In Brief for Those New to Therapy

If you ask ten different therapists what it is they do, you’ll get twenty answers. A therapist talks. A therapist listens. Using the term “therapy” implies only one thing, so for those who don’t know what therapy is, it’s hard to get a grasp on it. It’s even harder to understand that there’s many types of therapy.

So let me begin with a comparison to religion. Religion is similar to therapy, in that they both have belief systems. Therapy is usually based more on research and evidence, though, rather than faith. Trying to pretend that there is one “religion” doesn’t help to define what religion is, or to understand the different religions. Nor does understanding Catholicism tell you much about Buddhism. Understanding Catholicism does of course give you a frame of reference to understand other religions, but its minutiae don’t tell you about the minutiae of other religions.

I’ve studied and trained in a number of different psychotherapies. Psychodynamic, Gestalt, CBT, DBT, hypnotherapies, brief strategic therapy. Within that there are others such as supportive and insight oriented therapy. Maybe some of these are better fits for you as a patient than others. That’s fodder for a longer post, discussing what to expect from each therapy style. I’ll get to it. In the meantime I hope the idea can be seeded that no one therapy is absolute, and that change can come about in many different ways.

Let’s get to some myths and misunderstandings about therapy. Therapy isn’t simple. And it isn’t just listening or support. Or at least it shouldn’t be. It’s idealized from those outside. As if a little support is all that’s needed. As if people go to therapy to vent or complain about others, and somehow they come out “fixed.” That’s never how it works. Real therapy is more than that, and should be more than that.

Therapy is about change. This can be changing how you feel or think or function in life. It usually comes about through working with a therapist. A relationship is formed. Usually trust develops. This alone can help some people change.

Beyond this there are a number of strategies and theoretical systems. There’s simply talking about whatever comes to mind, developing a relationship with the therapist that can reflect other relationships, recognizing and changing thoughts to change feelings, changing behaviors or exercises that alter the way you feel. It can be about changing patterns in life.

Sometimes therapy feels good. Sometimes it involves a lot of effort. Both can be important.

There is not only one way to do therapy. Many therapists will become dogmatic about their approach, as if their way is the only way. I would again draw the comparison to religion. Many therapists become invested in the approach they learned first, just as many people stick with the religion in which they were raised. They may even push the belief that their approach is better proven than others. Other people wander and explore various approaches, for better or worse. The skinny on this is that different therapy styles may be a better fit for you as the patient (aka client or receiver of therapy). If you don’t feel like you’re making progress through therapy, perhaps it is a bad fit with the therapist or the style being used. Also it is possible that you’re not feeling a good fit because that which is being stirred up in therapy (bad feelings, annoyances, etc.), may be exactly what needs to be worked on in therapy.

Being told exactly what you want to hear is usually not that helpful in therapy. If that is all you want (to vent and be agreed with), then I’d suggest that therapy may not give you what you’re looking for.

Oh, don’t get me wrong. You may find someone to agree with you and allow you to vent the whole time. That alone may not lead to the change you want in your life, though.

In Brief for Those New to Therapy
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Paul Puri

Dr. Puri is a board certified psychiatrist, in private practice in Los Angeles. He practices multiple forms of psychotherapy, including hypnosis, in addition to managing medications. He attended medical school at University of Rochester, and specialty training at University of California, San Diego. He is currently on the Vol Clinical Faculty at UCLA. In his non-clinical time he writes TV pilots, and designs iPhone apps.

One thought on “In Brief for Those New to Therapy

  • September 24, 2013 at 7:25 am

    Excellent blog post. I get angry when some therapists try to pick apart other modalities. Any scientific practitioner should know that positive outcomes measures are mostly highly correlated with the individual therapist regardless of the modality.

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