I received an email from a young girl this week asking me how to explain what depth psychotherapy is about. A very good question and not easy to answer in a way that a young person can readily grasp. But it made me think about this post by Stephen Diamond, a post I tucked away and somehow hadn't gotten back to.
"The kind of psychotherapy I am describing here has less to do with the duration or cost of treatment than with how the psychotherapist views the nature and purpose of treatment itself. People have an innate need to ponder life's awesome mysteries. Real psychotherapy provides patients the opportunity, when needed, to grapple with these thorny questions--which are often closely, though unconsciously, related to their presenting problems. The goal of such therapy is to assist patients in finding their own philosophical or spiritual perspective in life, so as to be able to deal with future problems from a position of inner strength and stability. If psychotherapy continues to be viewed as a prescribed, predetermined, mechanistic cookbook recipe of techniques designed just to rapidly reduce or eliminate certain troublesome symptoms or behaviors, such topics will increasingly seem moot. Patients receiving such severely limited treatment today are tragically being deprived of a much-needed chance to consciously wrestle with what theologian Paul Tillich called "ultimate concerns" like the problem of evil, suffering, spirituality, meaning and mortality. We live today in a therapeutic culture that devalues talking or even thinking about such things. Today, psychotherapy patients are implicitly or explicitly discouraged to discuss or dwell on such soulful matters. But if psychotherapists and patients can recognize and respect the pragmatic therapeutic value, power and importance of addressing meaningful subjects such as beauty, God and death in treatment, then maybe psychotherapy--real psychotherapy--has some chance of surviving."
One of the reasons I have wanted to do the film series I posted about is to find a way to get at these questions about therapy and to open a discussion of what real psychotherapy is about.
Back when I was in graduate school in the late 60's, there was a distinction made between psychotherapy and counseling. Symptom focused, solution oriented work was considered counseling while the province of therapy was meaning, the psyche, suffering, dreams, the unconscious. Somewhere in the last few decades that distinction was lost and the expectation now is that therapy will be brief, behaviorally focused, and not concerned with matters of the unconscious and the psyche. Psychotherapy in this view is about feeling better. Consider how differently Jung viewed therapy:
"The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help the patient acquire steadfastness and patience in the face of suffering. "
and
"My work as a psychoanalyst is to help patients recover their lost wholeness and to strengthen the psyche so it can resist future dismemberment."
and
"Even a happy life cannot be without a measure of darkness, and the word happy would lose its meaning if it were not balanced by sadness. It is far better take things as they come along with patience and equanimity."
What is therapy about? It is about everything that is part of human life -- the good, the bad, the sacred and profane, beautiful and ugly. The basic instruction -- to say whatever comes to mind covers it. It is not limited to symptoms or problems. Whatever comes to mind.