Any form of psychotherapy must be guided by one overarching purpose: to help you, the patient, achieve that which you are seeking. Treatment must alleviate pain and suffering and it must result in greater self-realization and inner strength. Accordingly, therapy must be a constructive experience, and as work proceeds, there should be advances in your sense of well-being. Inevitably, as part of the process, there will be a reliving of childhood traumas and other painful episodes, but on the whole there should be an upward trend characterized by hope and greater self-esteem. Your capacity for intimacy in human relations and your enjoyment of life should increase, concomitant with a decrease in suffering and pain. Clearly, a therapeutic process in which such changes are conspicuously absent is cause for concern.
Analytic therapy obviously must deal with your past developmental history, but in doing so the therapist must seek to forge a link between the present and the past in order to help you understand the present in terms of the past. Nevertheless, it is essential that the focus of any therapy rest in the present and that it help you deal with contemporary conflicts and difficulties. It may be stated categorically that any therapy worthy of the name must effect changes on (1) your sense of well-being and (2) the quality of your interpersonal relationships—experienced as more harmonious and satisfying. Reconstructions of the past may, and often do, play a part in such results, but they can never be a substitute.
Therapy will fail if the therapist becomes an impersonal technician whose primary recourse is to the technical literature, who treats his or her craft as a “business,” or whose objective is to ferret out “pathology.” The ideal of analytic psychotherapy is the superimposition of a special, significant human relationship upon an earlier significant relationship for the purpose of modifying certain maladaptive and self-destructive thoughts, feelings, and actions. The new relationship can have a therapeutic effect to the extent that it meets important psychic needs and to the extent that it produces corrections in one’s cognitive structure.
What often complicates the therapeutic task so immensely is one’s pervasive unawareness of precisely those mental/emotional structures that are having the most profound impact on his or her experience and behavior. It is this tendency for self-deception that disguises and hides from oneself and others that which is most important to know clearly. Essentially, a good therapist must be able to recognize and support your positive qualities and strengths, particularly during turbulent periods. The therapist’s acceptance cannot be feigned, pretended, or hidden by a stance of “therapeutic neutrality.” Either it is present or it isn’t—and you will feel the difference.
An essential prerequisite for meaningful psychotherapy is the sense of collaboration, partnership, and alliance. No technical discussion can drive home the point more glaringly that therapy is doomed unless the therapist succeeds in enlisting you as an ally in a joint endeavor. Unless you can develop sufficient trust in the benign qualities of the therapist as a reliable helper, there is little chance that you will collaborate in the arduous task of permitting yourself and the therapist access to the source of your difficulties. The paradox is that while we are eager to find out what is so troubling, we are equally committed to the proposition of opposing change. Therapeutic work therefore entails, to an important degree, the erosion of those barriers by which you may be perpetuating your patterns of thinking, feeling, and acting. There is a well-recognized reciprocal relationship between the growth of trust and weakening of defenses—those same defenses that have been so protective and so critical to your very survival for so long. This conundrum challenges us to begin to trust once again and reestablish a profound, meaningful and healthy sense of connectedness with our world and those in it.
Jed Turnbull & Psychotherapy 