Wednesday, April 7, 2010

What is Good Psychotherapy?

Below is an article by Dr. Marlene Maheu, editor of Self Help Magazine, an internet magazine written by licensed professionals who "bring you the science of psychology"  (see Interesting and Helpful Links to the right).

I am posting the entire article here because it is a very good synopsis of what psychotherapy is.  It gives the reader some ideas of  what to expect will happen in a "good" psychotherapy. Generally, unless someone has had previous experience with psychotherapy or has had a close friend or family member who has, it's a mystery.  One doesn't know what to expect and, therefore, how to judge whether what is happening is typical and will be helpful.  Because therapy is a process and results are not immediate, it is often very difficult to judge whether what is happening is appropriate and whether, in the end, it will be helpful.  I think Dr. Maheu does a good job of talking about what to expect and why. 

How to Pick a Good Psychotherapist – Part I: What is Good Psychotherapy?

Posted on 15. Dec, 2009 by Dr. Maheu in DR. MAHEUOnline CounselingOnline CounselorOnline TherapistOnline Therapy
Someone commented on one of my blog posts about bad therapists today, and got me writing :) It's a few hours later, and I'm still enjoying myself, so here goes!
I'm writing this in part because the average person doesn't get exposed to plain information about what happens in psychotherapy.  People don't generally even know the difference between psychotherapy and psychiatry, let alone what to expect once they get there.
Once started, new clients are often broadsided by their feelings and don't know what's going on. When they ask their therapists what's happening, the explanation can cost them a few hours of therapy time, thereby delaying the goal the client was seeking, a solution to problem X. It's often needlessly frustrating for both the client and therapist.
Here's a synopsis of my view of good psychotherapy, based on over 30 years of being a mental health practitioner of various types:
Depending on the orientation of the therapist and whatever problem you are experiencing or questions you have, in the normal course of your psychotherapy, you will develop a relationship with that therapist.
Some schools of psychotherapy teach therapists to examine their relationship with you for clues that can shed extremely valuable insight into what happens for you in the outside world, your experiences, and your expectations. Other schools of psychotherapy do not teach that and think it is irrelevant.
Regardless, in that relationship with the therapist, if that therapist becomes important to you, you can expect to re-experience the range of emotions you have felt toward the most significant people in your life, such as your parents, other authority figures and lovers.
That's why some therapies will ask you to talk about those relationships. They have direct bearing on how you have learned to understand people and what to expect from them.
You might think about it this way:
If you grew up in an very huggy southern or middle European family, you would expect everyone to know your business and have lots of skills for how to deal with people putting their noses in your private affairs. But if you grew up in northern Europe, like Scandinavia, you would most likely not likely enjoy having people's hands on you or their noses in your personal life.
And now suddenly, as an adult, you have to deal with people from all sorts of backgrounds who have even more ways of interacting with you – some huggy, some nosy, some aloof, some who tease, some who relate by competing, some who want to know everything about you and other who just want you for your opinion of how they look.
Then when you can't stand your wife, or your co-worker makes a pass at you and you go for it despite your marriage; or your child dies; or you have a drink too many and hit a teenage on the side of the road at night by the beach, or your sister has cancer, or you might have trouble finding a husband, or you are eating, drinking, drugging, spending, gambling, or having sex out of control. You might not know how to deal with it and don't want to talk to your parents or other people about it. You want a trained expert. Your world is topsy turvy and you want someone to lean on for a while, someone to give you direction and perspective.
Those are the kinds of problems that most people go to therapy to resolve.
Well, because therapists are people, most clients find themself having strong feelings toward their therapist. If you consider the range of emotions that you felt toward your parents or spouse, you know that anger, resentment, jealousy, hatred, revenge or love, lust, infatuation, delight, security, belonging, fear … are all part of the normal ebb and flow of feelings in any normal and healthy relationship.
You can expect that at least some of not all those feelings will surface in a strong therapy. When people get stuck in overly negative or positive feeling states, the task of the therapist is to try and teach the person how to have proper boundaries, hang onto the relationship and weather the intense emotions that surface.
If the clients weather these storms, the results are typically intense emotional breakthroughs that help the client deal with very strong emotions in the world, outside the therapy office.
This is the supreme goal of many therapies, regardless of the problem that brings people into treatment. The inability to identify, express and properly respond to our own strong emotions is, in my opinion, the most significant problem that most people have in our society, and the one that has directly leads to our divorce rate being over 50%.
However, if the client is seriously disturbed, cannot become truly attached to the therapist because of their own emotional baggage, or struggling with the chemical imbalances otherwise known as mental illnesses, they cannot properly attach emotionally, and will quit therapy for reasons they believe, but are in fact, inaccurate.
Or they will fall in love and lust, not be able to handle it. They might make a pass at the therapist or drop out of therapy. They might never stop running long enough to understand out why a relative stranger (the therapist) is triggering these intense feelings.
They won't stick around long enough to heal the old emotional wounds that may have more to do with their past than whatever the current therapist has done in that office. They might never get the medical treatment they need to bring their perceptions in line with reality.
After all, how many things can therapists do that are worthy of hatred, revenge, love or lust? We are so limited in our "allowed" behaviors that we just can't do that many things that deserve such intense emotions.
While it can happen that a therapist is just plain bad, or made a serious mistake, it is much more often the case that the client is caught up on the normal process of having a safe place to learn to experience their emotions, find words to express them and figure out how to move on with the other goals of their therapy (get on with life) rather than get stuck in those emotions.
The really sad thing is that our parents, teachers and friends are just as clueless about the real psychotherapy process as anyone else. Who is left to inform the public? Most psychotherapists don't write like I'm doing now. Most are people-people. (Some of us happen to like writing, too 

Dr. Marlene

Friday, April 2, 2010

Developing Consciousness

"Unless we engage in developing consciousness, we become what was done to us-or its opposite."

 -Gregg Furth