Too many “psy”?
Understand what is psychotherapy or therapy and how does it work
There are still many questions about what psychotherapy is and how it works. Often terms such as psychology, psychoanalysis, psychiatry, and therapy cause confusion. Are there differences between them?
Psychotherapy, or simply therapy, is a process, a journey towards self-discovery. As such, it occurs gradually and requires a certain frequency and constancy. Each psychologist specialises in one approach or line / school of psychotherapy, sometimes more than one. The most well-known is psychoanalysis, created by Sigmund Freud. However, there are many other different approaches, such as Jungian analysis, Reichian therapy, Winnicottian approach, behaviour analysis, cognitive-behavioural therapy, acceptance and commitment therapy, rational emotive behavioural therapy, just to give some examples.
Whatever the approach, they all share essentially the same goal: helping the client to reflect and clarify aspects of his/her life, leading to self-awareness and well-being. In case of psychiatric disorders, the primary goal is symptom relief, and self-knowledge will follow in parallel, as therapist and client gradually understand how symptoms started, why have they appeared at this point in the client’s life, etc. What differentiates each approach is the set of tools that each will employ to reach these goals.
There are many important elements to the good development of a therapeutic process. I will highlight 3.
First, it is necessary that the client feels motivated to invest in treatment and is willing to reflect about aspects of their life. Psychotherapy is not always easy. Talking about and thinking over traumatic, sad and difficult events can take a good deal of energy, dedication and courage, although it is rewarding and liberating. The psychologist is the professional who is committed to encouraging the client to venture in the realms of self-discovery, respecting his/her own pace. The therapy does not happen only during the weekly sessions, but also throughout the week, even in the absence of the therapist. It is important that the client reflects on what was worked in the session, and how what was discussed and learned fits into his/her daily life, what changes can be made.
The second important factor is the therapeutic relationship. This is the name given to the bond that is formed between the client and the psychologist. It is normal that some sessions may be necessary until the client feels completely at ease and confident in the presence of the psychologist to open up. However, it is important that the client trusts the psychologist’s abilities empathise with the professional. Without trust the process stalls.
The third factor is the frequency and constancy of the sessions. Generally, sessions occur weekly, but can occur with greater frequency. Treatment can last from a few months to several years. The total duration depends on the goals of each client, the psychotherapy approach, how chronic the symptoms are, the therapeutic relationship and the particular pace of each person. But it is essential to clarify that in just one or even 3 or 4 sessions, it is very difficult for the psychologist to help the client “solve” all their complaints or difficulties. Often, people ask me if in one session a psychologist will be able to tell them why they behave in a certain way. Although therapy can bring benefits from the first session, it would be unrealistic and unfair to the client to promise that this would be possible in only one session. The psychologist also needs a few sessions to get to know the client and understand their emotional development, the circumstances that surround them and their goals. The human emotional development is very complex and intricate! The psychologist is not the absolute owner of all knowledge and do not have the answers to everything right away, it is only a professional who has been trained to facilitate and direct the client’s self-discovery.
Finally, I would like to define some terms related to psychotherapy and mental health which sometimes causes confusion.
Psychologist: a professional who has a bachelor degree in psychology and specialises in one (or more) psychotherapeutic approaches. Does not prescribe medication.
Psychiatrist: a professional who graduated from medical school and specialised in psychiatry. Is allowed and trained to prescribe medication.
Counsellor: this is a professional who works with counselling but necessarily has a degree in psychology. It is common to find counsellors with a degree in business, administration, economy or any other area who completed training in counselling and offer therapy. Psychologists can provide counselling, but not all counsellors are psychologists.
Psychotherapy: the process of psychological therapy.
Therapy: often used as a synonym for psychotherapy.
Psychoanalysis: an approach of psychotherapy created by Sigmund Freud.
Analysis: often used as synonymous with psychoanalysis.