What Is Psychotherapy Really?


You’ve seen it in the movies, and chances are good that you’ve been through some of it yourself. But what IS psychotherapy, and why do we seem so fascinated by it in our culture? Is it actually helpful? Do different kinds of therapy actually vary, or is it all really one mushy lump?

Of course you could check out Wikipedia’s entry on psychotherapy for a good deal of information on the subject. Probably more information than you want.

Let’s just get a few basic points down. A list format works well enough for this purpose. And, it might be a bit more fun if we start with myths about psychotherapy, and debunking them with some accurate information. So today we’ll talk about what psychotherapy isn’t. As a sculptor creates a statue, she removes what does not belong until the image emerges from the stone. And we’ll talk a little about what it is, once we understand what it isn’t. Or isn’t necessarily.

1. Psychotherapy does not usually involve lying on a couch with your therapist taking notes behind you. That technique arose in Freud’s psychoanalysis and remains a part of the tradition of post-Freudian psychoanalysis-style therapies. There’s nothing wrong with it, and it has its place, but it’s not what most therapists do. Further, even psychoanalysts that use this traditional technique do so generally in the context of intensive, long-term psychoanalysis, and not when the patient is in-crisis. In brief therapies and when patients are in crisis, even psychoanalysts, I am given to understand, generally sit face-to-face with the client. That positioning is the norm in most non-psychoanalytic forms of psychotherapy, which includes most therapies practiced today.

2. Psychotherapy is not necessarily a way to “feel better” or even to “be a better person.” Many forms of psychotherapy emphasize feeling better: being less anxious or depressed, having better control of anger, and so forth. However, I do not have such goals when I practice psychotherapy. Feeling better is nice, but it’s not at the top of the list of what people most want in their lives. When I ask people what they want to write in the memoirs when they’re 80 or 90 years old, they NEVER say, “I want to write that I felt better.” Occasionally they may say something like “I was a good person,” but generally they are much more specific, e.g., “I was a good father.” That’s what I want to do as a therapist. I want to help people become and live what they want to become, what they want to live.

3. Psychotherapy is not primarily a “venting session.” Few, if any therapists would like to define their therapy as primarily venting, even though there is certainly supportive listening involved in most forms of therapy.

4. Psychotherapy does not necessarily involve discussion of your childhood, though often it is worth some discussion. Some forms of therapy may emphasize discussing childhood experiences more than others. In my therapy, it really varies broadly, between extensive discussion of childhood to almost no discussion of one’s early childhood at all. It depends upon what’s needed.

5. Psychotherapy is not primarily a form of expert advice. It is not forbidden, as some people suppose, for therapists to give advice. I give plenty of advice. But that’s not the primary function of therapy, and often advice-giving can be an obstacle to real progress in therapy.

So much for what psychotherapy isn’t. Some words now on what it is, or should be:

6. Psychotherapy provides an opportunity to understand oneself better, to “know yourself.” This is a primary function of therapy. When we are aware of how we function, we can much more effectively live the life we want to live.

7. Psychotherapy provides the opportunity to learn new skills and new ways of responding to old problems. Therapy should provide new ways of seeing and responding to stubborn old problems. Those problems did not go away on their own, with conventional, friendly advice and common sense.

8. Psychotherapy is intended to change your life. It can be aimed at “problems” and framed in terms of “problems,” but I do not encourage that stance. Even therapists who do conceptualize therapy primarily in terms of problems would agree that therapy is intended to change the life of the individual, to shift courses from an unsatisfying life to a more satisfying life.

I will continue this list in the next blog post. My other life priorities are at this moment clamoring eagerly for my attention–literally!

More on therapy at our website:



Filed under Psychotherapy

4 responses to “What Is Psychotherapy Really?

  1. Great post. Lots of information here. Best wishes on your blog.

  2. Thanks for your kind comments! All the best to you from your northern neighbor. – Joe

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