WHAT IS PSYCHOTHERAPY?
Our professional counselors have the advanced training and experience that will help you with any concern you may be experiencing. We also offer something a little different: psychodynamic talk psychotherapy. Talk psychotherapy differs from other forms of therapy in several important ways. It looks at the whole human being and at the many complex factors that have contributed to making each person unique. because it focuses on the inner workings (the dynamics) of the person. Symptoms such as anxiety or depression, are viewed as signs something is hurting inside—that some part of the person needs attention, and can possibly benefit from individual talk psychotherapy.
Psychotherapy assumes the existence of the unconscious mind. This notion refers to the part of our lives of which we are usually unaware and includes dreams, hidden memories and assumptions, and subtle reactions to current experiences. In these shadows of our daily lives reside many of our old wounds as well as much of our untapped creative energy. As we become more aware of what is hidden inside us, we can resolve or come to terms both with internal conflicts and reactions to external events; we feel in better possession of ourselves and more empowered to make positive and life-affirming decisions. Creative energies no longer need to be spent on keeping old troubles in control, and there is more energy for love, work and play.
Another feature of psychotherapy is an emphasis on what is called "working through". Hidden, painful memories, for example, often block aspects of a person's natural development. In individual psychotherapy these blocks in our development are gradually revealed. The damaging impact of troubling early life events is examined and "worked through" in the safety and compassionate attention of the therapeutic relationship until the events are more thoroughly understood. You can see past and present events and people more clearly, and feel more whole and intact—and empowered to live more fully. You can understand old patterns and choose, for example, to relate to others in a different way. Within the confidential boundaries of therapy the honesty and courage necessary for this kind of understanding are discovered and encouraged. Having learned to know who you are—independent of other people's definitions of you--you can creatively and capably assert your own opinions and points of view.
HOW DOES PSYCHOTHERAPY WORK?
Life is not perfect. Often our experiences—especially our formative experiences—have interfered with our ability to work, love, and play with effectiveness and pleasure.
Individual psychotherapy affords an opportunity to uncover, explore, learn about and appreciate our perceptions, our hidden assumptions, the ways we have adapted to life—and how all these have come about. The exploration leaves us freer to develop aspects of ourselves and to make the life choices that improve the quality of our involvement with our activities as well as with the people around us.
In the process of psychotherapy, you can see beneath the surface and integrate intellectual understanding with your emotional experiences. The confidential psychotherapy session grants a freedom for your thoughts and emotional experiences to flow freely, a process sometimes referred to as "free association." In this free flowing process, thoughts and feelings about the psychotherapist often emerge; when they do they create a window through which you understand your inner processes more directly. You and your therapist jointly examine these moment-to-moment experiences in a non-judgmental manner that provides exciting new understandings about your experience of the world.
The exploration of the moment-to-moment feelings that arise in the psychotherapy session, including your feelings about the therapist, has another benefit. You are able to experience and "practice" the complexities of relationships in a safe, protected relationship with the therapist. This process should "transfer" gradually to other relationships in your life.
Psychotherapy offers a new drawing and a new freedom. Some have referred to this experience as awakening of the inner self, part of which has been hidden. This awakening is often slow and subtle. It is not a consistently ecstatic experience though there are moments of important insight and emotional surges that go with the insight. The process gradually becomes internalized, and goes with you after the therapy is completed, affording you new freedom for personal involvement in work, love, and play.
WHAT IS THE PSYCHOTHERAPY EXPERIENCE LIKE?
In this section, we will attempt to address the nature of the psychotherapy experience from the client's point of view. What actually happens in the day-to-day process of psychotherapy?
What are the client's responsibilities in therapy, and what might he or she actually do? What are the therapist's responsibilities, and what does he or she do-and not do?
WHAT DOES THE CLIENT DO IN PSYCHOTHERAPY?
Once you are assigned to a therapist with experience and advanced training at The New York Counseling and CSW Service, P.C. he/she is likely to be a useful guide through your unexplored territory, the work can begin. What do you do next?
Your primary responsibility in psychotherapy is to work toward becoming more aware of your experiences, thoughts, feelings, and memories and to talk about them during the therapy session. These experiences, thoughts, and feelings may be about any aspect of your present or past life; about the therapy or the therapist; about night dreams, daydreams and fantasies; about hopes, joys, sorrows, fears, and relationships—anything that may come to mind during the session, with as little filtering or censoring as possible. Although "preparing" for therapy sessions by creating an agenda or deciding what to talk about is a common practice among people who are beginning individual psychotherapy and concerned about "doing it right," people sooner or later come to trust that the process itself will bring to mind useful material. Sometimes it is the sequence of topics that are mentioned or events that appear to be "forgotten" that provide important clues to what is going on for you below the surface. It may take time for you to trust that your therapist is vitally interested in your most ordinary—or unusual—experiences and that she or he will not be judgmental or shaming no matter what you reveal or talk about.
It is sometimes particularly useful to report and talk about dreams, uncomfortable feelings such as anger and disappointment, and feelings of warmth or longing. Dreams can provide a useful window on your hidden inner life. Feelings about the therapist may have originated in relationships with important people in your past experience and are often linked to important memories. The therapist will therefore encourage you to talk freely about—rather than act on—feelings you may have about him or her.
The process of revealing thoughts and experiences that are uncomfortable, painful, or laden with shame or guilt is important in the course of therapy. Indeed, simply talking at length about the details of such experiences in the presence of someone who is interested and empathic tends to be helpful, in that it reduces the degree to which you feel alone in the experience or ashamed of some aspect of it. Revealing joyful experiences or points of pride and delight is also important. You and your therapist together work toward a compassionate attitude about aspects of yourself you have difficulty tolerating or understanding. This change is virtually always accompanied by anxiety, uneasiness, and resistance. Thus, psychotherapy does not move at a regular pace. It is not an intellectual problem-solving process, but a process of gradual exploration of emotions, thoughts and ideas, impulses, dreams and actions—all of which add up to the complex whole that is your inner experience.
WHAT DOES THE THERAPIST DO (AND NOT DO) IN THE COURSE OF THERAPY?
The purpose of the psychotherapy process is to provide understanding, freedom, and empowerment and to provide a safe context in which you can develop aspects of yourself that have not received appropriate attention in the past. It is this agenda of understanding and empowerment that guides the therapist's decisions. The therapist is always mindful of and interested in the unique nature of your present and past experiences, reactions, and feelings, and the particular ways these have been integrated. These therapists have undergone intense training, and are here to help you.
The therapist creates the context in which the work unfolds. After you and your therapist decide to work together, you agree on a contract that serves as a framework for your work. Issues such as frequency and time of sessions, fees and payment, use of insurance, vacations, appointments cancellation policy, and confidentiality are discussed. This basic contract and the regularity of sessions provide the beginnings of the sense of safety that is necessary for the work to proceed. Thus the therapist begins and ends sessions on schedule and monitors the various aspects of the basic contract.
The primary task of the therapist in psychotherapy is to listen with careful attention and without judgment or evaluation to everything the client brings to the therapy hour. The therapist listens not only to the content of what the client is saying, but also for the meanings that may lie under the surface and for feelings that may accompany the client's report of her or his experiences. The therapist listens to appreciate and understand, and thus helps create a process of careful inquiry in which the client and the therapist are vitally interested partners. The therapist may also ask questions or make statements that suggest ways to understand what is going on. He or she may respond to indicate understanding of your thoughts and feelings. The degree to which the therapist acts as a quiet listener or as an active participant depends on his or her understanding of what will be helpful to you as well as on his or her individual style.
In psychotherapy, the therapy experience is primarily for the client—not for the therapist. For this reason, and because this stance is useful in other ways, most therapists tend to reveal relatively little to clients about their personal lives or personal opinions on matters irrelevant to the therapy. The therapist's personal needs or wishes are not part of the relationship; the therapist meets these needs with people who are not clients. The client is best served by making life decisions independently of any opinions the therapist may have, with the therapy providing a context in which those life decisions can be clarified and understood. For the same reason, the therapist will generally be reluctant to "enter the normal life" of the client by accepting invitations, serving as a witness in legal actions, talking with the client's associates, and so on.
Individual psychotherapy is an intensely private matter, and works best if it is thought of and kept that way. The therapist, therefore, assiduously maintains the privacy of the relationship with the client. There are unusual situations in which the law requires the therapist to break confidentiality. The therapist will discuss these limits on confidentiality with you if it seems relevant to do so. In general, however, the privacy of the client-therapist relationship is protected by the therapist's code of ethics. The use of insurance sometimes limits this confidentiality, and the therapist may bring this possibility to your attention.
THE FEAR OF BECOMING DEPENDENT ON THE THERAPIST.
Prospective psychotherapy clients may have a variety of fears or concerns at the beginning of therapy. We discussed some of them earlier, such as the fear of being judged by the therapist or of being shamed by the feelings that arise in the process. What is most important is that any fears you may have should be discussed as openly as possible with your therapist.
One common concern felt by clients is that they will become dependent on the therapist and will have difficulty "making it on their own." There are good reasons for this concern.
Many people are, for a number of reasons, uneasy about feeling dependent on another person. Yet feelings of dependency are part of the human experience of virtually everyone, since they are rooted in infancy and early childhood (when dependency is necessary). The therapist will be interested in such feelings—just as he or she is in any other feelings. In reality, the therapist is committed to empowering you. Feelings of dependency in individual psychotherapy are transitory, and therapy does come to an end when you and the therapist decide the time is right.
For information about child/adolescent, group and couple therapy click on the links. Our therapists have years of training, and are here to help.