Counseling & Therapy & Psychotherapy

I think it must be confusing for anyone new to the world of counseling and therapy and psychotherapy to make sense of these three terms. In Portland, Oregon where I practice, or anywhere in the U.S., the questions are basically the same. What is counseling? What is therapy or psychotherapy? Are they different? To understand these terms is not quite so hard as it seems.

When you decide to “get into therapy” or “find a counselor,” typically you’re looking for someone to talk with, often for an hour a week, on a regular basis and for a period of time ranging from a few months to a few years. This can vary, but I’m giving you an idea of what’s typical. So, if you’re looking to work with a therapist or counselor for awhile, what do you need to know about the various terms you will encounter?

There are at least two ways to look at the terms: one is based in common sense, and a basic understanding of language; the other is based in the way various state and other official groups regulate the profession of psychotherapy, and in how these groups decide to use and regulate the various terms.

I’ll focus on the common sense version. This is according to me and is not an official view, though I think it’s pretty accurate.

Counseling and Counselor are common terms. To me they convey a more practical approach–helping to guide a client into strengths and away from negative ways of living. Some counselors seem to emphasize guidance and advice. But that’s not always the case, and often counseling is the same essential process as therapy or psychotherapy.

Therapy and Therapist are common terms as well. Sometimes they’re applied to fields like physical therapy which have nothing to do with psychological and emotional health. But in the context of working with psychological issues, they are general terms that refer to any practitioner who works therapeutically with individuals, couples, families, or groups.

Psychotherapy and Psychotherapist just make things more specific. When you’re working with a human being on psychological issues, you’re working with the “psyche” of that person. Psyche comes from an ancient Greek word meaning soul–the living reality of a human being. Psychotherapy is a therapy for the living human being. The word therapy itself comes from a Greek word meaning to care for, attend to, or heal some condition that ails the patient.

The terms your own therapist likes to use will depend largely on personal preference.

The state and the associations that regulate the various licenses that therapists hold have their own preferred ways of using the terms counselor, or therapist, or psychotherapist. I won’t get into these details here, and I can’t speak for any official groups. The important thing to know is that if you’re seeking counseling… or therapy… or psychotherapy (use the term that you prefer!) for something that ails you, just make sure you do a little research and inquire about your potential therapist’s background and qualifications. See if that person feels like a good fit for you, and then begin and see where the process of therapy takes you.

Depth Psychotherapy

There are many ways of studying and working with the depth of the psyche. The term psyche denotes the soul–the very substance of who we are as human beings in the world. Psyche refers to what we know about ourselves, and to what we don’t know about ourselves. Both the known and the unknown. What we know is referred to as conscious, and what we don’t know as unconscious. In reality, we are always a complicated mixture of both known and unknown.

So-called “depth psychology” and “depth psychotherapy” or “analysis” are especially interested in how the deep unconscious levels of the psyche operate. Depth psychologies argue that–contrary to popular opinion in our time–the bulk of who we are exists unconsciously. For the most part, we are unknown to ourselves, or known only partially. We tend to think that we know more than we do, and that we are in control of more than we are in control of. Yet we cannot escape the fact that the psyche resists our attempts to know and to control, and ultimately demands a sacrifice of such attempts. What we can do is listen to the symptoms, dreams, ideas, feelings, human relationships, and images that the psyche sends our way. A new, less troubled, more creative relationship to our deepest selves can then take root and begin to change our lives.

Working out psychological difficulties in therapy therefore means facing the unconscious, and listening to what it has to tell the client and the therapist. That’s the nature of the conversation in therapy. It is a conversation with the psyche that generates therapeutic changes over time.

The depth psychologist Carl Jung elaborated a depth psychology in the early and middle parts of the 20th century. Jung was a close associate of Sigmund Freud’s for a period of years. Just as his career seemed to be advancing towards its high point, Jung left Freud’s movement of psychoanalysis, and spent the rest of his career developing his own theories. The depth psychologies begin with figures such as Jung and Freud, and include many other, more recent psychologists who have changed the field of psychotherapy. Many new theorists have added to, challenged, refined, and re-imagined the psychologies of these two founders of depth psychotherapy and analysis.

Sigmund Freud, Stanley Hall, and Carl Jung, in the front, from left.

Sigmund Freud, Stanley Hall, and Carl Jung, in the front, from left.

Now we are at a crossroads in the field of depth psychology. The old divisions between differing schools of thought are becoming less and less interesting. The points of connection between the depth psychologies and psychotherapies are what hold more interest now. The reason for this is simple. All of these ways of thinking about the psyche and about therapy are attempting to understand what happens in therapy. The point of unity is the experience of therapy itself, and there are many ways of trying to understand what happens there, and how individuals undergo processes of psychological change.

The “Field” of Depth Psychotherapy

There are many ways to practice depth psychotherapy these days. One meeting point that I see between various theories is a focus on the therapeutic relationship itself. What happens in the therapy hour has a way of generating therapeutic change. That means it’s important to pay attention to what happens in the “field”–that is, the space of the relationship that exists between client and therapist, and encompasses them both in the therapeutic hour. Many contemporary depth psychotherapists recognize that what happens there is the most important therapeutic factor in getting a person’s life and development unstuck and moving.

Depth psychologies often refer to the space of the therapeutic relationship as a field–something like a field in contemporary physics. This is a space where different elements of the two individual psyches in the relationship interact on many levels. When things are going well, there is a feeling to this space of being held safely, known, and welcomed. When challenges come up, it’s safe enough to work them through in ways that create helpful changes that ripple through the client’s life and relationships.

An alchemical image of the relational field

An alchemical image of the relational field

It’s not the therapist’s interpretations and interventions (however insightful they may be, and however attached he or she may be to them) that matter most. To say that depth psychotherapy is insight-oriented therapy isn’t quite right, in this view. When a therapist makes an interpretation that meets and helps the client make sense of a felt experience that’s hard to put into words, often the therapeutic factor derives from the feeling of being understood, of being known and held by the space of this relationship, with this therapist. Insights happen, but the curative factor is not the strictly cognitive event of understanding one’s own unconscious process.

It’s more a matter of feeling known than of knowing rationally.

This is a key distinguishing factor of depth psychotherapy and analysis from other therapies. We see that therapy creates a relational field in which both conscious and unconscious processes of psychological development come into play, get unstuck, and move forward. The field of the therapy hour eventually extends outwards into the client’s life in the world as the effects of therapy manifest themselves.

Jung’s Red Book and Turning to the Psyche

I finally started reading the actual text–not the images or the commentary by the editor–in depth psychologist C.G. Jung’s Red Book. The first part is called the Liber Primus, which is Latin for First Book. I had been lucky a few weeks prior to watch a webcast of a seminar about The Red Book by Jungian analyst Murray Stein. That brought the material alive to me in a new way, and I’ve read a few sections now.

The Red Book is a big folio-sized volume full of visionary paintings and writings that Jung created during a difficult period in his personal and professional life. Over time he put the images and words together in a large red volume, whose blank pages he filled up with evidence of the quest to discover and embrace his own soul, which had become lost to him at that stage in life.

Pages from The Red Book

In the foment of his images and imaginative writings, so much is contained of what he elaborated over the years in his depth psychology. Here in The Red Book, his discoveries are in a kind of mythic or visionary form. In his scholarly and popular works, he teases out the meanings and implications of these same discoveries.

No doubt the publication of The Red Book, which for decades has been kept out of public view, will call attention to the roots of Jung’s psychology in his own experiences of the psyche–in himself, in the world, in the consulting room, in world mythologies, and in relationships with others. These roots are rather embarrassing to the modern way of thinking, which is so biased towards the methods of the natural sciences, and the statistical sciences. But the psyche–literally, the soul–has its own reality, to which anyone can pay attention, experience directly, make meaning of, and even elaborate in the form of psychological theory, in the case of Jung as the author of a depth psychology.

Jung often emphasized his scientific credentials and the empirical evidence that backed up his theories. He recognized that his psychology might not find its place in the world of psychology, psychiatry, and psychoanalysis, if others categorized him as a mystic (which they did anyway), who turned to the imagination and soul rather than to science and its methods. His thinking is oriented both to the inward, imaginative, artistic, poetic, and mythical, on the one hand, and to the empirical and scientific on the other. To put it another way: He investigates the soul’s landscape in a disciplined, methodical way, but with room for the soul’s fluidity. A method of discovery should match the object of the inquiry–in this case, the psyche itself, which is naturally in flux, always changing, and charged with deep emotion and powerful images and dreams.

In the images and stories of The Red Book, we discover the rich ore from which a life’s work came. The creation of a psychology and a body of written work began here, in large part, with intensely felt experiences and an attempt to grapple with them in word and image. The material is archetypal, but it is also deeply personal and reflects Jung’s own suffering.

In a section that I found very moving, Jung has a conversation with his soul. The two of them, Jung and his soul, got separated long ago, and the desire to reunite is intense. I will save the details for a later post, but it must be this desire that compelled Jung to return to his own foundations, and to the processes moving forward in his own experience of the psyche.

Above and Below

In the few hours that I have so far devoted to psychologist CG Jung’s recently published, The Red Book, most of that time has been spent gazing at the many images, which have so painstakingly been reproduced by digital imaging.

One dynamic recurs in many of Jung’s paintings: two forces, one pushing up from below, and one pushing down from above, meet in the middle. The two forces are generally imaged by Jung as obelisk-like forms, or half circles, or other forms that convey the forceful movement from below upwards, and from above downwards.

Right there in the middle, there often appears a mandala of some kind. Here, in the middle, where there is a tension between two poles, that is where the soul takes shape. That is where the individual human life becomes what it was intended to be.

Theoretical as this may sound, it does convey something common to our experience of psychological development and healing. In one way or another clients (and therapists!) are bringing various conflicts, various tensions from inner and outer life. The most basic tension may be this: everyone struggles to be who they truly, spontaneously are, given outer and inner realities that prevent the true self from coming into being. On the one hand, the outer environment and relationships may stifle the individual’s true self; on the other hand, the inner life of the individual’s personality may carry wounded or estranged parts of the self, and these also can stifle the expression of a person’s true being.

Each individual is in a developmental process through the whole life span, whether it is made conscious at all or not. Therapy brings a focus to the tensions and conflicts, the lost parts of self, the unknown strengths, and change begins to take place.

Jung used his own development as a person — “individuation,” in his terms — as a kind of experimental field where he could observe firsthand, from the inside, what happens as a person goes through major changes and comes to live more authentically the life given to her or him.

The Figure of Mercurius

Depth Psychologist CG Jung was fascinated by the mythological figure of Mercurius, who shows up in ancient alchemy as a trickster deity. Jung sees alchemy and its fantastical images and chemical experiments as a reflection of human psychology, and especially of processes by which individuals and relationships go through developmental transformations. Mercurius is the imaginary figure who gets us started on a path of transformation, and is also the ever-elusive goal of the process.

Here’s what Patrick Harpur says about Mercurius in The Philosopher’s Secret Fire:

“In Mercurius we see the characteristic that so excited Jung: he (or, she, or it) is coincidentia oppositorum, a coincidence of opposites, the point at which all the contradictions which rend existence are resolved. He is the beginning, middle, and end of the Great Work – prime matter, secret fire and Stone… Mercurius… is one’s own soul and also the Soul of the World; as personal as a lover, as impersonal as a god. Like the Tao, he is everything and nothing, everywhere and nowhere. Like a trickster deity he is both sublime and ridiculous, never allowing his spiritual side to become divorced from matter, never allowing the high mystical goal of the Great Work to become altogether divorced from its dark physical side.”

This is the language of alchemy and mythic consciousness, and is rather foreign to modern sensibilities. Yet the psyche, as anyone who pays attention to dreams and waking imagination knows, does not behave like a machine. Mechanical metaphors for brain and behavior tell us something true about a biochemical and behavioral basis for psyche, but to be in contact with the psyche means to be in contact with a fluid, moving, emotional, and image-rich level of your being. Here, in this experience of the fluid psyche, Mercurius is a guide. It is also the level where real changes in the individual can begin to take place as the process of becoming oneself – what Jung calls “individuation” – moves forward.

An image of Mercurius


Preferring “The Given”

There is an important phrase from the author Charles Williams (a friend of JRR Tolkien and CS Lewis) that I have remembered for years, especially when I have not gotten what I wanted, or have struggled to know and fulfill what I really want.

He speaks of “preferring the given.”

What does it mean to prefer what actually happens in our lives, rather than to cling to what we wish would happen?

For the most part, most of us spend most of our time wishing for things to be otherwise than they actually are. Jobs. Relationships. World events. Health concerns. Traffic. Whatever.

You could imagine preferring what happens, what is “given,” as a passive stance, as letting things happen instead of actively engaging and making changes. But that is not what Williams meant.

To prefer in this case is an active choice. It is to adopt an open stance to the world, to what comes into our lives. We don’t have to like things that feel bad–getting fired or dumped or hit with the flu–and preferring the given does not mean turning away from dark emotions. It doesn’t mean pretending that we are not hurt, angry, or grieving.

Imagine instead not having to like the bad stuff at all, not having to make anything nice or better when it really isn’t, but also standing with both feet planted on the ground, and facing what really is. So much of our energy typically goes into the frantic attempt to make things different, even the things that cannot be changed. What if that energy were freed up for other uses?

Sometimes we find that after releasing into life as it actually is, and actively choosing to face what happens both when we like it and when we don’t, then paradoxically the deep changes that we long for begin to come. It is as if our need to be (or to delude ourselves into believing that we are) in control creates a tight knot of feelings and thoughts and patterns that keep us bound up.

Nothing can move significantly if it is bound up. Preferring the given has the potential to create a clearer seeing, a spaciousness, and an open heart, and these shifts can loosen the knot in us that prevents our development from moving forward.

The center out of which we live can then shift from the “I” we thought knew the answers, or had the right plan, to another “I” in us that resides in a deeper place, and out of this deeper place a life and a self can emerge that feels more fulfilling, more authentic, and more trustworthy in the long run.

Charles Williams:

Charles Williams

In Between Places

There’s a lot in this quote from Jungian analyst Murray Stein’s book Transformation.

When a person goes through deep change, from one way of being and living to another, there is a time in between being the old self and becoming the new self, and this time period is confusing, disconcerting, sometimes exciting, and difficult.

Stein calls this period “liminality”–which means a time in between.

“In liminality, a person feels at a loss for steady points of reference. When the established hierarchies of the past have dissolved and before new images and attitudes have emerged fully, and while those that have appeared are not yet solid and reliable, everything seems to be in flux. Dreams during this psychological metamorphosis tend to show themes both of breakdown (images of buildings being torn down, of changing houses, sometimes of actual dismemberment and physical disintegration) and of emergence (images of construction, giving birth, marriage, the divine child). Angst is the mood of liminality. A person is ambivalent and depressed, and this is punctuated by periods of enthusiasm, adventure, and experimentation. People go on living, but not quite in this world. The analyst feels like the old man in the dream quoted above–watching a process unfold, observing the seasons passing, waiting patiently for new structures to emerge and solidify. It is an article of faith that what is under way is ‘a system “developing itself,” a process embodying the whole specific nature of the living creature’–faith that a butterfly will emerge from the cocoon where liminality reigns.”
-from Murray Stein’s book, Transformation: Emergence of the Self.



Yesterday Portland heated up once again nearly to the 100 degree mark. We were in an “excessive heat warning” until 10pm.

There’s a form of heat that happens sometimes in therapy. Things heat up. It can even feel a bit uncomfortable at first, until the client discovers that he or she survives and even feels liberated and energized from going through the heat.

During a heating process, clients may feel emotions that warm, such as anger, desire, or sadness. Learning to move through such feelings can create a greater sense of aliveness, and more resiliency for facing challenges.

Considering that so many clients who seek therapy are suffering from feelings of deadness in some way, learning to face and claim more warmth can create a shift towards aliveness, and a re-entering into the flow of life. Whatever was stuck, whatever was feeling dead, in need of change,  de-pressed, can begin to transform.

The psychologist CG Jung found many images from the ancient tradition of alchemy that expressed psychological processes such as heating up, cooking, and distilling. These images became a lens through which Jung could see and experience the work of psychological transformation.

Image of alchemical heating apparatus:

Alchemical apparatus for heating process

The processes I am talking about generally take some time, commitment, and attention in therapy. The heat comes and goes, as it does right here with the outside weather. Today it’s been 10 degrees cooler, and tomorrow maybe a few cooler still.