What Psychotherapy Is and Isn’t
Given that the term “psychotherapy” has been used to cover a wide range of methods and procedures, arriving at an accurate definition for the word can be difficult. While it is probably safe to define psychotherapy as a process in which emotional, behavioral and/or mental difficulties are treated through communication and a relationship between one or more individuals and a therapist, it may not be very helpful.
Put a little more simply, many of the difficulties we face in the present can be traced back to emotional wounds we suffered in earlier relationships. Psychotherapy uses the relationship dynamic to heal the wounds caused in previous relationships, helping patients regain self-confidence, trust and empowerment, and move their lives in the direction of their choosing.
While the communication between patient and therapist and the therapeutic relationship are the critical factors in therapy’s success, psychotherapy is much more than simply talking about your problems. Family members, friends and colleagues may be able to provide good advice or cheer you up, but these do not amount to lasting change and do not constitute psychotherapy.
First and foremost, the relationship between a patient and therapist is strictly professional and exists for the sole purpose of helping the patient. The only thing the therapist should expect in return is payment for their time and services.
I feel that last paragraph warrants extra emphasis, as the therapeutic relationship differs from all other relationships. When a therapist asks you how you’re doing, he or she doesn’t want the customary “Fine” or “OK” in return, your therapist really wants to know. When you disclose information to your therapist that information is strictly confidential. You can be completely honest without worrying about offending your neighbors, your boss, your spouse, or even your therapist!
For these and other reasons, therapists reveal little information about themselves to patients to ensure nothing they do changes how their patients present themselves. Extending the patient-therapist relationship beyond the therapeutic setting is no longer considered psychotherapy and can be quite damaging to the healing process.
How Psychotherapy Can Help
People seek the professional help of a therapist for many reasons, but more often than not an external life change or internal difficulties cause unmanageable anxiety, stress or pain. Quite often the cause is an obvious one, such as a job loss, divorce or death. But on many occasions, people seek help for issues involving internal feelings they can’t attribute to external causes.
Often, emotional stress comes from relationship difficulties with a spouse, child, parent, colleague or friend. Beyond just helping you find an equitable solution to your current dilemma, therapy can help you understand the underlying issues at work in the relationship and provide tools to help your relationship not just survive but thrive!
Some emotional stress and relationship problems are associated with a lack of a particular skill, such as anger management, the ability to cope with grief and loss, assertiveness or communication skills. Psychotherapy not only helps identify the reasons for the lack of these skills, but also enables people to acquire and improve these skills. In a very real sense, therapy can teach people how to do what they need to feel better.
Psychotherapy also provides a confidential and supportive environment in which to discuss issues surrounding traumatic experiences, such as an automobile accident, combat duty, physical or sexual abuse, or other violence. Trauma can overwhelm your capacity to cope and leave emotional scars that impair your ability to live a full and normal life. By focusing on healing the wounds caused by the trauma as opposed to just treating the symptoms of the trauma therapy can help you move forward with your life.
Even if you don’t have clinical symptoms or conditions, psychotherapy can help you learn more about yourself and others, as well as teach you techniques to overcome obstacles preventing you from reaching your professional and personal goals. In short, a commitment to the therapeutic relationship can help you become the person you want to be.
Along with a Master’s Degree in Clinical Psychology, I have been licensed as a Marriage and Family Therapist by the state of California. In California, licensed Marriage and Family Therapists (MFTs) are recognized by the state as psychotherapists, along with doctoral-level therapists, in most legal contexts. The Master’s Degree program MFTs must complete, along with 3,000 hours of supervised training and stringent licensing procedures, is specified by the California Code of Regulations and the state Business and Professions Code.
MFT licensure requirements include coursework and supervised practice in assessment and diagnosis, theory and practice, law and ethics, human sexuality, child abuse, human development, and counseling of individuals, couples, families and children. Additionally, annual continuing education is required to maintain the MFT license and ensure Marriage and Family Therapists are aware of current research and practice developments and incorporate new findings into their practices.
MFTs are trained to deal with relationships the professional, the personal and the intimate. As human beings, our happiness is to a large extent determined by the health of our relationships. Accordingly, relationship problems, be they of the past or present, are at the root of most of the issues we face in life. And this is precisely the area in which California MFTs are specifically trained to help.
As I’ve stated elsewhere, the therapeutic relationship is one of strict confidence. Your therapist may not disclose any of the details of your relationship or treatment except where specifically required or allowed by law. In accordance with the profession’s legal and ethical guidelines, you, the patient, have the right to:
- receive respectful treatment that will be helpful to you;
- receive a particular type of treatment or end treatment without obligation or harassment;
- a safe environment, free from sexual, physical, and emotional abuse;
- ask questions about your therapy;
- request and receive full information about the therapist’s professional capabilities, including licensure, education, training experience, professional association membership, specialization, and limitations;
- have written information about fees, methods of payment, insurance reimbursement, number of sessions, coverage (in cases of vacation and emergencies), and cancellation policies before beginning therapy;
- refuse to answer any questions or disclose any information you choose not to reveal;
- know the limits of confidentiality and the circumstances in which a therapist is legally required to disclose information to others;
- know if there are supervisors, consultants, students, or others with whom your therapist will discuss your case;
- receive a second opinion at any time about your therapy or therapist’s methods;
- request that the therapist inform you of your progress.
Copyright, 1989, California Association of Marriage and Family Therapists, Reprinted from The California Therapist, the publication of CAMFT, Nov/Dec 1989, by permission.
A therapist’s theoretical orientation describes what theories the clinician subscribes to when thinking about a patient’s problems and how best to treat them.
Because the majority of our emotional wounds occur in relationships, I believe they are best healed through relationship. Thus, I describe the therapeutic work I do as working “relationally” with my patients. This relationship involves the patient and me interacting with and engaging one another, with the goals of enhancing the patient’s self-knowledge and providing the patient with new and reparative experiences.
My work is informed primarily by psychodynamic theories, including psychoanalytic, Jungian, Object Relations, Self-Psychology, Intersubjective and Relational. I am also trained in Emotionally Focused Couples Therapy.
But putting theories aside, it is our unique experiences that shape who we are and how we operate in the world. Helping patients become aware of their motivations and seeing them become more conscious, mindful and successful in their relationships is what draws me to the work I love to do. Therapy is an empowering experience, and helping patients empower themselves is always a goal of the work we do.
“So, how long does therapy take?” While one of the more common questions I receive, it is also one of the most difficult to answer. Therapy is not a linear step-by-step process, and each therapeutic relationship and course of treatment is as unique as the individuals involved. Because individuals’ backgrounds and the severity of their problems vary widely, so do the lengths of therapy.
For mild problems, solution-focused treatment can be relatively brief. In cases of more severe, chronic or long-term difficulties, it is not unusual for therapy to last for a year or more. However, the choice to end, or “terminate,” therapy is always yours to make. If you feel you’ve benefited as much as you’d like from therapy, discuss your feelings with your therapist. At best, terminating therapy should be a mutually discussed and agreed upon decision. However, you should never feel held hostage by your therapist or the therapy process.
Deciding to seek professional help for your problems and selecting a therapist to work with are important and courageous steps toward your future happiness and well-being. Equally important is your commitment to achieving your goals through the therapeutic process. Psychotherapy can be difficult work, but the rewards of therapy can be greater than those of any other investment you can make. I encourage you to contact me with any questions you have regarding psychotherapy in general or my practice in particular. And, I congratulate you on taking care of yourself and taking the steps necessary to move your life in the direction you want it to go!
For more information on MFTs and the services they provide: