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Archive for February, 2015

What is Psychotherapy?

Posted on: February 27th, 2015

“No one would ever say that someone with a broken arm or a broken leg is less than a whole person, but people say that or imply that all the time about people with mental illness.”

― Elyn R. Saks


As a therapist, it is sometimes disheartening to hear others outside the profession discuss psychotherapy. There’s an air of fear and mistrust that surrounds therapy, as if one must be broken or weak to seek help. When asked what I do for a living, my answer is often met with unease. The person becomes clammy, guarded and responds with an uncomfortable laugh and request not to be psychoanalyzed. A part of me feels embarrassed and another part, concerned.


I find their response terribly ironic since one of the foundations of psychotherapy is confidentiality. Our role is to be confided in, though apparently only when necessary. Psychotherapy is a last resort for many, often when there is no one to listen or when we no longer feel we are able to go it alone. Many clients have shared, with tears in their eyes, the shame they feel having to come to therapy. While they find it helpful, their friends and family often scoff at their supposed weakness. I could not count the times I have heard a client lament over their loved ones telling them to “just get over it” or that their feelings are “just a phase.” It is difficult to imagine someone with cancer or Lupus receiving the same advice.


What is it about “mental illness” and psychotherapy that is so offputting and why is the suffering of others written off as a ruse?


A Conflict of Interests


The specific meaning of psychotherapy is difficult to pinpoint, and as this is a blog not a scholarly paper, I am not here to make definitive statements. Psychotherapy for me is a very personal exchange and takes on a meaning that cannot be quantified in a textbook. I imagine each client has a different understanding of exactly what goes on within the office walls of their therapist, each with its own validity. I find the existence of this profession both a blessing and a misfortune. It is a blessing in the sense that many are able to share their most painful experiences with another and feel listened to and understood. At the same time, it is a shame we cannot do this with our loved ones or within society in general.


This is the conflict I feel when met by an uncomfortable, clammy response after stating my profession. How can a profession supposedly built on empathy be interpreted as a profession of judgement? To be psychoanalyzed has become synonymous, in a way, with violation. I understand this to a point, we work within the realm of uncomfortable truths. Part of psychotherapy is the uncovering of hidden meanings, themes and experiences that cause us pain. We cover these up to avoid the pain, and the possibility that the sheet may be pulled away can be a frightening prospect.


Similar to how we avoid doctor’s appointments out of fear of finding something wrong with us, psychotherapy may raise our awareness of a problem we had not considered.  Awareness of something often requires change and change is difficult. This makes sense. However, doctors are often met with high regard for their work, rather than suspicion. One is not seen as weak for having cancer or a broken leg, but vulnerable and in need of help. However, depression, since we cannot see it or because of its limitation to the individual’s subjective experience, is treated as an attitude rather than a malady. Therefore, therapists are seen as those who adjust bad attitudes rather than heal suffering.


The Power of Empathy


Part of the reason psychotherapy is often misunderstood is because of it’s limbo between medicine and the humanities. While much of psychology is backed by science and takes place in hospitals and clinics, psychotherapy bears little resemblance to medical intervention. Infections are not cured by a doctor discussing the suffering it causes, but rather through antibiotics. However, grief, anxiety and depression can be relieved by talking through one’s experiences, emotions and thoughts in a caring and open environment. Yet, this seems closer to the spiritual counsel of a priest/rabbi/imam/etc. or the warmth of a close friend than a medical procedure.


Furthermore, it is the empathic relationship between the client and therapist that accounts for most of psychological improvement rather than any specific intervention. While medications help relieve symptoms, psychotherapy has been shown to be effective for 75-80% of participants*. Oddly enough, it is empathy and the helping relationship that accounts for most of the change seen in psychotherapy, or rather, kindness and personability. Yet, if you ask most people, I would assume it is the psychoanalyzing, assessment, medication, diagnosing and other cold, clinical interventions that are cited as descriptions of a therapist’s work. From the outside, therapists are seen as prodding rather than caring.


I have witnessed the impact of this perception on loved ones along with the prolonged suffering it causes. Rather than seeking a therapist to help ease the pain of a loss, strain of a transition or the disabling fear of anxiety, we attempt to forget them. This is like ignoring a toothache with the hope it will heal itself. To some, a therapist’s voice can be as unsettling as a dentist’s drill. However, psychotherapy is more like the cleansing waters of a bath.**


An effective therapist will help support, encourage, validate and listen to you.


Caring vs. Curing


My hope in writing this is to bring awareness to the misguided perception of our field and psychological suffering on whole. I fear the medicalized model of treatment that currently dominates the way we interpret, fund and treat the life problems of our clients infringes on our ability to aid them in the greatest capacity possible. The same philosophical assumptions that bring our field validity, objectivity and prestige in the culture are also infringing on the very purpose of its existence; to alleviate the suffering of others. Somehow therapist are understood as diagnosers over healers and judgers over listeners, which I do not believe is the intent of its practitioners.


I do not believe I am alone in these conflicts and experiences. Whether you are reading this as a therapist, social worker, patient, doctor or salesman, it is important to take away the importance of empathy and understanding in your life. Psychotherapy, in many ways, fills the need for acceptance and compassion in our culture. Hopefully, seeing a therapist will one day be understood as a way of caring for rather than curing ourselves.




*Check out  NREPP’s website for more information of importance of the therapeutic relationship.

**I apologize for picking on dentists here, you also provide a much needed and valued service!


“Who Am I?”

Posted on: February 2nd, 2015

“Human beings are works in progress that mistakenly think they’re finished. The person you are right now is as transient, as fleeting and as temporary as all the people you’re ever been. The one constant in our lives is change.” – Dr. Dan Gilbert, Harvard Psychologist and Author


I remember sitting in my 7th grade Health class listening to my teacher explain how our teenage years are a time to discover who we truly are. This baffled me. Discover who I am? Where do I go to find that out? It seemed like such a strange statement for my 12 year old brain to process. I didn’t even know where to begin or what my “true self” would look like once I found it.


As a culture, we spend a lot of time, energy and money trying to secure a sense of identity. Our search for self fuels our consumer culture and each new product promises to speak to our deepest desires and make us appear more interesting and secure . Ironically, the very objects we use to define us change with the seasons and we scramble each year to reaffirm some stable sense of being in the ever-changing (and often arbitrary) world of fashion.


However, I am not here to begrudge consumerism. My issue, rather, is with the search for a single, stable identity. As with the changing tides of fashion and the seasons they follow, we too are in constant flux. Each new experience alters the way we understand ourselves and the world.


Internal and External Self


There are two essential features of our self: the external and the internal. External features include where we live, our history, race, religion, how we dress, etc. This is how we present ourselves to the world and is a reflection of our internal self in some ways. Our internal self includes our values, motivations, dreams, personality traits, emotions, and so on. The latter is how we usually define our “real self.”


Normally, we are instructed by wise and insightful individuals to chose one over the other, usually the internal over the external. However, I believe both aspects play an important role on how we define ourselves and understand others. A lot of us believe we have to discover who we are as if it were a jewel hidden on some mountain peak in Peru. We search for it in our purchases, hobbies, books, and friends. We chase it as if it were something out there, waiting to be uncovered.


However, by searching for ourselves, we overlook the way we are continually defining ourselves from moment to moment. Each decision, each word, each thought we engage in defines us. Our identity is in a state of constant creation, even as we search for it. So why do we often feel like we are missing something?


Here are 4 Ways to Embrace the Changing Self that have helped ease my own feelings of discontentment in a seemingly never ending search for identity.


1). Don’t find yourself, create yourself. Searching for yourself is like trying to see with your eyes. It’s something we do naturally without having to try. We are constantly creating an identity, or playing a role, if only on a subconscious level. By acknowledging this, we begin to understand the freedom we have in our own self creation. We believe we are limited by our upbringing, our friends and family and environment. While these do play a role in our self definition, we have control over how we react to them.


We each have the ability to chose how we react to negativity, abuse, boredom, and to a future that seems defined for us. We define what is important to us, how we would like to be treated and how we present ourselves to the world. Authenticity is rooted more so in our passion rather than our circumstances. When we are involved in our passion, such as music, writing, basketball, running, or whatever, we act in the moment without having to make a conscious effort. Instead of allowing our environment to define us, we can let our passions express our deepest sense of self.


2). Accept your fears about being the person you would like. Fear is a powerful drug as it distorts our ability to accurately perceive reality. Fear prevents us from pursuing our passions and therefore from creating a satisfying identity. It is important to acknowledge what fears hold us back in order to confront them. In fact, one of the top five regrets people express on their death-bed is that they wish they had lived a life true to themselves and didn’t spend so much energy catering to the expectations of others.


Fear can take the form of a bully, criticism, discomfort, or challenge. If we chose not to face these, then we become defined by them. As I said, we are constantly creating a self by the choices we make. If we consistently chose fear, then we constantly define ourselves as fearful. When we are afraid, we are as brittle as a dried up leaf. However, if we allow ourselves to be forged by our fears, we become as a strong as steel.


3). Find like-minded individuals. You are not alone. We are all insecure about something and in some way searching for stability. With 7+ billion people on the Earth, there is bound to be at least one other person with the same passions and character as you. Take a chance, branch out and explore areas of interest. Read, blog, Skype, write a letter, and travel.


We all yearn to connect with others and part of defining our self is learning from the example of others. What type of person do you look up to? What characters do you identify with? These are telling insights into how we want to be perceived treated and understood.


4). Start right here, right now. Part of the problem with “searching” for a true self is that “self” becomes a goal. We travel the world in order to discover what’s in our own mind. In the end, we miss the point of it all, which is the experience of life as a process.


Instead, begin right now. Let us consider the choices we make, the thoughts we have, and how we spend our time and money. Our life is a collection of individual choices. If we are unhappy with who we are, commit to change. It’s never too early or too late to change our path. Also, if you’re happy with who you are, please, share it with others. Spread your kindness and be brave enough to share your experiences.


Embracing Change


Believing we have one true self limits our ability to adapt. If our sense of self is like a rock, it will  erode away by the weathering of time. However, if our self is more like a river we are able to bend and flow with the changes of life.


I enjoy the idea of creating a self because it places the responsibility in my own hands. If we are unhappy, it is because of how we respond to the events in our life. Likewise, we have the ability to alter our responses and physically change the way we live. It is an ongoing process and if we free ourselves from the bounds of history and circumstance, we can avoid a life of fatalism and helplessness. It starts with one decision.