What does being “in therapy” even mean?
It’s become somewhat mainstream to talk about being “in therapy” or to start a sentence with “my therapist says…” While it’s great that much of the stigma around “seeing a therapist” is decreasing, it’s concerning that there isn’t much consensus on what it actually means to be “in therapy.”
“Therapy” is a general term, much like “exercise.” There are literally hundreds of ways that one could exercise, much as there are hundreds of types of therapies out there. It narrows it down a bit to say “psychotherapy” as most people assume that this involves some form of “talk therapy” to address mental health concerns.
But even the word psychotherapy carries dozens of different connotations. Within the umbrella of what is referred to as psychotherapy are hundreds of different therapeutic modalities, approaches, techniques, and people with several different professional designations all claiming to do more-or-less the same thing.
To complicate matters further is the popularization of “therapy culture” on social media and now so-called “AI therapists” (i.e. algorithms that can give you the illusion of talking to another person). Large corporations and tech start-ups claim to offer “better alternatives” to traditional psychotherapy, when what they offer is, on average, an inferior service compared to a genuine psychotherapeutic relationship with a competent psychotherapist.
Let’s compare two short videos to see the stark contrast in what can be meant when referring to psychotherapy:
Notice the call to professional authority: “I’m a psychologist, and this is what happens in trauma therapy.” Notice the promise: “What you’re left with is a neat little pile of memories that fit neatly at the bottom…” Sounds pretty perfect, doesn’t it?
Contrast that with this video (a significant moment in a fictional psychotherapy session from the show In Treatment):
This video (dramatic as it is, background music and all) exemplifies the depth of knowing another person that can only come over the course of time in the context of a genuine human relationship. It leaves you with a bit of a different impression of what psychotherapy is really all about, doesn’t it?
So what is psychotherapy?
At its core, psychotherapy is a process that occurs within the context of a supportive, therapeutic (healing) relationship in which one person (the therapist) helps another person (the client/patient) to increase self-awareness and in doing so creates the opportunity for them to make positive changes in themselves and their life. The process usually involves confronting and overcoming some particular challenges that the client/patient is facing, which may include examining and modifying patterns of thinking, behaviours, ways of relating to self and others, and processing emotions.
This is not the same thing as supportive counselling, life coaching, or giving advice. Many people can offer these things, and sometimes they can be helpful – but it’s not what competent, highly skilled psychotherapists do.
Skilled psychotherapists listen very deeply to their clients/patients (to both what is said and not said) in the here-and-now of the therapeutic relationship in order to better understand them and to help them to better understand themselves. This is done in service of giving people the opportunity to meaningfully address the problems and challenges that bring them to therapy.
Meaningful psychotherapy is effective because it happens in the context of a real, human relationship where the therapist gets to know their client/patient very deeply. This depth of knowing is necessary so that the therapist can offer observations, interpretations, and insights that allow the client/patient to see things about themselves that they couldn’t see on their own. We use our professional expertise to help people to see how they are getting stuck in life and what it is about themselves that may be contributing to their difficulties. And we offer realistic hope that with hard work and commitment to the process, people can heal, grow, and change for the better over time.
This article was written without the use of generative AI. The featured image for this article was created using ChatGPT.
