those perceptions color our views of our daily life. Some misunderstand psychotherapy as playing a blame game, not accepting responsibility. Quite the reverse, psychotherapy encourages us to examine and challenge our own perceptions (which may or may not resemble historical truth) of the past. It is important to examine perceptions, because it is our perceptions which shape how we perceive our current world, and inform our decision making and actions.

Making meaning.

Human beings are meaning-making creatures. Faced with confusion, we will attempt to find meaning, even where there is none. Psychotherapy is about uncovering and addressing those meanings. Meanings may generated within one’s self, within one’s family, within one’s community, within one’s culture. Those meanings that may even be obscure to ourselves. A good therapist will gently challenge us to examine inconsistencies in our perceptions and beliefs about ourselves and our interactions with others — and to examine what they might mean. Psychotherapy does not generally come upon “Eureka, that’s it!” sorts of answers, although such insights may suggest further avenues of inquiry. It is a very process-focused endeavor that studies our questions about ourselves in a sustained, methodical, and patient manner.

Recognizing patterns.

Before we can begin to understand our patterns, we have to become aware of them. Part of what psychotherapy does is help to make people more aware of patterns and behaviors that they themselves might not have noticed. It is a process of teasing out the many possible sources that contribute to those behaviors. Many patients express a sense of relief when they are able to bring new meaning to a past situation they had viewed simply from one perspective.

When solutions become problems.

Often the problems we bring to therapy represent our best solutions to our problems — but they are solutions that have stopped working, and in some cases have become new problems. Psychotherapy is an intervention to help us not repeat endlessly the same unproductive solutions.

An authentic emotional connection.

Purely intellectual understanding is very limited. There has to be an authentic emotional connection in connection to our understanding of past events in order to effect meaningful change. A therapist will help you to hone in on, rather than gloss over aspects of your life which seem to be potentially loaded with emotional meaning. A good therapist will convey understanding and empathy for what you are going through. To a great degree, the connection you have with your therapist is what determines the success of your therapy.

Change takes time and collaboration.

Meaningful change does not happen overnight. Many of these patterns of behavior have been honed over years and years, and take time to examine, untangle, and reintegrate into our current lives. Since this type of therapy is more likely to focus on meaning rather than symptoms, it takes time.

It has been written that psychotherapy could conceivably occur between two people without one of them being a therapist. Yet this is quite unlikely. The way that therapists listen, without generally offering advice or solutions, is not the usual mode of casual conversation. A conversation dedicated, on a weekly basis, solely to the concerns of one person is not likely to occur outside of psychotherapy.

Listening in an informed, sustained way.

A therapist will listen knowing what types of life events are likely to have an impact on one’s style of relating to self and others. A therapist will listen knowing that each stage of life (e.g., adolescence, young adulthood, parenthood, middle age, retirement) brings its own unique set of problems, and what are the usual hurdles during these stages. Finally, a therapist will listen with an understanding of the pathologies that can develop in responses to certain problems and have experience in working with those pathologies (e.g., depression, anxiety, obsessive behavior).

Kalea Chapman, Psy.D.

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