Psychotherapy is like a cereal box.
Look at the Shredded Wheat or Corn Flakes box you poured your breakfast from this morning. There is a good chance that somewhere, in tiny print, you’ll see the words “enlarged to show texture.” This is done to highlight the cereal’s delicious nooks and crannies without falsely advertising the box’s contents.
The process of psychotherapy can be viewed similarly.
In good therapy, a client’s emotional life is often “enlarged” to show the texture and complexities of life that often go unnoticed (or unacknowledged) in the hustle and bustle of the day to day. This can show us unpleasant details that we’ve avoided, but it can also highlight personal strengths that have become obscured by emotional pain. Either way, the magnified version of our inner worlds gives us a chance to learn about ourselves and grow.
Here are some important ways this happens in psychotherapy:
Emotional Awareness and Mindfulness
When someone contacts me to set up an appointment there can be some specific complaints (e.g., “I’m depressed” or “I have panic attacks”). More usually, however, the inquiry resembles something like “I’m not feeling emotionally well, I am not sure what it is, it might be depression (or any number of other things), I’m not sure what to do about it, can you help?”
I will invite that person in and begin a process of building rapport and gathering history. I will get to know the person and invite them to get to know themselves better. I’ll often ask the person questions that they don’t hear on the “outside.” For example, a simple, “Can you tell me more about that angry feeling you just mentioned? What is that like for you?” can be very powerful. These questions aren’t platitudes. They are quite different than the often caricatured robotic therapist who says, “How does that make you feel?” Yes, I want to know how you feel but I also want to engage you in a process of exploring your feelings in a unique way. The emotional rapport and safety of the therapeutic relationship helps create a space where this can occur.
Another initial question I’m asked often is, “Why does this keep happening to me?” This usually occurs in the context of someone experiencing a series of unfulfilling or even damaging relationships. It can also be a pattern experienced repeatedly in the same dysfunctional relationship.
In therapy, exploring this pattern becomes a priority. “When did you first become aware of the pattern?” “Does it remind you of anything else?” “Are there certain relationships that don’t fit this pattern?” These are all questions designed to help someone think about and explore their experience in relationships.
Experiencing In the Moment
As a therapy deepens, people sometimes become more aware of feelings they have about the process (or me) while in the consulting room. This is a natural experience and provides a unique opportunity for client and therapist to examine the client’s inner life.
For example, someone might be understandably annoyed if I failed to show up for a scheduled appointment (It has only happened once so far in my career). An apology on my part would be in order and I would gladly, though embarrassedly, provide one. But, what if that same person reacted to my missing an appointment by recalling the time her father did not pick her up for his weekend, leaving her to wait sullenly on her mother’s porch steps?
If the patient is able to talk about this with me, in the context of my having missed an appointment and how that made her feel, we have a good chance of using the present moment to understand and work through some past pain.
These are just three of the many ways psychotherapy can highlight, magnify, and enlarge our very textured inner emotional worlds.
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Steven J, Hanley, Ph.D.