What might someone visit you for and how would psychotherapy help?
Life is full of challenges and all of them can be discussed in psychotherapy. Often, people seek treatment when they have a sense that they are stuck and could use outside help. Sometimes there is an awareness that a personal limitation is contributing to the impasse—especially when the problem is a recurrent one. All of us have learned certain strategies for dealing with life and we become so fluent in them that we aren’t aware of using them. Unfortunately, sometimes these strategies cause more difficulties than they solve. Because these patterns are not apparent to us, an outside view is essential for identifying them—this is why seeing a therapist can be so helpful. When such patterns become identified and known, we become free to choose other possibilities. Sometimes change will follow relatively easily once awareness is raised, yet other times a longer process of working through is required.
Could you describe how you work and what techniques you use to help your clients?
A crucial part of my expertise is the capacity to learn—as the treatment unfolds—how I can engage with a given person in a helpful way. I remember early in my training I was told that you have to invent a unique psychotherapy for each patient. At the time, that didn’t make sense to me, but it does now. The fact that treatment is inevitably tailored to each individual makes it somewhat difficult to generalize. That said, there are features of how I work that are consistent across different treatments. Listening is central to my approach. This involves listening for multiple layers of meaning, themes, emotional tone, and even to what is not said. It also involves asking questions that can help clients delve deeper into their own experience. Some clients expect me to be very active at the beginning of psychotherapy in terms of giving them feedback, advice, homework, and other interventions, but I don’t generally do so because I don’t assume that I know what would be helpful to someone at the outset. Listening carefully is what makes it possible for me to make comments and interpretations that will help facilitate expanded awareness. I have noticed that as a result of being listened to, clients’ capacity to listen to themselves (and others) is improved as well. Unfortunately, listening in a sustained way is a rarity in everyday life and I think it is one of the gifts of therapy. I would like to emphasize that psychotherapy is ultimately a human relationship rather than a technical procedure. It’s true I bring a lot of theoretical and clinical training and knowledge to the process, but that is all in support of the human element.
Do people really change in psychotherapy?
I prefer to use the word growth rather than change because I think change suggests that you’re changing from one thing to another thing and leaving the first thing behind entirely. People don’t work that way—we never cease to be connected to our pasts. We grow forward in time from our pasts. Often therapy involves revisiting the past to free ourselves from the way it is shaping our present lives. However, expanded awareness of the past does not separate us from it, it just changes our relationship to it. All of this isn’t to say that change doesn’t occur, I just find that growth provides a better metaphor for the process. To answer the original question more directly: yes, people often leave therapy with more self-awareness, more flexibility in dealing with life’s challenges, better relationships, and fewer symptoms, to name some of the improvements that can occur. This has been my personal experience as a therapist but it is also well documented in research.
How do you know when the process is complete?
Like anything in therapy, determining when the treatment is complete would be based on a collaborative understanding. When therapy begins, neither participant knows how it will unfold. It’s an organic process—we learn together as we go. Reaching a point where the client feels that their work is done is something that would emerge from our discussions in the same way that other understandings do.