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Psychotherapy: Clarifying Some Misconceptions

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Despite the fact that the public has a greater awareness and understanding of psychotherapy, many misconceptions and misunderstandings remain. Perhaps the following article will bring greater clarity to this issue.

First, the complexity of and the stresses that come with life today, make coping difficult for most people and, therefore, it is worthwhile to seek therapy. In other words, a person need not have an acute mental illness or profound depression to seek the services of a mental health professional.

There tends to be a belief that once someone enters psychotherapy, they are committing themselves to a process that will take years. It is true that many years ago, Freudian psychoanalysis usually called for therapy four times per week and often lasted for fifteen to twenty years. Today, clients and therapists view psychotherapy as a time limited process. In fact, there is a type of treatment called Short Term or Brief Psychotherapy. This lasts for 6 to 8 weeks or for a specified number of meetings before termination.

While psychotherapy involves talking, there are different methods of conducting “talking psychotherapy.” Choices of therapy include, 1. Psychodynamic Therapy that is based on psychoanalysis but is of shorter duration and meets no more than once or twice per week, 2. Cognitive Behavior Therapy based on changing behavior by changing ways of thinking about problems, 3. Marriage and Couples counseling that centers on marriage or living together, 4. Family Psychotherapy that centers on the entire family, including all the children, parents, grandparents and anyone else involved in shaping the lives of its members.

I hear from many people that they hesitate to find a therapist because it’s too expensive. There are many ways for people to find affordable therapy with licensed professionals. Hospital Outpatient clinics and not for profit mental health agencies provide low cost counseling by using student interns who are carefully supervised by clinical psychologists, social workers and psychiatrists. There are many professionals who are willing to set aside a certain percentage of their practice to low cost clients who, otherwise, would not be able to be seen in a private setting outside of a clinic.

Contrary to the old fashioned practice of psychoanalysis, therapy clients do not lie on a couch unless they choose to be in psychoanalysis. Therapy is conducted face to face in a pleasant office setting where therapist and client sit opposite one another. In addition, the therapist does not remain silent, a left over relic from the days of psychoanalysis. Rather, client and professional engage in a dialogue, regardless of the type of therapy.

Many people have the attitude that therapy deals with the past and ignores the present. It is true that during the era when psychoanalysis prevailed, the belief was that recovery from emotional problems would occur as a result of revealing hidden and forgotten secrets from years before. The belief was that these hidden memories were extremely traumatizing and, therefore, making them conscious would cure.

Today, it is still considered important to look at childhood memories. However, the purpose is to understand how those early events influence behaviors and expectations in the present. For example, a woman who grew up with an authoritarian father might expect or fear that possible boyfriends would be the same way. Therapy then focuses on gaining a more realistic view of men and on learning to avoid those who could be authoritarian. The focus of the therapy is on the present with an understanding of how it is shaped by the past.

If you feel you want to enter psychotherapy, it’s important to find a professional who is licensed to practice therapy. Among those are psychiatrists, clinical psychologists, licensed clinical social workers, licensed family and marriage counselors and licensed professional psychotherapists.

In my experience, a number of people asking for therapy want to know the type of therapy I practice. I find this to be a curious question because the individual is not asking how well we might work together. The only way to know that is to meet for a couple of sessions and then decide. Yes, there are differences between cognitive vs. psychodynamic therapy but, in my opinion, that is less important than the quality of the therapeutic relationship.  I am not alone in stating that the relationship between client and therapist is what helps people learn how better to cope with their issues.

The entire process of selecting and working with a therapist can be very confusing. Therefore, you are encouraged to submit comments and questions about this issue.

Allan N. Schwartz, PhD

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