Back to the basics but not self-evident (1): what is psychotherapy and who is the psychotherapist

This article is based on sources from my book “Dance of the miracles: the big journeys in the small steps” (in Greek – for now).

The image of the article is by Ermia Ersi.

 

[A]  Introduction
Nowadays, the palette of the available psychotherapeutic modalities

and their different variants is immense and unfortunately labyrinthian.

There are psychotherapies that are built responsibly on clear and structured philosophical assumptions and systems of thought.
They have clear principles, objectives and methodology, while their theory and practice is taught in accredited Institutions offering systematic, lengthy, costly and hard studies.

However, I think that unfortunately there are also other practices that should not be called “psychotherapies”.  They are nothing more than practices based on arbitrary thinking, without structured methodology, with vague or even metaphysical goals.
And yet, we have the sad fact that often, even in the present, we have several such completely arbitrary  (and often abusive) combinations of the words “psyche” (“soul”) and “therapy”, calling themselves “psychotherapy” – products of disturbed people, who in any case abuse for money or control or megalomania the naïve and exploit human pain.

At the same time, at least in my country, there’s an inconceivable chaos of terminology, zero information about what does and what does not a psychotherapist, while the psychologist, the psychiatrist, the psychoanalyst and the psychotherapist are often considered the same thing.

So, I thought, it might be useful to return for a while to the “roots”,

to the “basics” of the psychotherapeutic field, and to express my personal views in a series of 4 interconnected short articles, of which this is the first one.
All these articles are under the general title “Back to the basics but not self-evident” and they cover different aspects of psychotherapy and of some related to this word concepts (the secondary title of each article defines what exactly it is about.

This 1st article is an introduction to the conceptual exploration of the words “psychotherapy” and “psychotherapist”.

 

[B] What is “therapy”, healing”, “cure”
The word “psychotherapy” in its everyday use, is often confused with other words

of similar meaning, such as “therapy” (without the “psycho-” synthetic), “healing” and “cure”.
Often, all of those words are used vaguely, even if conceptual accuracy is necessary. So:

(1) The “healing” could be defined as “the process of coming to balance within oneself and with one’s environment. (… ) A person who experiences coming to balance (healing) will feel whole, see him/herself as physical, mental, emotional and spiritual being” (Baker, 2000, p 274).

(2) “Cure” could be the “elimination of an illness. A person may be healed without being cured, and a person may be cured without being healed. Conventional medicine does not primarily focus on the person who is ill but on the illness” (Baker, 2000, p 274).

(3) I think that the word “therapy”, alone, in everyday habitual use, sometimes leans towards the first of those two terms, other times towards the second, and sometimes somewhat vaguely leans towards both of them.
For me, “therapy” generally associates with:
“something that doesn’t work well or malfunctions – according to any kind of subjective perception”,
which through the therapeutic process becomes:
“something that works again or becomes again functional still according to any subjective perception”.

However, staying a little more at the word “therapy”, I believe that such a general conception of this word brings up several questions.

For example, from what exactly is someone relieved when undergoing a therapeutic process? Is it some scientifically diagnosed illness? Is it some subjective sense? What is the criterion of a successful “therapy”? What can be “better” after the therapy?
Also, the word “therapy” is very close to the old medical model that connects “illness” and “therapy” with a cause – effect  way of thinking.
At the same time, the word “therapy” leaves the door open to various alternative healing practices that may become very dangerous and painful when overpassing the boundaries
within which they can actually be very beneficial – an overpassing that is most common nowadays.

In conclusion, I would say that the word “therapy” in practice can relate to all levels at which a human being exists, that is to the “physical/bodily/sensory”, “emotional”, “cognitive/mental” levels.
Nevertheless, “therapy”:
(a) does not necessarily refer to all these levels at the same degree,
(b) does not necessarily imply concrete methodologies and structures,
(c) does not necessarily has beneficial results in time and depth,
(d) does not necessarily refer to a holistic perception of human existence.

Thus, we can have therapy for cancer, for the flu, for a stressful situation but also a deep massage, an artistic experience, holidays, good sex, swimming, yoga, reflexology and gymnastics can be very well considered to “operate therapeutically”.

 

[C] Approaching the concept of “psychotherapy”
The famous (and misunderstood) word “psycho-therapy”

is a composite term, and its two components are derived from the Greek language.
The first thing we can say about this word is that it is often abbreviated to “therapy” for easy use, but that doesn’t mean that “psychotherapy” and “therapy” are absolutely conceptually identical.
By the word “psychotherapy”, even when we mean it by saying “therapy”, we do not (or we should not) refer to the general content of the word “therapy” as it was described above.
There are many definitions of psychotherapy, depending on where the emphasis is on, but here is not the place to explore all of them.

Just as a start,

we could use a very simple definition: “psychotherapy is a professional relationship between a psychotherapist and a client that is based on therapeutic principles, structure and technique. It differs from other relationships in several ways” (Herkov, 2016).

I would add that the psychotherapeutic relationship also has specific goals and boundaries (for the use of the word “client” instead of the words “patient” or “someone in treatment”, you may see the other articles of this series).
Now, going a little further from this first approach, I think that there are some characteristic points that could be noted as important regarding the word “psychotherapy”.
Such points might be:

Psychotherapy involves change.

The psychotherapeutic process embraces all the dimensions of the client’s own self, with the overall goal of supporting him to devise ways “living better” in his life – “better” based on his own criteria, possibilities and limitations.
In such a view, the psychotherapeutic process cannot but involve change.
This is inevitable since a client lives as she lives because she sees, feels and senses herself in certain ways.
So, if these ways do not change, the client’s life can never change.

To feel “better” is not something standard.

Moreover, there are many delicate nuances in the word “better”. In fact, let us consider that this word describes a quality which is
(a) defined only subjectively by each person, and
(b) emerges from the dynamic relationship of the individual with the world.
So “better” cannot mean something standard and stable. It can be differently meant at the beginning, during or at the end or after the psychotherapeutic process, since the psychotherapeutic work usually means very profound changes in the ways that someone experiences himself in the world – and consequently experiences if, when and how may feel “better”.
In any case, psychotherapy, in our days, is closely linked to self-awareness, self-esteem and personal development. Psychotherapy, in one way, involves all three terms, but it remains a wider process both as to what it involves and how, and how deeply it deals with the human.

“Roles” and goals.

Brownell (2010) notes that in a rather open approach, psychotherapy has to do with the processes that develop when two people with specific roles, the psychotherapist and the client, meet in a professional context and, verbally or non-verbally, they work systematically with the client’s personal experience.
The psychotherapeutic process can clearly be described as “systematic” because the persons involved do not only do what they do through specific roles (the ones of the “client” and the “psychotherapist”), but they also have some goals in what they are doing. Very general speaking such goals have to do with the treatment of pain at a psychological level and inefficiency in everyday life.

Context.

Psychotherapy happens in  a mutually accepted context and the psychotherapist provides a service for which the client has agreed to pay a certain amount of money.
In the process there are moral and legal principles that protect the client and help the psychotherapist (Brownell, 2010, p. 16), because as the healing relationship develops, the client becomes more and more vulnerable.

Psychotherapy is experiential.

It is different to say  “I am in psychotherapy” and different to say “I am thinking or reading about psychotherapy or going to lectures or watch psychological programs in TV”, ignoring my physical responses, my feelings, my attitude to life and how my issues affect this attitude.

 

[D] Who is the psychotherapist
As it was noted above, the psychotherapeutic process involves the roles of the “client” and of the  “psychotherapist”.

So the psychotherapist is not simply someone with experience of or wisdom about life or some spiritual teacher.
The psychotherapist is someone who learns theoretical and clinical systems according to the psychotherapeutic modality of her choice. Furthermore, she is trained in the practice and the methodology of her chosen modality.
Based on this education and training, the psychotherapist organises the processes followed during the psychotherapeutic process.
Such professional training is achieved through specially structured Programs carried out by accredited Institutions.

In this respect, the psychologist, the psychotherapist and the psychiatrist are not the same thing at all.

The psychologist and the psychiatrist can become psychotherapists only through special and long-term education in the psychotherapeutic modality of their choice, following the Program of an accredited Institution.
Above all, psychotherapists should absolutely have their own deep and long-lasting personal individual and group psychotherapy.
If they have not worked deeply with their own personal issues and if they do not have a personal experience of the psychotherapeutic process, they are going to be for sure destructive when attempting to del with issues of other people.

In any case, to be a psychotherapist needs an autonomous education much beyond

what psychologists and psychiatrists learn in their professional studies.

Now, speaking about the psychoanalyst: he/she is also a psychotherapist who follows a particular psychotherapeutic modality, named “psychoanalysis”.
I note this because there are some clients saying “I am not having psychotherapy, I am having psychoanalysis” – which is totally wrong, since the psychoanalyst is  still a psychotherapist.

Another important issue connected with psychotherapy is that in some countries, psychotherapy is not even a recognised by the State profession (or if it is, the title of the “psychotherapist” tends to be claimed exclusively by psychiatrists…)
So, the psychologist is free to do whatever she wants by simply taking her degree – she can call herself a “psychotherapist” without any further training.
In any case, the widespread expression””I visit my psychologist” should rather be replaced by the phrase “I visit my psychotherapist” …

In group psychotherapy, more people are involved, and sometimes two or more psychotherapists, who can be combined in many ways in the process, directly or indirectly (as observers), are involved.

More details about psychotherapy, whether and how it is appropriate or “successful” go beyond the frameworks and objectives of this article.
However, you may also see the rest of the articles in my series “Back to the basics but not self-evident”, for more on this subject.


References

***Baker, S.F. (2000). Healing in psychotherapy: Using energy, touch, and imagery with cancer patients. Gestalt Review, 4 (4): 267-289.

***Brownell, F. (2010). Gestalt Therapy, A guide to contemporary practice. New York, NY: Springer Publishing Company.

***Herkov, M. (2012). What Is Psychotherapy? [blog post]. In PsychCentral. Retrieved on 2012, from: http://psychcentral.com/lib/2006/what-is-psychotherapy/

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