What is psychotherapy?
I wonder how many people who’ve never been to a psychologist actually know what therapy involves. I guess it isn’t really something we learn about other than maybe through TV series like In Treatment or The Sopranos. It’s definitely not as common as going to the doctor or dentist. So what actually happens in therapy?
The fact is that there is no one answer to this question. Each therapist is an individual person and there are also so many different types of trainings, each one informed by different paradigms (of which there are multiple). Each client is also unique and requires a tailored experience. I am actually quite a different therapist with my different clients. However, my core beliefs about what therapy is as well as who I am in the room (as in me, my genuine self) doesn’t shift too much.
So let me return to the question. What is therapy? Well it’s hard to explain. It’s almost as hard as asking what “What is a relationship?” or “What is healing?” Both these elements are crucial.
To make it easy for myself and maybe because it’s a bit fun, I’m going to use three analogies to explain myself. I often use analogies in therapy actually because so much of what is being referred to is abstract and elusive and analogies helps to make such concepts more concrete.
- The edge of the forest analogy
The reality is that people come to therapy because they are struggling with something. This is always the case. Struggles range from extreme psychological difficulties to your garden-variety existential crises. The latter could be questions about career or love or location but whatever the case the individual is asking a big WTF and needs help navigating through their feelings so as to come to some kind of resolution or peace. Perhaps they just need to experience themselves in relationship to these feelings so as to gain a sense of mastery or they need to overcome their fears around these feelings. Let’s face it, difficult feelings are hard and we mostly feel we can’t cope so we try and avoid them.
I like to think of my clients as if they are standing at the edge of a thick forest. The decision or crisis that lies at their feet is thick and dark. It’s scary. They look ahead at what they have to undertake and it feels overwhelming. In the forest they are going to come into contact with their inner selves. Inside it’s not all light and fluffy. There is darkness and pain. They will encounter that which most frightens them. But the only way out is through. In order to resolve the pain or overcome the fear they are actually going to have to step into the forest and walk into its depths.
And that’s where I come in. If you were going to adventure into something scary and threatening, wouldn’t you want someone there with you to hold your hand? I am in that role as your therapist. I stand with you at the edge of the forest and I will stand with you as long as it takes until you’re ready to venture in. And while we wait there we’ll talk about what yucky and frightening things might be inside the forest and we’ll practice holding hands and looking at each other and by doing that you will learn to trust me, to know that having me there makes it easier and safer.
And maybe we will talk about some of the ways in which you can equip yourself before entering the forest. Maybe I will give you tools that you will keep so that you will feel more equipped to manage the difficult things you may find in the forest. But mostly I will be just be there and that will make you feel safer and then we will take a step together and then another step. And before your know it you will be deep in the forest and you will look at me and say, “Wow this isn’t so bad. I thought it was so scary but actually it feels so liberating to be in here and facing it finally. I’m not actually that scared anymore”.
- The iPhone earphone analogy
What many people don’t realise is that therapy takes time. Again, therapists and techniques vary and certainly there are those that have quicker strategies. I am just far more interested in the kind of processes that take longer though. I do depth work, which means that I believe in an ongoing process. There are definitely therapies that don’t need to go on for long but for most I believe that the greatest benefits come after considerable time and commitment.
Although this may be a silly analogy, I think it’s fitting. You know how when you put your iPhone (or any other brand) earphones in your bag or pocket they come out tangled? It doesn’t seem to matter if they’re there for a minute or a day because somehow, almost miraculously, they manage to tangle into the most impossible mess.
Untangling earphones is annoying. But if you rush and fumble to untie the knots you often find that it gets more tangled and also your urgency starts to feel like pressure and your tension rises as well.
But if you take your time and slowly untangle the wires and loop each piece slowly out of the knots, it tends to go better.
This is how it is in therapy. Clients come to me in knots. They are a muddle. They’re confused and distressed. And often they want to find the solution immediately. Nearly every day I get asked, “So what can I do to change this?” or “Tell me what I must do differently!” They want solutions. And I can understand. You look at those knots and you just want to use your damn earphones. You want to move swiftly on. But it doesn’t always work like that.
Therapy involves patience and care. It requires a steady, consistent effort. And it’s best done without the pressure of urgency. You need to fight the urge to fix something quickly.
- The messy cupboard analogy
So we’ve got the forest – the mess of feelings that needs to be encountered – and we know we need time and patience and a loving presence (the therapist). But what are we actually going to do in therapy? What are the tasks of therapy?
Again this is personal but I like to think of it like this. Imagine a really messy linen cupboard. It’s tall and there are many drawers. Inside are bed sheets, pillowcases, blankets and towels. But they’ve just been chucked inside. In fact, this cupboard is so messy that when you open the doors everything kind of tumbles out.
For many people, the easiest thing to do might be to just ignore the mess. If you stuff everything back in you can close the door again and from the outside it looks fine. You won’t really know how messy it is and anyway when you imagine the mess it totally overwhelms you because its SO MUCH and it feels like it will just take too long and be too hard to tidy.
Well therapy is about tidying the cupboard. For a really long time, therapy might just be about talking about the cupboard and imagining the mess inside. For some time it might just be about looking at the mess and acknowledging the reality of this mess and how it makes you feel. We all have different reactions to our mess. Some of us want to run away. Some of us get angry. Some of us feel ashamed. Therapy is about being with those feelings.
And then it’s about bravely taking each item of linen out of the cupboard and slowly examining it and folding it neatly and putting it back.
But neatness isn’t the goal. It isn’t about having control. It’s more about the examining process. The neatness comes as a natural consequence of being okay with the mess.
So what did you think of these three analogies? Are there any of your own that you’d like to contribute?
Also, I’m thinking about making this blog into a video or podcast. What do you think of that and is there any other topic that you would like me to address in a vlog or podcast?
Please share your ideas here.