Dr. Matthew W. Turner, Ph.D., ABPP / FAACP
Board Certified in Clinical Psychology, American Board of Professional Psychology
Fellow of the American Academy of Clinical Psychology
Orientation to Psychotherapy
"Well, what can I expect from my therapy?"
"Nothing but work." - Elvin Semrad
What benefit can I expect from psychotherapy?
- Symptom relief
This may take the form of sleeping better at night, reduced anxiety and tension, less intense emotional reactions and more rewarding interpersonal relationships.
Making what is unconscious conscious, "Know thyself." Once unconscious patterns in relationships or triggers to anxiety or depression become conscious this places a person in a position to make a positive change.
Having an internal sense of freedom, no longer being controlled by anxiety or depression, thinking and feeling for oneself, and setting limits or boundaries on self and others.
Establishing an identity that is derived from internal integrity and authenticity, a capacity to live by one's values and to be honest about one's feelings, attitudes, and motivations. The flip side to this ideal is experiencing one's identity solely by reference to connections outside of your self, for example, being defined by a job or career or marriage or role (e.g., parent).
Recognizing and accepting one's faults and shortcoming and not being dragged down by them. Self-esteem often comes from increased self-knowledge, awareness of your own thoughts and feelings and what you want from life. Self-esteem also derives, in part, from doing something (a job, hobby, role, etc.) well.
- Recognizing and Handling Feelings
Moving to a place where one can know what they are feeling, to understand why they are feeling that way, and to have the internal freedom to handle emotions in ways that benefit yourself and others. A key aspect of mental health and happiness is an acute awareness of our emotional life. We feel whether we want to or not and all must grapple with how to handle feelings; whether we ignore and stuff them, express them physically, or have them periodically escape through anxiety that feels foreign.
- Ego Strength and Self-Cohesion
Ego strength and self-cohesion are 'psychobabble' terms that refer to the capacity to cope with life's difficulties in a realistic and adaptive way; or put another way, to deal with the stress inherent in life and not fall apart. When stressed, one ideally does not want to be paralyzed by guilt nor give way to impulses and act irrationally.
- Love, Work, and Mature Dependency
The capacity to love and work are what Sigmund Freud, the founding father of modern psychotherapy, viewed as the ultimate goal of psychotherapy.
Moving to accepting what cannot be changed and taking on a new capacity for addressing what can be changed is an overarching goal of psychotherapy. One way to think of how therapy unfolds is to slowly accept the fact that one's psychological problems reflect accidents of a complicated fate and endowment, not some personal defect or failure; and moving to the painful appreciation that even thought this is true, no one but you can be responsible for solving those psychological problems.
Mature dependency refers to handling one's natural dependency in their own best interest. Dependency is often a negative word in our culture, but we are all dependent to one extent or another on other people.
- Pleasure and Serenity
Grieving over what is not possible and getting onto what is sets the stage for being able to feel pleasure and a sense of serenity.
How long does treatment take?
This is always a tough question, and there are no hard and fast rules. Some people need as little as 10 sessions to receive significant symptom relief and / or address the crisis that brought them to therapy. Research has demonstrated significant symptom relief in about 20 to 25 sessions, on average, for a variety of problems, but many problems take much longer to fully address, particularly long standing difficulties with relationships. One way to think about this is that many mental problems and relationship difficulties derive from many years of deeply entrenched experience and therefore may take a few years (one to three) of treatment to fully overcome.
What is my job as the patient?
The role of patient (Latin: one who endures) in psychotherapy is fundamentally to look at oneself honestly and be willing to work on that self. Easily said, difficult to do. Without a doubt, the job of the patient is much harder than that of the therapist. In therapy, it will be your job A.) to talk about what is foremost on your mind, B.) be willing to carefully think about interpretations given by the therapist BUT be willing to reject them if they feel wrong and discuss why C.) be honest about your thoughts and feelings about the therapist and the therapeutic relationship so as to learn more about how your relationships outside of therapy work (this is difficult and may take time to get comfortable doing) D.) think about the last therapy session between the sessions (a lot of what happens in therapy goes on between the actual sessions ) E.) be willing to apply what you learn in therapy to you life outside of therapy.
Material for this is taken in part from Nancy McWilliams' Psychoanalytic Case Formulation (1999) and Irvin Yaloms' The Gift of Therapy (2002).