Although in recent years Psychotherapy has grown immensely in popularity, in some aspects it continues to remain clouded in mystery and marked by a lot of fears & misconceptions from its’ past. Therefore, alongside trying to explain what Psychotherapy IS (“What is Psychotherapy?”, “Why should we all bother with Psychotherapy?”), I believe it is equally important (if not even more so…) to try to explain what it is NOT.
In this section I would like to at least try to address some of the main existing myths & misconceptions about the field, which are still alive today.
Myth n1: Psychotherapy is only for the …
There are many myths about what should fill this blank space, but the connotation in all of them remains roughly unchanged. This myth can not be farther from the truth. The reality is that psychotherapy is, in a way, the main form of sanity – after all, it requires a functioning mind to be able to examine itself! For those interested in gaining a more detailed understanding of this topic, a fuller answer is offered below. But in short – there is no single profile or characteristic for the person that would benefit from Psychotherapy. But if there were, it would most surely be that Psychotherapy is for the human with a mind…
More detailed answer:
From the birth of psychotherapy on, until roughly the late 70’s and 80’s (the exact date varies among societies), the main aim of therapy was to help treat patients who are somewhat “unwell” and are presenting with various Mental Health (MH) difficulties. This has since significantly changed. On the one hand, as the famous psychologist and founder of the positive psychology Martin Seligman points out, in the late 90’s psychotherapy and psychology moved away from the so called “Medical Disease Model” to a new stage, now called “Growth model”. The main principle of the medical model, as the title clearly suggests, was centered on uncovering what is essentially “wrong” with people and curing them or “fixing” them, hence the idea that there must be something “not right with you” in order to seek therapy. But in the current new stage (“Growth model”) the focus is placed also on growth and self-improvement, without necessarily placing predominant interest in or even requiring the presence of disease or pathology. On the other hand, in the 90’s and early 2000’s people worldwide, and especially in the US, started feeling that “psychotherapy is simply too good to be left only to the sick!” (Yalom, I.)
Of course, as a medical profession, psychotherapy continues to this day to be offered to people experiencing MH difficulties, such as difficulties with emotions, clear thinking, memory or a distorted sense of reality, or have a diagnosable condition, but it is by far not limited to rendering itself useful only to this group of people!
Q: Does it mean there is something wrong with me if I turn to psychotherapy?
A: Psychotherapy in a way requires a high degree of “mental healthiness”, in order to be offered to an individual, as it requires a certain amount of psychological strength and a grown-up approach, in order to be able to be truly engaged, co-operative, to be challenged and ultimately to learn new ways of thinking, coping, …being.
From the perspective of the Growth model, it can be extremely helpful in addressing negative patterns; increasing and sustaining success in whichever dimension feels important to the client, as it helps clarify deeper internal desires or wishes, exposes internal fears or ambivalence that could be sabotaging the desired success and helps resolve possible internal dilemmas.
It is generally accredited with helping people become more connected not only to themselves, but also to others; with creating a sense of purpose, meaning or vitality in life, as well as with increasing levels of resilience, empathy, compassion and significantly higher levels of emotional literacy – something of constantly increasing value and importance in our modern days.
Q: If I have friends and family, why should I at all try psychotherapy – shouldn’t they be enough?
A: The need for Psychotherapy has NOTHING to do with and is in no way a reflection of how social one is, as it is not a process that can be replaced or “outsourced” to any other social contacts, like a partner or a friend! It is simply a very different realm, which falls way outside of the remit of responsibilities OR of the personal and professional abilities of one’s loved ones. As a general rule, the role of the close people such as friends, family and partners is mainly to love us and support us. The role of therapy is completely different – to help us understand ourselves and know our own mind, help us change and often learn how to love ourselves and others better. It is actually a process that could be equally helpful to people who are experiencing issues with low self-esteem or higher levels of anxiety, which are preventing them to build satisfying close relationships AND to people who are overly active and social and always tend to be surrounded by others, out of fear of being alone. It is simply the therapeutic goal in mind that shall vary.
Q: What if my therapist thinks I am odd?
A: Although oddness clearly presents itself in the form of a spectrum, all of us humans, as individual representatives of our species, are odd in our own specific ways. Us, Psychotherapists, are not in the business of judging people, but of understanding them! We are curious to all aspects of oddness or difference in our clients, do not judge or feel repulsed in any way, as we know full well, that as fellow humans, there is a bit of oddness in us too…
Myth n2: Psychotherapy will take many years and cost a fortune
The short answer to this question is that in both the Physical and the Psychological Medicines the answer regarding length of treatment is and should be based solely on the problem at hand. It could take anything from just a handful of sessions, through a few years and in some small number of cases, can indeed require at least life-time monitoring, if not treatment too.
Psychotherapy is, without a doubt, a big investment one must assign him- or her-self to, not only financially, but also in terms of time, energy and overall commitment. That is why it is important to address this question openly, especially as the question about time is one that is very often raised by patients and clients, both within state or insurance funded treatment provision centers, e.g., the NHS, and within private practice alike, but for very different reasons. Often people accessing therapy through their insurance or through state/charity funded treatment are worried that their therapy will be cut short before they feel they have made enough progress or feel ready to continue unsupported. Unfortunately, in modern times, there are often times when treatment decisions, such as the one on number of sessions offered, are not made for clinical reasons, but for structural, financial and administrative reasons.
On the other hand, people can often be worried about how big of an investment are they committing themselves to, when entering therapy through private practice. This causes a huge split and confusion in the mind of societies and individuals alike, often allowing only for these two contradicting messages to be circulating into the public consciousness:
- you will need to go to psychotherapy for the rest of your life, non-stop,
OR
- you just need 6 sessions of psychotherapy and you will be fully sorted, no problem, and if you are not – then, of course, psychotherapy simply does not work (or at least, your particular psychotherapist isn’t worth it and you should seek another one, who will better do the trick. Unfortunately promises for such quick successes are very common in various advertisements, but should be listened to with great caution)!
Both of these viewpoints about therapy are highly reductionistic and misleading, so let’s try to explore them more closely. First of all, no such question will even enter our mind and occur to us to be posed when it comes to the medicine of the body (that is, the Physical medicine), as it will straightforwardly sound rather absurd to anyone – well, surely length of treatment for a minor infection and for a chronic life condition do and SHOULD vary substantially! Similarly, like in the field of the Physical Medicine, in the medicine of the mind (Psychological Medicine) the length and intensity of the Psychotherapeutic treatment will largely depend on the condition one is being treated for, and varies depending on the individual circumstances, aim of therapy and actual severity of presentation.
Studies seem to show that a very large proportion of the presenting conditions and issues get positively treated in short-to mid-term basis, but indeed, just like in the field of the Physical Health Medicine, there are conditions that require longer term treatment, in order to be “cured” AND such that actually are never “cured”, but only their symptoms are successfully managed for the rest of the patients’ lives – much like in the case of arthritis, diabetes and high-blood pressure.
What has changed between before and now:
At the very start of Psychotherapy it was indeed a very long and intensive process, most often lasting a number of years and therapy sessions were amounting to up to 4 times a week. This was due to a number of reasons, some of which being down to the very fact that the field was simultaneously being developed and discovered; that this was the main the type of therapeutic model for most existing modalities at the time, and many others. Although this way of working continued to be the norm for a very long time, nevertheless, this reality has changed substantially in the past decades. Although this may still be true for some small group of cases (this is now usually done either solely based on treatment need and should not be excluded as a necessity, when is in the best interest of the patient OR as a part of something called “personal therapy”, a training requirement for psychotherapists in training), for the majority of people nowadays the time they spend in Psychotherapy is certainly very different. This is due to a number of reasons:
The modalities, which still follow this type of undoubtedly very successful, but yet clearly very lengthy and expensive model of approach are now significantly decreased (again, keeping in mind both that even for these modalities not ALL people and cases would require such length or intensity to begin with AND that some more severe cases would still require the same therapeutic intensity irrelevant of modality). This is due to a number of complex reasons, some of which include the fact that the psychological understandings and psychotherapeutic thought have themselves gone a long way in being revisited, opening ways to other modalities with different models of work; the increased awareness of many psychotherapists worldwide about the substantial financial burden, that such an approach can pose on clients and thus can serve as barrier to seeking help, which led them to consider other ways of treatment provision, etc.
In addition to that, there are now Psychotherapeutic modalities that by their very design of approach are specifically oriented to be Short-term (also called Brief-Intervention) Solution Focused.
Last, but not least, most psychotherapists tend to discuss with their clients what is it that they really want to focus on – a specific dilemma, a traumatic issue, a current circumstance; what is the question that brings them to seek therapy at this very moment! This is actually paramount for a number of highly important reasons, one of which is that the free will, engagement and full cooperation of the client is essential to the work, if it is to be successful! This is because “psychotherapy, unlike castor oil, which will work no matter how you get it down, is useless when forced on an uncooperative patient.” (Abigail Van Buren) The client and the therapist are ultimately one team. Therefore, ultimately the patient will have a substantial say in the length of therapeutic engagement, as he/she will in a way “choose” the scope of the therapeutic work.
Some people can chose to focus on something very specific or contextual, like a divorce, a dilemma or a bereavement and once that issues is successfully processed internally, can proceed to terminate therapy; at other times people might focus on exploring certain aspects of their life and then pause and take a break, only to resume psychotherapy again if they decide to, later in the future, for another issue, that feels pertinent to their lives at that moment or when they face another crossroad to cross; while a third group may choose to focus on more foundational processes, healing and personal growth and stay in therapy for significantly longer.
Myth n3: Psychotherapists are “weird” and psychotherapy is largely to be feared and avoided
This occasionally still persistent fear of both psychotherapy in general and psychotherapists in particular, can actually be easily understood in the context of the field’s historical journey. It is hardly surprising that psychotherapists have, for quite some time, been viewed as rather strange, especially when you consider them from the perspective of their contemporaries, given the often provocative and sometimes even radical ideas they used to come up with! Let us try to make sense and better understand some of these fears and beliefs through looking at the ways in which they came about historically:
Earlier in time there was a widespread belief among people that Psychotherapists are somewhat dangerous, as they have strange powers over people, such as reading their minds or “playing” with their inner worlds (unfortunately traces of this belief still exist in society today). There were, at times, high concerns that psychotherapists can even manipulate people and make them do things they would never themselves choose to do or want to do. Hypnotherapy, for one, was at its’ start, a field particularly surrounded by this cloud of view. There was, nevertheless, a rather small element of truth to the origin of that suspicion: at the start of the discovery of the powers of hypnotherapy there were a lot of hopes about what this field could do – some of these hopes, though, were largely exaggerated ones! There were indeed circulating ideas and a number of books and fictions were written over the idea of whether hypnotherapy could be used as a tool for creating the perfect killer – a simple man can possibly be hypnotized and then manipulated to do something horrible and would not even remember the event, or know about it afterwards! However, it very quickly transpired that this is actually completely impossible… As explained earlier on in this website, unlike the castor oil treatment, psychotherapy is not done TO the patient, but WITH his/her will on board and therefore he or she simply can not be brought to such states of hypnotherapy under no circumstances. Although with time the majority of these fears were discredited and long forgotten, some concerns, though far removed from their origins, can still be found circulating around.
But there also exists a much more mundane explanation for this somewhat common and widespread suspicion about psychotherapy and psychotherapists. The experience of being so well understood, of having your mind “read” and occasionally even interpreted to your own self may have been seen (and occasionally can still be so…) as a very out-of-the-ordinary experience and therefore can evoke some sense of fear. It could therefore be experienced as a sort of hidden power akin to magic, which is to be feared and avoided, largely due to the reason of it not being properly understood. The reality, though, is very different – this ability is not at all about special powers, but about special training and not about magic, but about science (although I doubt there will be a psychotherapist who will not agree to psychotherapy occasionally seeming very magical…). With that science there are limitations – the mind can not be explored when its’ doors are shut, needs to have opened up and agreed to this, therefore continuing to have a lot of control and a say in the process.
And in regards to the risk of manipulation – this indeed is something rather important to be considered, but again only within the remits of the realm of any professional relationship, which involves high degrees of trust. All personal and professional areas, which are characterized by high levels of trust, require very special monitoring and high levels of ethical standards, as indeed any presence of trust allows certain room for suggestibility and manipulation. This concerns not only the field of Psychotherapy though, but also that of priests, counselors, doctors, teachers and a number of other fields, where one party puts trust in the professional – including astrologists and any other healers. (If you want to know how to best protect yourself from possible unethical practice see “Choosing a Therapist”.)
So, to sum it all up, generally speaking, psychotherapists nowadays are much less weird than modern movies and myths proclaim them to be. Currently there are psychotherapists of different races, classes, gender and general human eccentricity, from which you can chose the best fit that feels RIGHT for you. Psychotherapists are as different and as colorful as are all other types of humans! Again – it’s the fit that counts.