What is Psychotherapy and How Does it Work?

Written by Patrick Cleveland, LMFT - Founder & Clinical Director 

What is Psychotherapy and Personal Growth? 

Psychotherapy as I understand and practice it can be defined as the process of expressing our feelings and thoughts, trying to understand what they mean, and then making informed choices, goals, and interventions in regards to them with a trained therapist. To explain further, 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. Teaching Personal Growth and Social Development at Long Beach City College has helped me to evolve my views on psychotherapy. 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.  It is also the case that many people come to therapy not because they are suffering from a specific mental health issue, but because they want to grow in some way. 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, how to better manage work stress, to uncover why they procrastinate or self-sabotage, to achieve a greater sense of joy, or to work through what is holding them back from making a major life change or career choice. In other words, psychotherapy can be 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 distinction. 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.

How can therapy help me?

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

  • Attaining a better understanding of yourself, your goals and values
  • Developing skills for improving your relationships
  • Finding resolution to the issues or concerns that led you to seek therapy
  • Learning new ways to cope with stress and anxiety
  • Managing anger, grief, depression, and other emotional pressures
  • Improving communications and listening skills
  • Changing old behavior patterns and developing new ones
  • Discovering new ways to solve problems in your family or marriage
  • Improving your self-esteem and boosting self-confidence
  • Increased access to multiple aspects of self without shame
  • The ability to better tolerate ambiguity and uncertainty
  • The ability to be more truthful with oneself

Do I really need therapy?  I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

 What is therapy like?

Because each person has different issues and goals for therapy, therapy will be different depending on the individual.  We view the therapy session as an open time and space for you to speak to whatever questions or issues you would like to address and work on. This can take the form of discussing current events happening in your life, the status of your relationships, your personal history relevant to your issue, or discussing progress (or any new insights gained) from the previous therapy session. We don’t have an agenda and we allow our clients change topics and re-evaluate goals as they see fit.  We work on building trust and rapport with our clients so they can feel free to say whatever comes to mind with censoring anything. Freud referred to this as the process of free association.  Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development.  Either way, it is most common to schedule regular sessions with your therapist (usually weekly or bi-weekly).

Our Approach to Therapy

1.Holistic: We want to learn about you as a whole person: your history, family of origin, social circle, activities, hobbies, hopes, dreams, and not just your current symptoms or problems.

2. Client Centered: We collaborate with you, based on what we have learned about you as a whole person, on what issues or questions you would like to work on. We don't have a one size fits all approach. We are open minded, non-judgemental, and tailor our approach to meet your needs.

3. Psychodynamic: We listen and look for unexpressed and unconscious feelings and thoughts that play a role in your current life. The purpose of uncovering and understanding our unconscious life is to attain a greater knowledge of self for prolonged healing and growth that we can more deeply integrate and implement into our lives throughout its entire course.

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. A primary goal of psychodynamic therapy 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.

Theories and Modalities We Draw From

We draw from various psychodynamic theories such as Lacanaian psychoanalytic therapy, self-psychology, object relations, inter-subjective psychotherapy, and Jungian psychotherapy. Although psychodynamic therapy is our primary orientation at Daybreak, we also utilize an eclectic 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. In working with couples our main orientation is emotion focused therapy (EFT), and we also implement some of the research and techniques of the Gottman model. Some of the other theoretical orientations that we also draw from are, Gestalt therapy, family systems, cognitive-behavioral therapy, dialectical-behavioral therapy, mindfulness, Buddhist psychology, humanistic psychotherapy, narrative therapy, and solution-focused therapy. From my studies in philosophy, I also have expertise in existential psychotherapy which originated from ideas and concepts derived from philosophers associated with existentialism.

A Brief History Of Psychotherapy   

 Psychotherapy, originally called psychoanalysis, was created by Sigmund Freud 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 much trial and error with various methods of his time he chose to put his medical expertise to the side and began to listen to what his patients had to say. This radical idea of listening to someone’s thoughts and feelings and helping them work through them sparked the beginning of psychotherapy. Freud found that beneath his patients deepest feelings and thoughts were unconscious motivations and meanings that could only be deciphered and interpreted. Freud found that expressing our feelings, thoughts, dreams, fantasies, and unexplained behaviors in conjunction with making sense of what they mean can be healing, 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. 

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