Monday, January 4, 2010

My Take On Psychotherapy

Whenever I tell someone what I do for a living, I'm guaranteed with at least 90% accuracy that the next sentence they use will have the word "analyze" in it.  This is very understandable.  I think for most people, the word "psychotherapy" conjures up thoughts either of Sigmund Freud or some movie with a therapist in it.  Unfortunately, I have yet to see any movie that offers a clear and accurate representation of how I practice.  In fact, most therapists in movies are protrayed either as having their clients lay down on couches and talk about their dreams or as having sex with their clients.

For a long time, I've wanted to write this article for people who are interested, in an effort to clarify what I do.  However, explaining this in a clear way takes a bit of time; more than what would be acceptable in general conversation.  My goal is that by the end of this article, you will have a clear sense of 1) how I practice, 2) some things this work has taught me, 3) the benefits of psychotherapy, and 4) why I do what I do.  Before I begin with those main points, I'll very briefly summarize my work experience, but will start by dispelling those understandable, yet false assumptions some people make when I tell them I'm a psychotherapist.

First, I don't have sex with my clients. :)

Second, I don't "analyze" people.  Honestly, from asking some people what they mean when they use that word, I've found that different people hold different meanings of it.  For most people though, the word "analyze" seems to mean that I am forming assumptions about my clients based on what they are saying, or that somehow I magically know some "truths" about them, or that I somehow know them better than they know themselves.  This could not be further from what I actually do.  I am adamantly opposed to assumption making and work very hard in therapy to avoid doing so.  The main reason is that when people, therapists included, make assumptions without checking out their assumptions with the other person, they are usually wrong.  To counter the possibility of assumption making, I frequently ask my clients in session what they mean by statements they make, so I may have as clear an idea of what they are saying as possible.

Third, I rarely talk with my clients about their dreams.  If I do talk with clients about their dreams, it's likely because the client brings it up first and wants to talk about them.  If they do, then I will.  Sometimes I ask my clients if they are experiencing recurrent nightmares, but this is because recurrent nightmares are often a sign of trauma.  Maybe I'll write another article later about my take on dreams, but to do so now would risk emphasizing something that I tend to put little emphasis on.

It's important that you also have some brief understanding of my past work experience.  In high school, I volunteered at an inpatient hospital program with people who had head trauma.  In college, I volunteered at and was hired to be a staff member at a domestic violence shelter while also working in a community based residential facility for people diagnosed with chronic mental illnesses.  During graduate school, I worked at an inpatient hospital program for people with severe Obsessive Compulsive Disorder.  After graduate school, I worked as an In Home Therapist for many years in inner city and metro Milwaukee.  I've co-instructed about seven different graduate school classes, training students in how to practice psychotherapy.  Currently, I am working as an Outpatient Psychotherapist for a clinic affiliated with a hospital.  I have been there for over seven years and so far have had close to 1,100 cases total at that clinic.


First, you should know that in my job, I meet with anyone for just about any problem.  I regularly see children and their parents, adolescents, couples, and adults of any age. I do set some limits however.  I do not work with sexual perpetrators and children who have been sexually abused when the legal system is involved.  I very rarely get involved with legal processes of my clients.  I also do not work with people who have autism.  I set these limits because the field is too big as a whole to be an expert at everything, so therapists must somewhat narrow their focus.  Outside of those concerns, I will and do meet with anyone for anything.

To me, people seek therapy because they have one or more than one problem which they have tried to solve themselves, but have not been able to.  When I practice psychotherapy, the therapy follows a general process.  This is not always the case, but often it is.  The process begins with the person telling me what their problem is.  This lasts until the person and I both feel that I have a clear understanding of the problem.  After this, I ask the person what they are wanting from coming to therapy (i.e. what they are hoping to accomplish or what their goal is).  I then spend time talking with the person about their goal, until both the client and I feel I have a clear understanding of their goal.  After this, I work with the person to achieve their goal.  When they do achieve their goal, we either work on some other goal the person chooses or therapy ends.  Of course, this is an extremely simplified overview of what I do.  The actual application of this process entails a great deal more and can be quite complex.

From this, you can see that therapy with me focuses on what the other person wants and not what I want or think the person should do.  At times I may offer my own thoughts if the person asks, but the goal of therapy is driven by the client.  It is as if the client is standing on a trail in front of a forest, which leads to many different destinations.  The person usually knows where they want to go, but doesn't know how to get there.  If they don't know where they want to go, I'll help them decide.  I see my job as helping them get through the forest to the destination they want.  As the client walks through the forest, I am there walking at their side, not in front of them telling them where to go and not behind them either pushing them along faster than they want nor holding them back (unless they are purposefully walking off a cliff or making efforts to push someone else off).  The client chooses the pace at all times.  Instead of "Psychotherapist", I think "Professional Problem Solver" best describes what I do.


I have learned a great deal from this work; far more than I am able to write about and perhaps more than words can say.  Yet there are some things I'd like to pass on for people to know, because I think they will be helpful to anyone who reads this.  The following paragraphs are just important points and therefore the paragraphs may not smoothly flow together.

People present with many different types of problems, yet it always amazes me how people's problems are really not that different from each other.  I have found this to be true regardless of ethnicity and socioeconomic status.  We are all different, yet in many ways we are very much the same.  Some people's problems are internal ones, meaning biological.  Others are external, usually having to do with relationships.  Yet it is most often the case that people's problems are some combination of both.

I believe that the vast majority of all people are inherently good, not inherently bad or evil.  Most people want to be good people and make efforts to act in good ways.  Most people are nice people and want to help others and be cooperative.

I once heard a saying that "most people solve most of their problems most of the time".  Through many years of practice, I have found this to be absolutely true.  People are resilient, courageous, and strong, despite sometimes feeling that they are not.  In fact, I have found that the people who think they have no strength, resilience, and courage are often the ones with the most.  It is often the case that these people end up being my greatest heroes.

This one is so important, I feel it needs to be capitalized:  ALL PEOPLE HAVE INTERNAL AND EXTERNAL PROBLEMS. NO ONE IS PERFECT.  Very often, people come into therapy feeling very alone, as if they are the only ones with the problems they have.  This could not be further from the truth.  I think people come to feel this way because, generally speaking, we in the United States do not openly share our personal problems with others.  People ask us, "How are you?" and we respond, "Fine." even when we are not "fine".  We put on social masks, hiding who we really are and what we struggle with inside.  This is especially true early in new relationships.  Our society's social conditioning in this way causes problems for people.  You are not alone in the problems you have.

It is the strong and courageous people who seek help for problems they struggle with, admit their faults and make efforts to change themselves for the better.  It is the people who claim that they have no faults and do not make efforts to change themselves who are weak.  This is the opposite from what many people are taught, but I see it as true.  Where is the strength and courage in never seeking help for problems or never admitting faults or mistakes?  Stubbornly walking through life in this way is one of the worst mistakes a person can make.  Such a person's life will therefore always be constrained and curtailed by their problems, which will not only affect the person in enormous ways, but also people they interact and have relationships with.

The last piece I will write about concerning what I have learned is also a piece of advice.  I think all parents should do some reading about parenting and discipline, preferably before having kids.  If parents were to do this, it would preempt so many other problems.  With great humility, I recommend these two books for all parents to read: "1-2-3 Magic" by Thomas Phelan and "Parenting with Love and Logic" by Foster Cline and Jim Fay.  Both are two different styles of parenting which I recommend parents blend together in ways that work for them.


The benefits of someone seeing a psychotherapist for problems they are stuck with are great, however I must add this caveat:  Not all therapists are the same.  We each have our unique personalities, beliefs about psychotherapy, and styles of practice.  Therefore, if you see a therapist and do not like them or if they are not helpful, go see another therapist.  Please don't make a false generalization that because one professional was not helpful, none will be helpful.  Keep looking until you find one that you click with.  Different people click with different people.  To me, a good therapist is one whose clients think are good and who help their clients achieve their goals for therapy.

Therapy has so much good to offer people.  First, you get to meet with someone who is a professional problem solver, has met with many other people and has helped those people solve their problems.  Therefore, the therapist will have more knowledge about solving problems than most other people.  I do think people should seek out family and friends first to help them solve their problems, because doing so usually works.  However, when and if family and friends can not be helpful, seeing a good therapist can help turn a person's life around for the better.  Second, what is discussed in therapy is confidential, so you don't have to worry about gossip or what your friends and family may think about your problems.  Sometimes people can be very judgemental.  Good therapists are not.  Third, therapy works.  I find in working with people that the vast majority of people do achieve their goals.


There are many reasons why I do the work I do, but I'll start with the broad, overall reason, which is best summed up in three words:  I love it.  I love it so much, words can't really describe it.  I feel so lucky and honored to do this job.  I feel it is perfect for me.  I get to meet with people who are struggling in their lives and help them turn their lives around for the better.  What could be better than that?  I can't imagine what.  I never want to retire from this job.  In fact, retirement seems like a nightmare to me.  If I can do this work until the day I die, I will die very happy.  Obviously, I don't see what I do as "work" or a "job".  I think of it as a love that people pay me to do and most days I can't believe I actually get paid to do it.

Now I will get more specific about why I do the work I do and as before, will list the main reasons in a paragraph form, though one paragraph may not smoothly lead to the next.  First, I would say that I have always loved people.  To me, nothing is more important than our relationships with others.  The work I do doesn't make me a lot of money, but I could care less.  I get more out of this work than any amount of money could provide.  This is the reason I never play the lottery.  Money doesn't bring true happiness to people.  For me, there is no better feeling than seeing someone make changes in their life to turn their life around for the better and then eventually see that person reach their goal.

Almost inherently, I have always been facinated with people, human behavior, psychology, and why people do what they do.  This job feeds that fascination.  I am also inherently a thinker and not a doer.  I would not be happy or successful in any job with a lot of physical work.  People have different skills and talents and mine is not building things.  Others have those skills and talents and I am so grateful for them, for if it wasn't for them, I'd be living in some dilapidated hovel in the forest.  I am happy people with those skills and talents get to do what they love, but for me, my mind craves and needs thinking.

I love that I get to meet with people and have them talk with me without the social mask on, which I referred to earlier.  I get to know what people really think, how they really act and why they really make the choices they make.  It's as if I get to pull back the curtain and see the Wizard for who he really is.

I hope this article has helped clarify what I do and why.  Please feel free to respond with any questions or comments you have.