Psychotherapy FAQs

Dr. Daniel Meckel addresses some of the thoughts and questions that you might have about psychotherapy as you consider entering into it:

WHY DO PEOPLE GET INTO PSYCHOTHERAPY?

Most often, people come to therapy because their distress over something in life has become intense and urgent, and they want help in resolving it from outside the realms of family and friends. Some feel hopelessness, even despair; others have simply come to the point of taking action after a long time of thinking about it and bearing a lot of distress.

The decision to go into therapy can come in the wake of a challenging or traumatic event in one’s life, like a separation or loss, an infidelity, the loss of a job, a conflict that has peaked in an important relationship, a failure to achieve something, a crisis in the life of one’s child, or the need to make a difficult and major life decision. There are many different reasons, as you can imagine. What unites them is the fact that something specific and upsetting has happened to the person, and he or she is seeking therapy in order to deal with it. In therapy, that person wants support and perspective in order to move through and past the experience.

People also seek therapy for more general reasons -- because they have been feeling bad (perhaps for a very long time) and don’t quite know why. Examples include feeling persistent sadness, anxiety, helplessness, anger, loneliness, guilt, uncertainty or self-doubt. These feelings may seem vague and their cause unclear, but they are no less real or disturbing than a reaction to something specific, and they can be just as destructive in a person’s life, often more so.

Additionally, people come to therapy because of long term negative patterns in their life and relationships. They might be aware that they contribute to those patterns but don’t know exactly why or how to stop; they feel locked into them. This could include a pattern of troubled relations at work, entrenched and repetitive struggles within and across intimate relationships, or longstanding ambivalence that keeps one from developing close relationships. Again, there are countless ways in which we can get into destructive patterns and so sabotage our own lives and well-being.

DOES BEING IN THERAPY IMPLY “WEAKNESS” ON MY PART?

Sometimes people feel that going to therapy is an admission that they are weak. The truth is quite the opposite. Successful psychotherapy requires that one be willing to recognize that there is a problem and to enlist someone’s expertise and person in addressing it. It requires the strength to stay with the process, and the courage to be honest with oneself. Therapy can be enjoyable and calming at times, to be sure, and it is almost always very engaging. It also requires hard work and a good therapy session will sometimes bring one into closer touch with distressful emotions and memories. One must be (or become) ready to look closely at oneself and one’s life, and to explore issues that can be difficult to talk about. At the beginning, it takes time to build up the comfort and trust to do this. We get there at your own pace.

WHAT DO YOU TRY TO ACCOMPLISH WITH PSYCHOTHERAPY?

Several important issues fall under the topic of therapeutic aims. They include: How we first establish specific aims in therapy; the deeper and broader aims that can arise in the course of treatment; and personal strengths that emerge and indicate positive change.


Establishing specific aims of therapy at the beginning and staying with them

You confirm the aims of your therapy. I help you to consider the possibilities, clarify your aims, and get clear on how we'll know when you've attained them. People sometimes come to therapy with certain aims clearly in mind, such as "to see my way past a difficult divorce," "to find better ways of relating to my partner," "to feel less anxiety and sadness," "to make an important career choice," "to recover from my devastating loss of a loved one," "to deal with strained relations with my parents" . . . . If therapy moves too far afield from your aim for it, we work to get it back on track. Specific aims have to do with specific problems, and allow for clear measures of attainment. In other words, it's usually clear when a specific problem has been resolved. And at that point the therapy may well be complete. However . . .

Personal aims for therapy can deepen over time

It often happens that in the course of working on a particular problem, one discovers that it is connected to deeper and long standing issues. You might come to recognize that the problem that brought you into therapy has been emerging in various forms for many years and may well continue to re-emerge unless you get at the root of it. For example, a person who was struggling to break free of a complex and tangled relationship discovered that the difficulty was connected to the death of his mother. In this case, the work on a present relationship lead us to the work of grief.

Emerging Strengths in Therapy and Analysis

In addition to relief from the symptoms that lead one to seek help, another way to think of therapeutic aims is in terms of the strengths that you stand to gain and that will serve you in your present predicament and more broadly in the long term. Here is a list of such strengths, as therapists have encountered and formulated them over the years. You might find that one or more of them apply:

Insight: An understanding of the internal and external background to the struggles that have brought you into therapy. We craft this together. A good understanding has the feel of truth and is useful in living.​

Agency: An internal sense of freedom. This comes with an increased ability to see things clearly and make decisions without being paralyzed or unduly influenced by the inner conditions that brought you into therapy – conditions such as anxiety, guilt, other people’s expectations, conflicting emotions, unexamined assumptions about yourself and others.​

Identity: A sense of continuity and integration of the many expressions of who you are. The experience of successfully bringing who you are to some if not many of your relationships.​

Self esteem: Feelings, assumptions and thoughts regarding one’s personal worth or worthiness. A modicum of self-esteem is essential to handling life’s difficulties and accepting happiness. Low self-esteem, including self-loathing, impacts people’s lives far more commonly than one might realize, leading him or her to feel alone in a sense of inferiority or guilt.​

Ego strength: The capacity to cope with life’s difficulties in realistic and adaptive ways, based on clear perception of ones inner condition as well as one’s external situation

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