Exploring Depth Psychotherapy

pathway to the psyche

Here’s a start to a few blog entries exploring important aspects of psychotherapy as practiced by depth psychologists of various stripes.
Let’s assume a basic working definition of depth psychotherapy. Let’s assume that it’s a form of therapy that goes out of its way to include the unconscious psyche in treatment. By unconscious psyche we mean at minimum certain dynamic patterns that are always at play beneath the surface of our awareness. Let’s assume that engaging the psyche stimulates growth and movement and often helps to ease problematic symptoms of emotional suffering.

So how does a therapist go about engaging the psyche? Truth is, there are lots of ways. There are lots of schools of thought in the history of depth psychotherapy, each with its own opinion about how this should be done. Today, as neuro-mania (the reduction of all psychological experience to brain phenomena) reveals its limits both as theory and treatment in psychiatry, renewed interest in the depths of the psyche is creating excitement as psychology begins to re-balance its lopsided though important focus on brain and behavior.

The best place to start exploring is the therapeutic relationship. Someone comes to therapy, usually in a state of suffering and concern. Something in the suffering–the symptoms–expresses the individual’s difficulty. I’ve found that it’s rare that people will seek out and commit to psychotherapy when they are feeling okay. Maybe they begin in a state of crisis and difficulty, and then begin to feel better, and continue therapy for the sake of further personal development, but it usually takes a painful difficulty, or symptoms, or a loss, or an illness, or a life crisis to bring a person into my office to begin an adventure of self-discovery and renewal.

The relationship of therapist and client therefore includes this aspect of seeking help, wanting relief and healing. At the same time, it’s odd to say yet definitely true that most people are ambivalent about the very same changes they long for. I can say this based on my experience both as a therapist and as a client! There’s something scary about change, apparently. Sometimes this is called resistance. Forces for change are mobilized, but so are forces against change. This is normal, and a good therapist makes room for ambivalence and facilitates change at the pace the client is okay with.

One fundamental gain in psychotherapy is the experience that the client has of being seen and understood. Having a hard time brings isolation, and most of us tend to hide the less fun aspects of our lives. Who wants to hear that? we say to ourselves. Or we try to share what’s going on, but it’s too much for our friends and families to handle, or seems to be. That’s why a depth psychologist will try and provide the kind of safe container that welcomes all of the client’s conscious and unconscious parts into the mix.

One final note for now: I’ve noticed over the years that many people in my office feel a deep longing that is almost unspeakable. Something is missing. It’s hard to say exactly what, but there is a felt sense of lack, and a heartache. I’m not saying therapy necessarily is the answer to this longing, but it can be surprisingly effective is accessing the longing and can even change the way a person gets to bring it into the world outside. Deep desire can lead to interesting transformations that ripple outward through a life. Transformation can happen from the inside – out. Inside the therapy office to outside in the world. Inside the inner self to outside in outer behaviors.

I will save this inner – outer dynamic for another post.

 

Dream On

We depth psychologists talk a lot about dreams. But what is it to dream? And what is it not to dream?

Psychoanalyst Thomas Ogden has this to say in “On not Being Able to Dream”: “Much has been written on what dreams mean; relatively little on what it means to dream; and still less on what it means not to be able to dream.” He goes on to tell about Wilfred Bion’s notion that the activity of dreaming is more fundamental than we normally think.

Dreaming is not identical to the “dreams” we wake up remembering. Instead, when we are functioning well, dreaming is happening all of the time, waking or sleeping. It is the unconscious psychological work of linking elements of experience that have been stored in memory. Dreaming makes sense of our emotional realities by making these links and giving elements of experience form. This can take place while we are sleeping, and it can take place while we are awake.

I remember consulting with a very experienced psychoanalyst a few years ago about cases. I asked him how he worked with dreams in his own practice, with his own clients. He said that his approach had changed over time. Now, he said, he thought of each session itself as a kind of dreaming. In other words, each session enters the space of making associations, links, and playing with meanings. Client and therapist dream up the session together and so engage in learning from experience.

In this view, the background experiences held in memory are raw ingredients. We can’t digest experience without first dreaming it. The act of dreaming cooks the raw ingredients. It creates a meal that we can eat and share with others.

Bad things happen when we can’t dream. At the extreme, some individuals become unable to dream when in a psychotic state. Psychological digestion is disturbed, and the results can be catastrophic. For most of us, there may be moments of failing to dream–aspects of self and world that we choke on and need help to swallow and metabolize. That’s where psychotherapy comes in and creates a vessel for this alchemical work.

“Every Rule”

Not so very long ago, before the cold and wet, I had occasion to play foursquare with a group of elementary school kids. It got competitive and wildly hilarious both. Rallies were sometimes long with dramatic saves and shots. I began to play for real, and our collective energy intensified. We taunted each other and did spins and slams and low shots that couldn’t be gotten.

Now, you may not know it, but these days each time you end up the server in a game of foursquare, you get to set the rules for that round. It could be basic rules, no additions or subtractions. Or you might allow double hits, or serving outside the box (“birdie out of the cage”), or “bus stops,” “back stops,” and the list can go on and on.

One of the kids was new to me and had moved to the states from another country some time ago. I had a sense that he might feel a little bit the outsider, though we all got along great. I liked him; he had moxie. He introduced us to a new notion when he got to the server’s box. He called it “every rule.” It’s a little hard to define “every rule.” In practice it meant every player could try any move at any point, and could try its opposite too. “No” did not exist. Some players liked trying this and kept calling for “every rule” when serving. Others were disgusted by the chaos it created and tried to reign us back to sanity.

But by that time a mania had taken hold and we found ourselves in the thrill and hilarity of breaking down the very notion itself of rules. This was lots of fun. Then, at a certain point, different for each player, it became dull. If all was permissible, then the server could devise a serve that no one, not even a superhero, could possibly return. Taken to its logical extreme, “every rule” took the fun out of the game. It spelled the end of the game, actually.

Still, I feel fondly towards this experience of everything permissible. I can’t even try to describe the irruption of fantastic, here-to-fore unthinkable moves made possible under the reign of anarchy. We broke through to a new level. At the same time, as we danced on the edge of the thinkable, just one more step and experience became dull, predictable, since any player could exploit permissiveness to score a boring personal win.

I offer these memories as an instance of breaking down and breaking through the given rules; of soaring into permissive freedom; of recognizing both the necessity, and the relativity, of boundedness. In a strange way, some degree of boundedness was necessary to experience the thrill of unboundedness. Otherwise, the unbounded thrill lost its interest and its creativity.

Relationship with the Unconscious

I remember sitting for a time with some Buddhists when I lived in California. By sitting I mean going to a center, which happened to rent space in a Quaker church, and sitting for a couple of hours, once a week. What did we do while we were sitting there? We listened to a teacher of Vipassana or mindfulness meditation, and then put his teaching into practice, which meant quietly paying attention–to our breath, to our thoughts, feelings, and body sensations. I never took on the mantle of Buddhism myself, but the experience there has stayed with me.

Today it came to mind. I was thinking about thinking, and how in any given day, thoughts and feelings and images–the flow of our internal worlds–move along of their own accord. Sometimes it feels as though I have little say in how they move. They happen, quite forcefully at times, and I may find myself on the receiving end. In terms of depth psychology, we are continually fielding the forceful influx of the unconscious psyche.

I remembered something the meditation teacher said about how, when we quiet our minds and simply pay attention to what is happening, suddenly we realize how incredibly busy and noisy it is inside. It can be rather distressing. I believe the Buddhists call it the “monkey mind.” Stop for a moment, and notice all the crazy monkeys jumping and swinging about, making a big racket. And you thought you were master of your psychic house! Think again.

Okay, so now to transpose things into the milieu of Jungian psychology, or any depth psychology that acknowledges the unconscious as a significant force in the human psyche. The personal self or ego does not rule over the unconscious psyche. It is one player on the stage of a drama, and it’s not in charge of the production. But it does have a say; it can take a stand.

Broadly speaking, the other players consist of unconscious forces, which Jung calls complexes. Complexes are emotionally charged thoughts and images that have an autonomous life. They have a personal aspect, based in our individual traumas, biology, and patterns, and an archetypal aspect, expressed in the over-arching images of myths and fairy tales. In their archetypal aspect, the complexes are the gods and goddesses, who rather notoriously do not have personal human welfare high on their list of priorities.

So what of the human? What of the self that wants to take a stand? That wants to move from the receiving end of unconscious forces to the active, choosing end? That is not interested in being a plaything of the deities? It’s not an easy matter. Consider the mundane experience of moving through your day. A terrible mood may overcome you. A thought about an old relationship might take hold of you. A feeling about your unworthiness might convince you. An old wound might open up and suck you in. It’s hard in the moment to take a stand in relation to these psychological facts that happen to us. But say that you do. In your own way, you meet the force of the unconscious with a counter-force. You demand room for “me.”

I would propose that then, when you make that demand, the unconscious will respond differently. I am reminded of a dream I heard once. The dreamer had been chased recurrently in the dreamworld by a sinister figure. Finally, one night, something changed. The dreamer turned to face the persecutor, and things were different after that. Not necessarily easy, but now there was a more symmetrical relationship between the person and the forces of the unconscious. The prey had turned to the predator and said, in effect, “I see you!” And, “You don’t just get to do what you want with me. I have a say in this relationship.” Now there is the possibility for an encounter, a negotiation, and ultimately, the ability for the person to make a demand on the unconscious psyche to contribute something worthwhile. Maybe we can even imagine that the psyche has wanted this kind of encounter with us all along.

Dis/connected Connection

The other day I headed up to the mountains. Just for a day. I’m lucky to live in Portland, Oregon, where that’s possible–to drive up into the wilderness and back within the space of a mere 10 or 12 hours. I gave myself a day off from my counseling practice, from family, colleagues, friends, and the familiar sights and rhythms of the city. To go away, and to come back. It’s important. It always feels good and leaves me with a reminder that “I want to do this more often.”

I left early so as to make the best of my time. The night before, in an uncharacteristic spurt of organizational prowess, I laid out everything I needed for the time away. When I woke before my alarm, I slipped out quietly into the cold air and dim light of early morning and was on my way.

It was about 20 minutes into my drive when I found myself reaching for my cell phone, only to find… no phone. Not in my pockets. Not in my bag. Not in the storage area under the armrest. Nowhere. I stopped and rifled through everywhere I could think to look. Twice. Nothing. Had it fallen out of a pocket onto the street? Was it on the table at home?

I noticed my anxiety rise as I contemplated my venture without that apparently indispensable tool, the cell phone, that only 15 years ago I did quite well without. What if I had car trouble? Or sprained my ankle on a trail? What if there were a family emergency? Or a client crisis? No one would be able to reach me, and I could reach no one, short of a pocket full of change and the rare sight of a pay phone. I reproached myself, my disorganization, my mistake.

Now, just to clarify, I don’t have a phone with lots of fancy stuff. No iPhone. No “apps.” Not even a less expensive knockoff of said device. No offense to the wonder of those technologies, but I don’t particularly want anything like that. I have a recording of the singer Tom Waits telling stories and jokes to an audience in Birmingham, Alabama, and I like it when at one point he laments the cell phone that is also a camera. “Why can’t something just be what it is?” he asks. My phone does have a camera, but it’s basic. I went for one that can take a beating too, which is fortunate, since I’ve already left it lying out in the grass on a dewy night once or twice by accident. It has a permanent defect now where the damp got in and messed up the display, but it works fine.

As the absence of the phone sunk in, I found myself driving down the freeway and country roads, slowly letting go of my anxiety at being dis/connected from the spirits of the air, those invisible transmitters of text, image, and voice, to other humans far from the actual place I inhabit at any one moment. A strange calm came over me, and a release. I was free in a new way for that day, from the fear driven by my attachment to those invisible connections. Then it was evening, and I was back. Nothing bad happened. I felt happy and refreshed and wondered whether I would leave my digital device behind on purpose next time. I thought to myself that maybe–thanks to technology–never being dis/connected means never really getting a chance to go away, and to come back, and I expect the soul wants that chance.

What Can’t be Spoken

I’ve had a little hiatus from writing here on this blog of mine. The holidays, travel, fun, stress, the usual suspects. And a certain hesitancy to pick up the virtual pen and write again. Even the word “blog” irritated me just now as I wrote that first sentence. Blog … what sort of word is that? Blog, bog, log, boggy feelings, being weighted down, a mere cog in the wheel … the associations that come to mind are not particularly pleasant. It sounds like something that gets stuck in one’s gut and needs medical intervention to remove it. “Thank God, I went into the surgecenter and got that blog removed yesterday. I feel so relieved!”

Can you feel my resistance and irritation? What can really be said, I wonder, in the end? What use are words? These are dangerous thoughts for a therapist who practices “the talking cure.” My funk will pass, I know, and likely I will write my way through it and into a space where the words mean something again. They will communicate thoughts and feelings, and I won’t feel so bloggy.

In the meantime, I will report that I have recently been perusing the websites of many local artists here in Portland, Oregon, exploring the art realm here and looking at many images of sculpture, painting, drawing, and photography. I have also been watching a few documentaries on great masters, including Pablo Picasso, Michelangelo, and Louise Bourgeois. Among the many motivations, conscious and unconscious, leading me to these explorations stands a feeling that sometimes the important things cannot be spoken. They must be formed into images.

In his book, The Art of Sculpture, Herbert Read identifies the work of sculpting as the artist’s formation into image of an emotive state that exists within. Whether this is a comprehensive definition that holds true for all sculpture in all times and all places I don’t know, and don’t frankly care. For my purposes it works well. Reading this led me to take up hammer and chisel myself this past week and begin shaping a large block of aerated concrete–into what form, I don’t yet know. But something is moving now; that much is clear. There is an intelligence and an emotional reality embedded in the material, and it’s my job to notice what it wants, and to help it come into being.

Already I feel less bloggy. Something like this process I am describing often happens in therapy. Things get stuck. Words don’t come, or when they do, they don’t say what we want to say. Then an image comes, in a dream, a waking fantasy, or a piece of artistic work, and the flow of communication of thoughts and feelings comes back, and with this flow words once again mean something, and even prove indispensable.

Longing for Paradise

I recently picked up a psychology book that I’ve had my eye on for awhile now. It’s written by a Jungian psychoanalyst named Mario Jacoby. The book is, Longing for Paradise: Psychological Perspectives on an Archetype. Jacoby’s theme centers on the importance of the paradise archetype in psychological life and development, not to mention in the work of psychotherapy.

This is a bit of a different take on “paradise” for psychological thinking, and it provides a good jumping off point for some reflections.

The usual schtick in psychology on this matter smacks of “nothing but” reductionism. Reductionism happens when you take a complex phenomenon and break it down into its component parts, and say that the complex whole is nothing but the sum of its parts. Here are some reductive variations that you might come across on the present topic: The longing for paradise is nothing but a regressive wish to dissolve into infantile, oceanic feelings of oneness, free from the conflicts that real life involves. Or, the longing for paradise expresses a developmental failure to mourn the loss of unity with mother, and to accept separateness. Or, the longing for paradise afflicts those who didn’t get an adequate holding environment in infancy, and so they forever long to redress that early lack. Or, the longing for paradise shows a rejection of limitation, and should be analyzed away as an inflated identification with the realm of the archetypal, and specifically with the archetypal Mother.

These are all possible ways to understand thing A (the longing for paradise) in terms of thing B (some form of developmental / psychological problem). Thing B is supposed to explain how and why thing A comes about.

Jacoby, in what I’ve read so far, knows how to think about paradise in developmental and psychopathological terms. He points to the early holding environment, in which mother and caregivers must respond adequately to the hunger, anxiety, distress, and need for touch and loving attention in the infant. If a good-enough experience at this stage doesn’t happen, he offers, significant disruption of emotional and relational health later on is likely. An inordinate fixation on paradise and a pursuit of paradisiacal experiences might well grow out of an early trauma to the holding environment, in which some degree of paradise is actually appropriate for the sake of the utterly dependent infant.

Naturally, psychology wants to explain the longing for paradise in terms of the early environment and early relationships. Where else but with mother do we ever get some measure of paradisiacal experience? Infancy even entails a certain timelessness. The rhythm of relationship to mother is the ordering principle of the moment-to-moment experience of being that psychology imagines the infant to live. Grown up time does not exist for the baby.

Modern attachment theory and infant observation seem to support such thinking. Clinical experience also seems to support the notion that early traumas to primal relationships create suffering in clients, and that the therapeutic relationship, when it works well, can bring some measure of healing to the early wound. The image of paradise is one image among others that can come up in this area of experience, in or out of the therapy room.

However…

I think we need to think symbolically about this. A psychological theory is a kind of symbol that happens to be highly differentiated. But it’s a symbol nonetheless. I am using the word symbol in the sense given by the depth psychologist C.G. Jung. A symbol, in Jung‘s psychology, is a living reality. It’s an image that forms in order to communicate something that words can’t express adequately in a rational way. A symbol expresses an unknowable reality that otherwise we could scarcely approach at all.

I’m proposing that the psychologist or psychoanalyst is using the image of a good enough mother-infant relationship as a symbol. It’s a symbol that psychology uses to communicate to itself something unknowable–in this case, the elusive image of paradise, imagined as a state of being that is touched in infancy.

It’s important to take note that when a psychologist looks at the realm of infancy and begins to make theories about the infant’s inner experience, there is naturally a significant degree of projection involved. What the therapist experiences in working with clients at this early level of emotional experience, as it gets expressed in psychotherapy, ends up as part of the theory about the infant’s inner life. Even the therapist’s own longing for paradise gets into the mix, and possibly imagined as a lost state of being that the infant must have experienced, or is supposed to experience when things go well.

And why not? It’s very legitimate to create theory out of clinical and even deeply personal experience, in addition to data such as the observation of infants and mothers, so long as we are aware of what we’re doing.

Stay with me a moment longer if you‘ve come this far. I know this is getting long, and perhaps muddled.

What I’m coming around to is the fact that no matter the brilliant insights of psychology into the developmental substrate of the paradise archetype… the image of paradise remains the image of paradise, and psychology will never divest that image of its power by explaining it theoretically. Sure, the archetype can cause problems in living and relating. But in itself it’s not something to be fixed, cured, treated, analyzed. The longing for paradise speaks to an experience common to all human beings, whether or not the primal relationship with mother got disrupted. That’s what’s meant by calling it an archetype: it’s typical of human existing to touch this particular place.

What remains to examine is how this archetype expresses itself in psychological life and in psychotherapy. I’ve got a ways to go in Jacoby’s book, and so maybe I’ll save the rest for another post.

The Power of Not Now

Various popular renditions of spirituality and therapy in our current culture encourage us to live in the present moment. We are told to realize the true self in the now–to become conscious, aware, transformed. Sounds good, right?

That is my simplistic take on what seems a common thread of much spiritual and psychological and therapeutic thinking these days. The thread of “living in the present moment” has good precedent in Buddhist and Hindu thinking. I’m not for or against this thinking, but it’s worth playing with for a moment.

To begin with, I wonder why this goal of living in the now isn’t working better, for more people.

I have to wonder how well any of our popular spiritual and therapeutic self-help is working for us. Take a stroll through the self-help and popular psychology sections at Powell’s bookstore. While there’s some good stuff being written, at least now and then, these strolls tend to elicit a certain despair in me. So many theories, systems, and recipes for well-being. The striving for an elusive cure to what ails us goes on forever, aisle upon aisle, world without end. What does that tell us? We want to become conscious, live in the now, make sense of suffering, manage depression, cure addictions, alleviate anxiety, heal wounds, transform behaviors, and renew relationships. And we evidence an unending appetite for new methods of achieving these ends.

What if, instead of striving for a final solution, we slow down and spend some time with the longing in us that drives much of this striving? Our culture values drive, achievement, mastery, and consciousness, and does not encourage us to slow down and feel things that might not be terribly comfortable at first. But I suspect that the human heart, with its longings, confusions, stuck points, unconsciousness, and hurts, will ultimately evade our desperate attempts for a final fix. As a result, we may in the end feel like we’ve failed to live up to some psychospiritual standard of good living–being in the now, being conscious, healed, on top of things, whatever.

A more human approach might help us remember the power of “not now.” We need room to be stuck, confused, defended, and to let our development take the time it needs. The movement of psychological development–individuation, in Carl Jung’s terms–is a spiral path, some have said. Progress is made towards a center, but we also go round and round. That’s just how it is. We are chagrined to encounter our “same old shit” in new and deeper forms over the years. We come around again to the same old joys too, and remember how easy it is to forget them. Real change happens in this cyclical way.

Image of the Spiral

We sense the presence of the center as a kind of timeless “now,” though we don’t get to hang out there forever. If we actually did succeed in fixing / curing / redeeming the innate messiness of a human life, and living 24/7 in a state of ultimate conscious realization of the self, we wouldn’t be living a human life any more. We’d lose touch with the longing that reminds us that there is, after all, a center that we are circumambulating. We’d lose touch with the wounds that open our hearts to others that we’re sharing our lives with.

I think that this take on things makes room for letting go into a development of the self that truly gets the striving ego out of the center… which I think, in the end, is the point of those who tell us to awaken into the present moment–as it is, with all its messy glory, not as we’d like it to be.

Midlife Crisis (and Transformation) in Portland?

What might a so-called midlife crisis really look like? And does it really happen here? In Portland, aren’t we (I’m generalizing to make a point) pretty well put-together? We’re conscious about the environment, intentional about what we eat, invested in local communities, authentic in relationships, and so on….

It’s not good or bad to have these ideas about being conscious and well-put together, but it’s important not to take them as literal truths. Part of the danger of such literalism is that something important could get overlooked: that there come times in life where our self-image falls apart–a little or a lot–and may even need to fall apart for us to transform. Midlife is a period where this sometimes happens, leading to a renewal of life and self.

The so-called midlife crisis is often seen in psychology as happening as early as 35 years old, and often later, at some point in the 40s or 50s. The psychologist Carl Jung contributed a lot to the psychology of midlife. Jung’s view feels a little old in some ways, but still holds deep insight if we adjust for cultural changes that have occurred since his time. Jung argued that the first part of adulthood usually focuses on adapting to life in society. We get educations, find work, build a career, have relationships, become parents, and thus establish a well put-together place in the world.

It’s usually once we have been through a lot of this stuff of life’s first half that we may reach a critical moment. It certainly doesn’t happen to everybody, but something may come along to upset the structures that we have so carefully built and tended in the first half of life. The outward cause of the upset could be a death, an illness, a divorce, the loss of a job, a new relationship, an inner malaise, a depression, trauma, or any number of events on the outside or inside of life that threaten to shake up the known structures of life and self.

A lot of strong feelings can come through during this time. It’s not necessarily all bad or all good feelings that come, but an intensity of feelings and a variety too. The Jungian analyst Murray Stein and others have written about midlife crisis as a kind of second adolescence. If you will remember the tumultuous feelings and developments of your first adolescence, you might get some flavor for the second adolescence of midlife. Like the teen years, midlife can be a major transition into a new phase: what Jung called the “second half of life.”

And like the teen years, midlife can feel unsettling. We can feel confused and uncertain of the future. It’s often a rich and satisfying time as well as a challenging one. We may begin to realize that the old structures of our life could use some readjusting. We may begin to enjoy living in ways we forgot we knew. A feeling of renewal can come, and a feeling of increasing freedom to be ourselves.

The midlife crisis and transformation doesn’t tend to happen without struggle. There’s a reason people in one form of midlife crisis or another end up in therapy. In Jung’s view, therapy can facilitate a long-term process of change. The uprooted feelings of midlife can lead into a new feeling of rootedness, deeper in our real selves than we had imagined possible. Then life can proceed out of a new source of vitality and development.

I ran across this poem by Pablo Neruda today, and I think its language evokes some of the feelings and potential of the so-called midlife crisis and transformation.

Lost In The Forest
by poet Pablo Neruda (1904-1973)

Lost in the forest, I broke off a dark twig
and lifted its whisper to my thirsty lips:
maybe it was the voice of the rain crying,
a cracked bell, or a torn heart.

Something from far off it seemed
deep and secret to me, hidden by the earth,
a shout muffled by huge autumns,
by the moist half-open darkness of the leaves.

Wakening from the dreaming forest there, the hazel-sprig
sang under my tongue, its drifting fragrance
climbed up through my conscious mind

as if suddenly the roots I had left behind
cried out to me, the land I had lost with my childhood—
and I stopped, wounded by the wandering scent.

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.