Written by Patrick Cleveland, LMFT - Clinical Director
What is Psychotherapy?
Psychotherapy was originally created by Sigmund Freud and known as psychoanalysis in the late 19th and early 20th century in Vienna, Austria. Over the years as other schools of thought emerged and branched out from Freud's original methods and theories the term psychotherapy came to be used in order to better encompass all of the wide ranging modalities that came after psychoanalysis. Before Freud's ground breaking theories, the medical model of mental illness dominated psychology. A major component of the medical model is the notion that the doctor is the expert, knows what to do, and the patient follows his orders accordingly. There were many vague and unfounded theories about mental illness as a result of this approach since consciousness is not like a failing organ that can be observed under a microscope. Freud took note of this and decided to try something radically different. After unsuccessfully experimenting with various methods, he chose to put his expertise as a medical doctor to the side, and began to listen to what his patients had to say. This radical idea of listening to someone sparked the beginning of psychotherapy. Listening and giving feedback are still fundamental components of all psychotherapeutic modalities at least to some degree. Freud found that beneath his patients deepest feelings and thoughts were unconscious motivations and meanings that could only be deciphered and made sense of after they were expressed in language. Freud found that expressing our feelings, thoughts, dreams, fantasies, and unexplained behaviors in conjunction with making sense of what they mean can be curative, therapeutic, and promote personal growth. After expressing and deciphering what they mean we can arrive at an ethical position where we are able to now make a more conscious decision about a course of action. In the most basic sense I can explain it without getting mired in theory: the process of expressing our feelings and thoughts, understanding what they mean, and making informed choices in regards to them is what psychotherapy is all about.
Psychotherapy and Personal Growth
I view psychotherapy in two ways: 1. As an effective psychological treatment for a variety of mental and emotional issues and 2. A method to gaining personal growth and knowledge of self. I have been teaching personal growth at Long Beach City College for the past 2 years and doing so has helped me to evolve my views on psychotherapy. This is how I have come to view psychotherapy in two ways. Some people come to therapy suffering from depression, anxiety, trauma, addiction, etc., and are seeking psychotherapy because it can be an effective treatment for those issues. As a result of their psychotherapeutic treatment they are also doing personal growth work and do gain a better knowledge of self as a result. However, in private practice my experience has also been that many people come to therapy not because they are suffering from a specific mental health issue per se, but because they want to grow in some way. Everything in their life can be seemingly fine and they just want to utilize psychotherapy to work on a personal growth issue. For example, they may want to learn how to be more assertive with others, how to hold better boundaries with family and friends, how to practice more effective communication skills with others, to uncover why they procrastinate, to achieve a greater sense of joy, to work through what is holding them back from making a major life change or career choice. In other words, psychotherapy can applied to many personal growth issues and is not used solely for the treatment of mental health issues. I see many clients in both of these categories which is why I feel it is important to make this distinciton. Emphasizing this also helps to serve the purpose of fighting against mental health stigma in trying to create awareness and knowledge by informing the public that many people seek out psychotherapy for a variety of issues and not just for mental health treatment. Psychotherapy can be a life changing and amazing experience and I want as many people as possible to be open to experiencing the wonder, insight, and transformation it can provide.
What is Depth Psychotherapy and How Does it Work?
Depth psychology acknowledges the dynamics between our conscious and our unconscious mind. It seeks to find ways to understand and connect our varied behaviors, particular thought processes, and relationship patterns with unconscious, unresolved, or unprocessed emotional experiences in our lives.
Certain behaviors or feelings we call “symptoms” are often ways we try to keep our sense of self alive and whole in order to maintain balance and stability. Throughout the course of therapy as clients explore their emotions, thoughts, patterns, and behaviors, previously exiled feelings and parts of self can emerge to be acknowledged and explored with the therapist who acts as a safe and containing presence. I view a primary goal of depth psychotherapy is to understand the underlying dynamics that keep you stuck in destructive patterns and limit your choices of behaviors and expressions. As awareness grows, you become more aware and free to choose healthier behaviors and align with more authentic ways of being; you become more trusting, autonomous, confident, and grow to have a greater capacity for intimacy and an increased ability to accept and adapt to change.
My Approach to Therapy and Counseling:
Although the various depth, existential, and psychoanaltyic theories are my passion and areas of research, I mainly utilize an eclectic foundation and approach to therapy focused on meeting clients where they're at with the best therapeutic intervention, theory, and style that suits them and facilitates their personal growth and healing. Some of the theoretical orientations that I draw from are Lacanaian psychoanalytic therapy, self-psychology, object relations, relational psychotherapy, Jungian psychotherapy, Gestalt Therapy, Family Systems, inter-subjectivity, cognitive behavioral therapy, dialectical behavioral therapy, Buddhist psychology, humanistic-existential psychotherapy, narrative therapy, solution-focused therapy, and other approaches to psychotherapy I find helpful. I have extensive training in the areas of depth psychotherapy which is associated with the psychoanalytic tradition of therapy orignally founded by Sigmund Freud and later expanded upon by Carl Jung, Melanie Klein, Donald Winnicot, Wilfred Bion, and Jacques Lacan. I also have expertise in existential psychotherapy which originated from ideas and concepts derived from philosophers associated with existentialism such as Soren Kierkegaard, Friedrich Nietzsche, and Jean Paul Sartre that were applied to the counseling field by the early existential psychotherapists such as Viktor Frankl, Rollo May, and Irvin Yalom. Depth psychotherapy, humanistic-existential psychotherapy, and cognitive-behavioral therapy are the main theoretical orientations I draw from when practicing psychotherapy.
Free Association and the Work of Therapy:
A significant aspect of the therapy I practice is teaching and helping my clients learn how to free associate. This is a difficult practice that takes time to learn and employ. Free association is the practice of learning to speak as freely and openly as possible by saying whatever comes to mind without censoring or judging anything. It is not just 'free' but also uncensored 'full speech' in which the client learns to speak whatever is on his or her mind however difficult or insignifiant it may seem, without filtering or judging it. The purpose of this is to express our emotions, thoughts, fears, worries, wishes, and fantasies as openly and freely as possible in a safe environment and therapeutic relationship, and to understand the relationship between the language we speak and our unconscious feelings and thoughts that mobilize it. Learning and practicing this in therapy is what I call the work of the client. This work allows the client to take more ownership and credit for insights and progress gained in therapy because it is rooted in the language and work that comes directly from them. I take a non-expert approach to practicing therapy. I am not by any means the expert of your mind: you are. You know yourself better than I do and always will. I want to listen and understand you in order to help you see and learn things about yourself that you don't know that are censored and concealed in the things you do and the language you speak. Expressing our feelings and thoughts, uncovering the unconcious material behind them, and understanding what it means helps us become more in tune with our selves, builds self awareness, enables us to make more informed decisions, and is what I refer to as the knowledge of self.
Dream analysis and Exploring the Unconscious:
Some ways we can take notice of the unconscious contents of our minds to help bring them to the surface is through dream analysis, the exploration of fantasies, daydreams, wishes, and deciphering mistakes and 'slips of the tongue' or things we said or did and didn't 'consciously' mean to. Sigmund Freud wrote that, "Dreams are the royal road to the unconscious." In studying the various dream theories of Sigmund Freud, Jacques Lacan, Carl Jung, and applying them to both my own life and the life of my clients I have found their contributions to be exceptionally valuable and insightful to understanding aspects what is censored and repressed within us. Dream analysis can be uniquely insightful and helpful in navigating life transitions, relationship patterns/issues, behaviors, emotions, thoughts, etc. I encourage clients to pay more attention to their dreams, fantasies, and behaviors while in therapy, and to bring any of this material they wish to discuss in therapy.
How Depth Psychotherapy Works to Help you Learn, Grow, and Heal:
So why look at my unconscious mental life if all I want to do is feel better? What's the point of depth psychotherapy? These are excellent questions to ask. The purpose of self-knowledge and understanding our unconscious is for prolonged healing and growth that we can more deeply absorb and implement into our lives throughout it's long course rather than offering only quick fix tricks and coping skills that various psychotherapeutic or behavioral techniques often provide that will help you feel better in the short term, but may leave you vulnerable to a recurrence of the same feelings, thoughts, or behaviors in the future if a deeper knowledge of them is not gained and put into practice. By processing both our conscious and unconscious feelings and thoughts regarding the words, narratives, and meanings we have applied to circumstances and events in our lives we can better arrive at a moment of openness, awareness, and enlightenment to than begin to see yourself in a different way so you can learn to practice coping skills with more efficacy, make more informed decisions to address your issues, begin to harness your full potential in order to do so, and ultimately create a new way of being in the world.