What Psychotherapy Isn’t
More than perhaps any other profession, psychotherapy is lampooned mercilessly. Probably every television sitcom ever aired had episodes whose great source of mirth was the inept or eccentric ministrations of a therapist. Unfortunately, truth is stranger than fiction. There are many incompetent therapists doing business and they contribute to the skewed and negative perception the public has of what we do.
Psychotherapy is not a massage. It is not "unconditional positive regard", although sometimes that’s part of it. There is nothing wrong with support and nurturing, but they are not, by themselves, psychotherapy. You need to feel you can trust your therapist, but it’s not necessary that you always be comfortable. In fact, if your therapist’s questions don’t stir up a little discomfort, you may not be getting anywhere. Sometimes therapy can even feel downright brutal [Patrick]. With another patient, at another time, therapy can indeed seem an amorphous, vague, and even aimless process [Mike, John]. Either way, you should still see those changes in attitude and behavior that you want from the treatment
Psychotherapy is not advice. The world’s full of advice. Part of what brings you to treatment is that you’ve become lost in that advice and can’t sort out who’s to heed; the last thing you need is yet another voice to consider. The goal of treatment is for you to rediscover your own voice, your own priorities, and the courage to act on them. I do not have to tell a patient what to do about his marriage, career, paranoia, anxiety. If I can help him become aware of what’s happening to him, inside him and between him and others, he will know better than I what is best for him. And next time he won’t get so confused. It’s like that old aphorism: Give a man a fish, you feed him for a day; teach him to fish, and you feed him for life. As a good friend and colleague put it, "my job is to help clean off people’s glasses".
A good way to think of this distinction between psychotherapy and something that is therapeutic -- advice, support, teaching new skills, teaching about feelings and behavior -- is to consider: Does it foster insight. This is an important word that has fallen out of vogue. Insight is not learning in the intellectual sense. It is a kind of intensely personal and energizing experience that needs to be at the heart of all good treatments. [Why psychotherapy, Evan, George - II, Ron II, Ed - II]
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