What Cures - II: Why a Psychotherapist?

Treatment is a process of becoming aware of your own particular personality processes, of the parts of you that need or want things that make the rest of you miserable, and of how they all fit together. This is your story, your unique path into and out of psychological difficulty. It will not be the same as anyone else’s. While it will of course have similarities with others’ paths, you can only go so far on someone else’s story. Books, lectures, and other forms of treatment that are not individual to you are generalizations, composed of common elements from many or most people. Valuable as these are, they are like statistics. They tell you what goes on with most people, but in any individual case the answer could be different, even vastly so. [Compare Patrick and Mike.]

Moreover, if you do find your answers, you are likely to resist them (see Why psychotherapy, Greg). We are dealing in therapy with the most inaccessible and heavily guarded aspects of you. That is simply the nature of the beast and it’s why, I believe, there are so many self-help books. It is not that any of them are bad -- well, some are -- but they cannot accomodate to your unique personality style, difficulties, and interests, nor can they usually overcome resistance. At different points in our lives we are open to the ideas in a self help book, but when we are not -- when resistance is high -- they won’t help no matter how good they are.

What is needed, then, is a relationship, even if it’s only for 8 sessions. The bully and the flincher (from Personality) both need to become aware of the same motives and feelings but each will do so in his own way, his own time. The flincher, for example, is probably going to admit sooner that he’s afraid, but he may have a great deal of trouble acknowledging how angry it all makes him; the bully will openly discuss these aspects of himself in probably the opposite order. Treatment will progress for each according to his own comfort level, depending on a lot of environmental and personal factors that may be pressuring them to change, and only in so far as a therapist can help them make contact with this unconscious and highly uncomfortable material. So the therapist has to become someone they trust and who’s point of view is valued. Otherwise it’s too easy for what he says to be dismissed, too easy to fall back into old habits. On the other hand when that relationship is in place, wonderful things can happen. [ John, Jim, Mike, Patrick]

Difficult to define and itemize, some people have never been comfortable with the idea that relationships count in psychotherapy. This point of view is particularly strong in the past 20 years or so. But the fact is that even back in Freud’s circles a century ago, when talking about the "therapeutic relationship" was pretty scandalous, psychoanalysts were admitting that successful treatment depends heavily on the analyst’s charisma and skill in cajoling the patient into trying a new behavior.

If this section is giving you the feeling that psychotherapy is some mushy, undefined kind of faith healing that you either believe in or not, be sure to look at the next section, " A note on how psychotherapy works".

A Note on How Psychotherapy Works