We are always faced with so many forks in the road. Right? Decisions that will take us one way or another. The particular fork in the road I am talking about here is the one that is relevant to our subject: Long-term Psychotherapy. Because as it stands, people, therapists and laypeople alike, can conflate two completely distinct notions of what psychotherapy is and what it should do.
On one side of the fork, there is the rationalist view. We are solving a problem, curing a defect, or pursuing a goal. In this view, psychotherapy is a science, its effectiveness should be proven through scientific inquiry, and its process should be evidence based. The client is the consumer and the therapist is a service provider. We diagnose problems; we measure outcomes and results; we evaluate effectiveness; we fix what is broken.
The other side of the fork is the philosophical side, that of self-knowledge. In this view, psychotherapy is a continuation of a very old system of thought (back to the Greek philosophers at least) that is predicated on the idea that coming to know ourselves deeply allows us to make freer choices and construct more satisfying lives. It is a process of engaging with another person who can reflect to us who we are from an outside perspective. In this view, nothing is broken. We are building a kind of maturity and psychological freedom that cannot be created quickly or easily–and that cannot be created without the engagement of another mind.
While the first view promises certainty, simplicity, and action, the second view is more nuanced, more nebulous, and more frightening. We come to a fork in the road. Do we want to face ourselves, with the messy and discouraging tangle of motives and feelings we are wrestling with in order to have an inner freedom and connection with our own reality, or do we want to function well, feel better and get on with it? There is no right direction of course. We are always, at every moment, deciding how to use our one precious life.