What is psychotherapy?

Psychotherapy is the process of patient and therapist working together to get the patient unstuck. When I first saw patients 48 years ago, I realized that therapy was bigger than I was. That realization remains valid today. I have witnessed the power of therapy thousands of times.  I began providing therapy in my twenties and still lacked many relevant adult experiences as result of my having been cloistered in Catholic priesthood seminary and in graduate school. In spite of my inexperience, the patients achieved their goals and enhanced their lives by therapy. These patients were often older than I and were married with families. Many had lived through wars, on the home front or on the battlefield, and had weathered economic recessions and even the Great Depression. They struggled under clouds of despair, anxiety, memories of domestic terror as children, psychoses including schizophrenia and bipolar disorder, and substance use. And as a result of therapy, they discovered their paths forward; they became unstuck.

So, what is psychotherapy?

Providing psychotherapy is an art that requires a myriad of explicit and intuitive skills. Those skills are acquired through individual study, classroom training, providing therapy under close supervision, and listening to patients. The classroom training is intense during graduate school but must be continued yearly throughout one’s career. Looking back I think I was a “good enough” therapist early in my career, but my proficiency has continued to grow. In spite of all, I have occasionally encountered gaps in my knowledge and struggled to get back on track with certain patients.

What is the role of the patient?

Although I take pride in my work, the patients are the stars of therapy. They bravely flounder in a state of beneficial uncertainty for weeks, months, and even years. Here is the secret: Patients ultimately heal themselves. My job is to set up a healing environment. The courageous work on the part of patients account for my early “successes” in providing therapy as well as my current satisfaction in still practicing.

What are my allegories for patient-therapist cooperation?

I use a metaphor and a story to illustrate the therapy process to my patients. First the metaphor: Needing therapy is like being lost in the middle of a tropical island jungle. Safety requires reaching a beach. The therapist has been parachuted into the island at the patient’s location. Neither the therapist nor the patient knows the way out. Each has knowledge, skills, and abilities that complement the other’s. Working together, they find the beach. In the next post, I will elaborate on the knowledge, skills, and abilities of a competent therapist.

Another story that illustrates therapy is the 1976 episode, titled The Hunters, from the Michael Landon series, Little House of the Prairie. An old blind man played by Burl Ives and the 9-year-old Laura played by Melissa Gilbert find themselves in an isolated mountain range. The old man and the little girl have to find a doctor to save the grievously wounded Charles Ingalls, the victim of an accidental gunshot. The old man had not been off the mountain for 30 years. By teaming up, the old man with his keen sense of smell and hearing rekindling his memory and Laura with her agility and eyesight find their way to help.

When I tell these two allegories to patients, they listen grimly but don’t object. When I try to lighten the mood by giving the patient the choice of roles in the second scenario, I am always assigned the role of Laura.

What is the mission for future posts?

• The next post will address the characteristics of effective therapists.
• Subsequent posts will highlight posttraumatic stress disorder (PTSD), autism spectrum, happiness, cognitive behavioral therapy (CBT), mindfulness, and beyond.
• I expect this blog to have two types of posts, those pertaining to psychotherapy and health and those pertaining to scientific psychology. Spoiler alert: Scientific psychology is a hard science and much more than psychotherapy.

What is my invitation?

I eagerly look forward to your comments, questions, and suggestions for further posts. Of course, I would be honored if you signed on as a follower.

Warm regards,

Dr. Michael

About the featured image: A gate at Tulloch Castle on the Scottish Highlands. (Photograph by the author)