I use the term psychotherapy to describe psychological work that is deeper than counselling, usually over a longer term (one or more years). Psychotherapy is usually needed if distress is severe and chronic, or if personal growth is desired. The way psychotherapy is done is also a little different to counselling. Psychotherapy often guided by two key questions:
- What is behind my difficulties? and
- How do I make change last?
Also, whereas counselling generally focuses on finding ways to reducing symptoms, the process of psychotherapy tends to be more organic and spontaneous. What is focused on is what emerges as important to client within the session.
While the outcome of psychotherapy is as unique as each individual, here are some principles that I believe support change:
All emotional experiences have a reason
All emotional and psychological experiences have a reason. If emotions seem to come out of the blue, the task in therapy may be to raise awareness of what is happening. The practice of being “present” to our sensations and emotions provides a foundation for change.
All of your internal experience is valuable – because it is yours
One goal in therapy may be to work on acceptance of all of our feelings, be they pleasant or unpleasant. In fact, I believe that trying not to have feelings or rejecting any part of ourselves leads to depression and agitation. Acceptance does not meant resignation or giving up, but instead means not fighting yourself to be something other that what you are. Acceptance can also not avoiding things we need to do, or mean reclaiming ownership of things we project onto other people.
Often learning this acceptance requires building up our trust in ourselves, including the trust in our capacity to withstand intense feelings. Psychotherapy can be a place where the skills to tolerate, regulate, express, and appropriately act on feelings can be learnt.
There is a particular challenge in facing what is held as the “darker” side of our humanity – for example, our human capacity for hatred, and jealously. Often our human vulnerability, or our even capacity for success evoke difficult emotions. In my opinion, acceptance of these emotions is supported by being able to have them at the same time as remaining in connection with another person – in this case the therapist.
Being kind to ourselves is immensely valuable
Self-criticism is often extremely incapacitating and requires compassion and strength to change. Kindness also needs to extend to the reasons we do potentially negative things (such as avoid difficult things or criticise ourselves). Our avoidances all have a source, and were often begun as a creative way to resolve problems or even to survive.
Kindness is needed in the acknowledgment that some of the things we do create harm to ourselves or others (however inadvertently). In psychotherapy, both the intention and the costs of these behaviours can be acknowledged. Skills can be learnt to support the recognition that these behaviours may no longer be needed. The intention may be that old habits fade in compulsiveness and are joined by new habits that allow us to expand into an increasing range of experiences.
Change requires more than just skill development
The goal of being ourselves with others requires that we:
- Enter into the process of establishing trust with another;
- Reclaim those parts of our identity that we fear or reject; and
- Confront those things we do that sell ourselves and our loved ones short.
Psychotherapy does not seek to remove all difficulties in life, but instead to learn to cope effectively and positively with challenges. Psychotherapy does not seek to remove difficult feelings, but to learn to be less reactive and distressed in the face of these feelings, and to integrate these feelings into our understanding of themselves.
I believe that the key tool by through which these changes may happen is the psychotherapy relationship itself. My primary approach to psychotherapy follows Gestalt therapy principles.