FREQUENTLY ASKED QUESTIONS ABOUT PSYCHOTHERAPY
Why Go to Psychotherapy?
Speaking to a non-biased professional is a different experience than speaking to friends or family. Many if not most people have times in their lives when it would be helpful to speak with a non-biased professional about something emotionally painful or confusing.
Sometimes a person finds that something they’ve been able to successfully avoid dealing with for a long time is becoming more and more difficult to lock away. Sometimes there is grief, stress, uncertainty about a decision, or relationship conflict that has become unmanageable. Sometimes there is a definite problem like depression, anxiety attacks, or substance use.
Life transitions like moving, changing jobs, or children leaving home also can become unexpectedly stressful or difficult. Adolescence is a time of transition that can be quite hard to navigate. For couples, financial stress, raising children, or built up anger can all cause strains in the relationship that they find they cannot overcome themselves. In short, there is a wide range of reasons for seeking psychotherapy.
How Does Psychotherapy Work?
Psychotherapy works by looking inside you. There are many different approaches and techniques for doing this, and many different opinions about the best ways to go about it, but ultimately, it is your inner self that must be dealt with in some way.
Everyone has perceptions, thoughts, and beliefs about themselves, others, and life in general. These ideas drive emotional reactions, and vice versa, in ways that are complex and that deeply affect our functioning. Psychotherapy involves shedding light on unknown feelings and perceptions that are involved in the difficulties you are seeking help for. You can't overcome something before you really understand what it is.
Why Focus on Feelings?
"But what are you feeling?" has become a humorous characterization of stereotypical therapist-speak. The stereotype has a grain of truth to it. Psychotherapy often emphasizes emotional expression as an important focus of treatment.
There are reasons for this. There is significant empirical evidence that emotions are both psychological and physiological in nature. Both the psychology and physiology of emotions is such that emotions must be expressed.
Emotions continuously seek to be expressed one way or another. Expression in words is usually essential. It is not always essential - sometimes artistic endeavors or physical activity are sufficient.
But when problems begin and continue, it is almost always because there are thoughts and feelings that are seeking expression in words and are not receiving the depth of expression they need. Your problems have much to do with your psyche trying to get your attention.
What Do You Mean By Expressing Feelings?
Expressing feelings does not mean dramatic emotional displays. It means allowing yourself to speak from deep within. There may be intense emotions that are expressed. The expression may be dramatic. But that is not always the case. Expression may be much more subtle. Whether dramatic or subtle, when an important realization is made, it is always powerful and change-promoting.
Why Not Just Move On?
Just moving on means unexpressed things have to be bottled up. The memories, thoughts, or feelings that you are attempting to bottle up will continue to seek release. You will expend mental energy on keeping them away. The more you are pushing away, the more mental energy you will expend. Mental energy saps bodily energy.
Small levels of distracting oneself are okay. We all do this. But when too much is being avoided, it becomes less and less okay. The drain of energy from bottling things up can cause problems with low motivation, loss of pleasure, lack of vitality, and tiredness.
Bottled up thoughts and feelings seeking to be known can also disturb your sleep, cause insomnia, and interfere with concentration. Emotions seeking release are insisting you pay attention to them.
The internal conflict between emotions pressing for release and you attempting to push them down can make you very preoccupied. You can become unable to concentrate or focus as well. You can become distracted and not able function quite up to your normal level. When it gets bad, you might not be able to focus at all. Stopping to face what you are avoiding can relieve these consequences of pushing feelings away.
What's the Point of Talking About It?
One of the points is so that you can take control of how things get expressed. Emotions and thoughts that are not expressed in words will come out in other ways. They might come out in addictive behaviors, eating problems, withdrawal from people, impatience, or temper outbursts. They might manifest in the body in the form of heart palpitations, upper or lower GI problems, or fatigue. They might cause sleep disturbance or compulsive behaviors.
It is also often necessary that these things be expressed not just to yourself, but to another person in the context of a connected relationship to that person. Different forms of therapy emphasize the therapeutic relationship to a greater or lesser degree. In the form of therapy that I practice, the therapeutic relationship is viewed as very important and central to the therapeutic work.
Speaking to someone else is not the same as thinking to yourself. Things are more likely to come to the surface when you’re trying to communicate to another person than when you stay just within your own thoughts. You hear yourself saying things you had no idea you thought or felt.
Why a Psychotherapist?
Someone who is skilled in listening and trained in working with the mind can help you explore and understand yourself in ways that can be very helpful. Naming and expressing what is going on within you in a more accurate way is often in and of itself relieving of emotional pain.
Help does not always come just from being heard though. There is often working through that is also needed. A professional can help with both the realization and the working through.
What Kind of Psychotherapist?
There are many different levels of training as a psychotherapist and many different ways of working in therapy. (see the "Type of Therapy" page for more about types of therapy). I am a Ph.D. level psychologist with specialized training in working in the ways I have just described. I have a Ph.D. from the University of Miami. I am also a psychoanalyst. I have completed six additional years of postdoctoral training to become credentialed as a psychoanalyst by the American Psychoanalytic Society. I have ten years of clinical experience in full time private practice and five years of previous experience in hospital and community mental health clinics.
Doing it Yourself
Some people feel that seeking psychotherapy is “weak”. They would rather “do it themselves”. In reality, seeking psychotherapy is doing it yourself. The therapist does not do the work for you.
Psychotherapy is more akin to going to the gym. It is a place to develop your inner self. The therapist, the setting, the regular appointments, the therapeutic relationship, are all part of the equipment.
You do not get advice on what you should do, but you do get help in becoming better able to decide for yourself what you should do and becoming more able to do it. That is the true “doing it yourself”.
Does it Take a Long Time?
Some things don't and some things do. It is sometimes possible to work in a way that is short term. It depends on how deep or longstanding or difficult the problem is. In the first few sessions a psychoanalytic therapist can gather enough information to give you some feedback as to how they understand the difficulties you are presenting. They will also make a recommendation to you about what they feel will be most helpful in terms of length of time, frequency of sessions, and focus of sessions. You have a great deal of input on this. The two of you can collaborate on structuring a therapy that is both helpful and manageable in terms of time, finances, and emotional impact.
Where Can I Find Out More?
Below there are links to websites that provide information you may find useful. Please feel welcome to contact me at any time to explore whether or not psychotherapy seems like something that might be good for you at this time. I am happy to help you decide if you would like to take the next step or not, and/or if I might be the right person for you or not.
If I am not a good match for you for whatever reasons, I can help connect you to someone who might be better suited to your particular needs. I know many excellent clinicians in the area who specialize in many different kinds of issues. For example I do not work with young children or do psychological testing or prescribe medication, but I know quality people who do and I will be glad to provide those names to you.
If you wish to learn more you can get more information from these websites: