Support versus Structure

Psychotherapy comes in a variety of modes and systems and can be difficult to understand, even if you are in the field. It is even more difficult if you are not. There are really 3 ways to organize an understanding of types of therapy: as supportive versus structure building; as problem-solving versus growth promoting; or as depth versus non-depth. A psychotherapist is a member of the team of skilled professionals that promote your optimal quality of life. You have a car mechanic, a physician, teachers for children, an optician to make your glasses. You could, of course, learn any one of these trades, but you cannot do them all. Sometimes it is said that it takes a village to raise a child. Actually, it takes a village to make any life work well. Come to think of it, that is probably why we have villages.

If we take one perspective and look at types of psychotherapy from a supportive or structure building view, we can think about what our goal is in entering a psychotherapy relationship. After all, sometimes you see your mechanic for an oil change and sometimes you need a complete engine overhaul. You decide what you are seeking. Supportive psychotherapy is aimed at solving one problem or dealing with current emotional distress or alleviating current tension. It is feel better therapy, which is aimed at resolving whatever concrete issue or thought pattern that is creating pressure on you. You can visit a therapist and feel better, and then later, you may visit the same therapist again for a different issue, or even the same issue, and feel better again.

Ordinary life is challenging. Feeling better is important. It allows us to keep pedaling in our lives and keep taking care of what is important to us. It is vastly more constructive to feel better by being in a good relationship and being understood than to seek kinds of pain relief that are escapist, or worse, destructive. We call a friend, turn to a family member, or vent to a spouse. The empathy and understanding of the other person makes the challenges easier to bear. And sometimes they even have a good idea. But first, the load has to be lighter.

Structure building therapy is not about coping with difficulties but about changing our internal experience of being. It is about expanding our perspectives of the world, questioning our assumptions, and examining our internal models of how the world works. It is about recognizing how we might be making things more challenging than they need to be. By partnering with a skilled, caring professional, who knows how to protect a safe space in our lives, we can engage in the luxury of time to pursue our best self understanding and self-expression. It is not so much about changing our minds as about freeing ourselves from the patterns of being that limit us.

Structure building psychotherapy is not for the faint of heart. It takes time and resources. It makes us uncomfortable and even frustrated as we confront our own internal biases. We might have to feel shame, hurt, rage, despair, or sadness. We might have to encounter happiness, joy, and expansiveness. All those feelings we have been avoiding all these years. There is no guarantee that it will be worth it, that it will “work” or that we will be glad we excavated our own psyche. The therapist might be limited or inept. He or she might be an imperfect person.

We are in charge of our lives. We decide what is important and where we want to put our limited resources of time and money. Some people take a cruise. And some people get out their tools and their team and take an internal cruise. We make of it what we will. Like running a marathon or climbing a mountain, people who engage in the challenges of long-term, individual, structure building therapy sometimes do it because they have no other choice. And some people do it because its there and the exhilaration of being freer feels worth it.



About norasblog

I am a psychotherapist with a private practice in downtown Chicago.
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