There is a lot of mystery surrounding the concept of psychotherapy.Psychotherapy gets a lot of serious and joking flak from people who do not understand what it really is in its real and best form.In fact, the unusual mixture of privacy, intimacy with boundaries, and business found in therapy is paradoxical and confusing for many who have never experienced it.This has led to incorrect or derogatory characterizations of psychotherapy and counseling that do not assist the public in learning what therapy actually entails.So what does good and genuine therapy do, and how does it do it?To put it in simplest terms, therapy is the invitation to new learning and the actual work of new learning.However, it is not as simple as handing the client an operations manual like "Your Undepressed Brain" or reading such a manual with them.Therapy is a kind of learning that is taught directly only in small part.What, then, is it that the client needs to learn, unlearn, or re-learn?Clients in psychotherapy, like all of us, have learned habitual and repeated ways of 'being in the world' and 'being with others' (or not being with them).These ways of being are usually learned at critical points in development, are related to absent, blocked, or problematic attachments to important persons, and interact with biology to form what is often called 'character' (the behavioral expression of personality).These character habits get us through the day and help us 'get by'; they are our usual ways of coping with life and our usual ways of obtaining, maintaining, or avoiding attachments to others.These habitually learned 'ways of being' become problematic they tend to bring us to treatment.Our habitual ways of structuring life can eventually become problematic because they ensure that we know what to expect in life but also stunt our growth-or actually lead to deterioration.To clarify and expand, for some persons the 'expected' in life is chaos and this, too, may be difficult to release if it has become familiar.Growth and change entail risks and tolerance of the unknown, and most of us don't want to take the risks or deal with the unknown.Imagine a client whose main orientation is 'I don't need anyone; I can do everything myself.' There are people in the world who have learned that the way to safely relate to others is to avoid any dependency.We must understand that in our individualistic, high-achievement culture this is actually valued behavior, so it could very easily take over.When this person is told that he is too selfish or independent, needs to open up and share, why does he fail to listen and learn? It does not sink in because giving simple instructions does not address the actual underlying dynamics of the behavior.There are many ways to alter those dynamics, but first we must understand them.Although unconsciously or habitually continuing this interpersonal stance does not make him feel truly 'happy' (rather, it probably feels like a constant treadmill at high speed!), when he is sealed off in most areas of life he does not have to face the uncertainties of connecting and sharing with others.Will they be accepting? Hurtful in some way? Indifferent? Even when he can see that his patterns do not advance his life and also cause others to actively avoid or dislike him, pushing for total self-sufficiency is sufficiently familiar and rewarding that he will not give up the role even when confronted directly.So, one part of the puzzle that is addressed in therapy is the fact that rewards and punishments are not completely universal for human beings.A piece of information we would want to know to help this client would be the specific and personalized ways in which excessive superiority is rewarding, and the specific and personalized ways in which depending on others is unappetizing.One way to approach this is to explore what dependency and self-sufficiency mean to this man.Therapists might address such an individual in different ways.One way might be to 'notice' out loud that the client seems to be doing so well--why does he need help? This could lead to interesting and important developments in the therapy relationship that could lead to clues and cause situations that show the client his behavior, rather than tell him.Another way might be for the therapist to notice how the client attempts to pull the therapist into the same interpersonal dynamic--how the client shows the therapist that the therapist is not needed.Notice how this is different than giving simple verbal commands and instructions.The client actually gets to experience in real time how his actions pull on other people.This is called experiential learning, and it is much more powerful than book or instructional learning, especially for emotional and habitual problems of which we are frequently partially or completely unaware.Therapist questions and responses are designed to persistently offer unconditional acceptance even when the client and others do not give that acceptance, but they also open a window into the unknown and unexpected.This exposure to the uncertain gives the client a chance to respond differently in turn, to confront and try out something new while in a safe environment, and to open the doors of possibility-which is necessary before change can take place.The unknown and uncertain are inseparable from change.Sometimes we need someone who cares and who is trained to purposefully and beneficially introduce this uncertainty--someone who is not so entwined with our habitual life patterns and is therefore better able to offer a new response.The many different methods and traditions in psychotherapy are, in my view, simply different delivery systems for these crucial ingredients.I hope that this article will assist in opening up new perspectives on the nature, purpose, function, and helpfulness of psychotherapy.
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