“Psychotherapy is too risky”

Myths about psychotherapy: Number 3

Why doesn’t everyone have psychotherapy? Is it because some people are suspicious of, or even hostile to, psychotherapy? I think the answers to these questions are based on misunderstandings.

I sometimes hear people say that psychotherapists “mess with your mind”. Well ok, it is true that psychotherapists seek to bring about changes to harmful thoughts, hurtful feelings and damaging behaviours. But in every case the person doing the changing is the client not the psychotherapist.

Another concern is that psychotherapists follow ‘crackpot’ theories that at best do nothing and at worst cause harm to the very people they are supposed to be helping. In their training psychotherapists learn to evaluate a range of approaches. In doing this they find out what is useful in these approaches, and to recognise and avoid potential pitfalls. At the end of their training psychotherapists tend to adopt one or two of the approaches studied following certain figures and practicing particular psychotherapeutic techniques.

Related to this is the fear that psychotherapy is a waste of time. This is sometimes expressed in the form “All that time and all that money to just talk about my problems” or “I’ve given away all my secrets for nothing”. At the surface level this may seem to be true. You will spend a lot of time talking about very personal things. Yet psychotherapy is not simply talking. Psychotherapists are trained with people like you in mind. They are trained to know what they can and what they cannot do. Their knowledge expands and deepens with experience.

And they are aware of the risks. Your psychotherapist will begin with an assessment session to judge whether they are the right person to offer you psychotherapy. You will then spend some time discussing the issues you are bringing to your psychotherapy. From this, you will together agree a plan for your sessions.

You will always be in charge and should always feel in charge of your psychotherapy. To make sure this happens your psychotherapist will check-in with you at the start of each session. They will also check-out with you at the end of the session to see how you are feeling and to ask if you want to say anything further.

Where your psychotherapist thinks there could be beneficial changes to your sessions they will suggest these changes in advance. They will ask whether you agree to the proposed changes and if you don’t agree to adopt these changes then they will not be adopted. Your psychotherapist will remain open to your views throughout your time together. They will hear you and keep your psychotherapy safe.

Claude Steiner

How to live free from script

Claude Steiner (1935 – 2017) developed Transactional Analysis (TA) to include more of the social aspects of our experience and the ways in which how our life history affects the way we interact with others.

In “A Warm Fuzzy Tale” (1969) he used a fairytale format to explore the impact of different human interactions. When people give each other “warm fuzzies” (Berne’s positive strokes) they flourish. When fuzzies are withheld, rationed, or replaced with plastic fuzzies (e.g. giving a child sweets instead of attention) or “cold pricklies” (negative interactions) people, and the societies they live in, are damaged.

In “Scripts People Live” (1974) Steiner explored how the messages we give ourselves (or are given by others) in childhood (such as “I am boring” or “I am more intelligent than other people”) can be carried through the years and become part of their “life script” forming important parts of their self-image and affecting their personality.

These script messages may no longer be true – if they ever were – yet people may go on believing them and behaving in accordance with them. This can damage relationships. For example, the message that “strangers are dangerous” may help keep you safe when you are young but can be unhelpful when you are an adult forming mature relationships.

Recognising when we are following a script and learning how to stop following the outdated messages enables us to move into the present. In this way Steiner’s approach helps us understand how we may have become anchored to the past, how we can learn to move into the present, and how we can make a future for ourselves that is happy and fulfilling.

Steiner’s last words were “Love is the answer”.

“My friends can give me all the help I need”

Myths about psychotherapy: Number 2

Nurturing social support from loved ones and friends is an important part of maintaining our mental health. Our needs, however, sometimes go beyond these relationships. When they do, we can benefit from professional assistance.

Psychotherapy may seem similar to friendship. There are however some important differences. Like your friends, your psychotherapist will listen to your feelings about your current concerns. Unlike your friends, psychotherapists are trained to talk with you in ways that will help you to acknowledge your true feelings and to find positive ways forward. In doing this your psychotherapist will be empathetic and non-judgmental. They will not tell you what to do or offer to do it for you.

In friendship your friends’ needs and interests are as important as yours whereas your psychotherapy is all about you. Everything your psychotherapist does is directed towards helping you.

Friendship does not need a plan or purpose beyond enjoyment. So, with your friends, you can relax, have fun, play sport or visit different places. In contrast, psychotherapy is planned and purposeful, moving towards one or more mutually agreed ends. And with your psychotherapist, you can only do psychotherapy. Your psychotherapist may be friendly, but they are not your friend.

Some of your private thoughts or feelings might appear hurtful or shocking if they were said to a friend. A psychotherapist is a trained professional who understands that we all have unpleasant thoughts and feelings. They know that talking about them in a safe space is important and helpful. They will not judge you.

Sometimes you may not know what you truly think about someone or something. Your friends may assume they know your thoughts already and rush to find quick fixes. Your psychotherapist will sit with you, listen and help you to clarify your thoughts so you can come up with the right solution for you.

Eric Berne

An introduction to the founder of Transactional Analysis (TA)

Eric Berne (1910 – 1970) trained as a psychiatrist. He became interested in the Freudian tradition and went on to train as a psychoanalyst. Berne had psychotherapy with Paul Federn. Though Federn was a close colleague of Sigmund Freud he had a different understanding of the ego and believed that people could consciously engage with it.

Berne developed these ideas and ended up rejecting Freud’s notion of unconscious processes. He believed that people could learn to recognise what was happening and change the way they responded. He wrote a series of articles on this topic which led to the San Francisco Psychoanalytic Institute refusing him full membership.

Berne decided to pursue his own path in psychotherapy, focusing on the importance of social interactions in nurturing or damaging our mental health. Berne referred to this way of working as ‘Transactional Analysis’ or ‘TA’.

With Transactional Analysis Berne replaced Freud’s Id, Ego and Superego with Child, Parent and Adult ego states. The Child ego state expresses our feelings and emotions. The Parent ego state represents the orders and rules we have been given or have given ourselves. The Adult ego state represents how we are and what we are learning.

When we are in the Adult ego state we can modify our feelings and question our desires. In this way we may come to feel differently about ourselves and behave in a more psychologically healthy way.

In my work as a psychotherapist I find Transactional Analysis to have certain limitations such as the sometimes confusing use of the terms ‘child’, ‘parent’ and ‘adult’. Nevertheless, I find Transactional Analysis to be a very useful way to understand and to explore our psychological lives.

“Psychotherapy is only for crazy people”

Myths about psychotherapy: Number 1

As much as I’d prefer not to use words such as ‘crazy’ or ‘mad’ they keep on coming up time and again in phrases such as “Psychotherapy is only for crazy people” and ‘You have to be mad to see a psychotherapist”. In fact, I’d say that such words speak to the most common misconception there is about psychotherapy. So, allow me to tell you how I see this.

Just as everyone has physical health, so everyone has mental health. Just as you can work on your physical health so you can work on your mental health. When you face challenges with your physical health you seek appropriate professional support. Similarly, when you face challenges with your mental health you should seek appropriate professional support.

No one is perfect. Your capacity to function varies from area to area. You may be very practical and not so sympathetic. You may be very sympathetic and not so practical. This means there are many reasons for you to come into psychotherapy. Perhaps you want to form a lasting relationship or start a family. Perhaps you are wondering about a career change or retirement. Maybe you are coming to the end of your life or maybe a love one has recently passed away. Psychotherapy is not just about anxiety or depression or for people who are in crisis.

Psychotherapy offers you the opportunity to understand yourself better. In coming to this understanding, you will come to appreciate certain things about yourself both positive and negative. With this understanding comes the ability for you to address longstanding and unnoticed unhelpful beliefs and damaging behaviours. This in turn will offer you the opportunity to move towards a happier and more fulfilling life. In psychotherapy, everyone can grow.