What is Psychotherapy?

Overview:  in sum, “psychotherapy” is “talk therapy.”  Psychotherapy is an exploratory journey undertaken by the psychotherapist and the client into the client’s mindset to help the client discover, from the client’s perspective, the sources of the symptoms, the client’s own contribution to the presenting problems, and to develop alternative coping strategies in response thereto.

Psychotherapy is the relationship between a psychotherapist and a client or clients with the express goal of helping the client(s) overcome psychological distress, replace maladaptive behavior and/or automatic negative thought mechanism, and help the client(s) lead a more meaningful, enjoyable life.

While psychotherapy is a “verbal” exploration, there will be times when, depending upon the severity of the client’s impairment, medication may be necessary.

A Brief Look at the Numbers:

Statistical studies show that mental illness is a common ailment.  In the United States, the estimated number of people who suffer from mental illness annually vary from a low of 20% to more than 25% of the population.  Applying the lower estimate of 20% to the U.S. Census’s March 2010 estimated population of 309 million, this translates to more than 61,796,000 people in the U.S. afflicted with mental illness.  A small proportion, approximately 5.8%, suffer from debilitating “Serious Mental Illness” that dramatically impairs a person’s ability to take part in major life activities including enjoyment of family, community, school and/or work.

The most common mental illnesses fall under the following categories:

Mood Disorders:

• Major Depressive Disorder
• Dysthymic Disorder
• Bipolar Disorder

Schizophrenia
Anxiety Disorders:

• Panic Disorder
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Generalized Anxiety Disorder (GAD)
• Social Phobia
• Agoraphobia
• Specific Phobia

Eating Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Autism
Personality Disorders:

• Antisocial Personality Disorder
• Avoidant Personality Disorder
• Borderline Personality Disorder

Beyond those who suffer from Serious Mental Illness are people who suffer from mild to moderate psychological discomfort.  While they are able to function within the school and work settings and may not meet all of the requirements for specific diagnosis, their ability to enjoy life’s activities may be limited.  These restrictions manifest themselves in the person’s ability to interact with schoolmates, co-workers, and significant relationship, e.g., the client’s spouse, children or parents.

For those suffering from mental distress, the dominant feeling may be anger, sense of abandonment or betrayal, self hate or self pity, and lack of interest.  Because the client is functional, e.g., able to attend to responsibilities at home, at school, and at work, most individuals suffering from mild to moderate psychological distress or mental illness are often dismissed.

Dangers:

Drug and alcohol abuse, addictive and other maladaptive behavior often are associated with psychological distress or mental illness.  Abusing alcohol, drugs and other addictive behavior oftentimes are attempts at numbing an individual’s negative feelings and thoughts.  While the sufferer may feel that drugs and/or alcohol help control symptoms of mental illness and/or distress, these substances in the long term actually worsen the problem.

In more extreme cases, suicide is viewed as an escape from mental distress.  It is estimated that at least 300,000 people attempt suicide annually and more than 30,000 succeed.

How Does Psychotherapy Help?

Psychotherapy is also known as “talk therapy.”  Psychotherapy can be a one-on-one discussion between the client and the psychotherapist or the client and his family or significant other, e.g., spouse (assuming the family or significant other is available and willing to participate in treatment) and the psychotherapist.

At the outset, the goal of psychotherapy is to build a working, trusting relationship between the client and the psychotherapist.  Within the context of this partnership, both psychotherapist and client engage in an exploration of the client’s presenting problems, the amount of distress the client feels, triggers and current life circumstances that maintain the presenting problem, and the behavior’s impact on the client’s functioning, enjoyment of life activities and relationships.

A direct outcome of these open, trusting discussions between the psychotherapist and the client is insight into the client’s way of perceiving the world — a way of thinking that triggers the client’s automatic response mechanism.  Having a better understanding of the client’s way of thinking and automatic response mechanisms along with the distress they bring to the client, the psychotherapist and client then work together to formulate interventions that are within the capacity of the client to perform.

Psychotherapy is a time-intensive process.  With the client’s willingness, psychotherapy is a journey into the deepest thoughts of the client with every step uncovering aspects about the client that the client may have not been aware of, forgotten, or consciously ignored or dismissed.  Psychotherapy is not only about unearthing the client’s past painful experiences, although that is a great part of psychotherapy.  More importantly, psychotherapy is the process of discovering the client’s ignored or dismissed strengths and resilience that helped the client cope and survive past trauma.  Psychotherapy is the process of arming the client with fresh insight into the client’s abilities and capabilities, to overcome present and future challenges.

The ultimate goal of psychotherapy is to help the client attain proper functioning within the context of the client’s relationships at home, school and work.  The psychotherapist is a partner in helping free the client from psychological distress that prevents the client from enjoying life activities.

Additional Interventions:

In some cases, depending upon the severity of the symptoms of the mental illness and the resulting impairment, a psychotherapist may refer a client to a psychiatrist for medication.  The medical intervention is in conjunction with psychotherapeutic treatment and both go hand-in-hand.  While the majority of clients may not have to be referred for medical treatment, some diagnosis do require medication.  These include schizophrenia, bipolar disorder and forms of depressive disorder.  In these cases, Marriage and Family Therapists (MFTs) work together with psychiatrists to determine the need for psychotropic medication.  In most cases, however, psychotherapy is sufficient to help the client.