Some of the confusion in people’s understanding of psychotherapy seems to come from the idea of therapeutic tasks. What exactly are we trying to do or change or accomplish when we enter into a psychotherapy relationship? Different modes of therapy address this question in different ways. There are many task focused, problem solving forms of therapy. You want to quit smoking, lose weight, cure a depression or improve your marriage. Because there is a concrete task, the therapy lends itself to measurement, and the effectiveness of a therapy can be based on speed. If you are trying to do something, the faster you can accomplish it, the better. And you can use a scale or questionnaire or even subjective questions to evaluate how it is working.
It is a reassuring to view our lives in concrete terms. It makes us feel in control, as if we are managing our lives in clear, understandable ways. We do not need to turn to our unreliable state of mind, which varies in seemingly unpredictable and random ways.
This view is a comforting parallel to a medical model of healing in which we have a problem and we see a doctor to fix the problem. Insurance companies understand psychotherapy in this way. Fair enough. It is the job of the insurance companies and the medical establishment to return us to normal functioning.
Sometimes, though, we do not have a simple problem. Sometimes our lives are out of focus, we feel a lack of meaning, or we yearn for a vision of an unclear future. We want to express our deepest selves through our lives, and we cannot see the obstacles and limitations we are creating for ourselves.
Who are we outside of our families, our friends, our cultural ideas? What are the fundamental ideals, interests and qualities that are the fullest expression of ourselves as human beings? How do we know what is really at the base of our experience and expression of ourselves? How can we use this one life to its maximum, wring the most of everything out of it?
Good long-term psychotherapy starts there. If you ever have physical therapy, you find a lot of times that the body part functions better than it did originally after it has been injured and restored with physical therapy. There is a magic to it. Who knew that my knee was not functioning optimally? It was only after it was injured and restored through physical therapy that I realized how much better it could be. I would not have sought therapy without the injury, but with the therapy, I got a lot more than I expected.
Most people come into psychotherapy having tried self-help, different kinds of groups, and a variety of techniques, feeling chagrined, embarrassed and discouraged. But when everything goes the way it is supposed to, what they find is a possibility of peace of mind, a fuller expression of themselves, and a deep, abiding satisfaction in their lives. They find that they are so much more complex, interesting, alive, and powerful than they realized. Much like getting lost and discovering something you did not even know you were looking for.