Therapist

“ At present, the possibility of overcoming them depends heavily on clients themselves, their ability to find an approach to therapy that is appropriate for their personality and their goals or problems, and their good fortune in locating a therapist who is able to help them to summon the faith, energy, determination, and courage necessary to overcome their sense of demoralization. ”

“ Some approaches to therapy are most appropriate for treating certain problems or responding to certain personal interests; others are better suited to providing help with other problems and concerns. Choosing a therapist with an orientation that is right for you can be extremely helpful and can help you save much time, money, and energy. ”

“ The term psychotherapy is often used to imply more advanced professional training, whereas counseling is something individuals with more modest academic credentials may practice. Whether a professional is called a counselor or a therapist has to do with his or her level of training, with the setting in which services are offered, and, to a certain degree, with that person's theoretical orientation. ”

“ As we have seen, social work counselors, psychologists, psychiatrists, biofeedback therapists, hypnotherapists, and other therapists may all offer their services through private practice. In general, there can be definite advantages to counseling in the setting of a therapist's private practice. You are given a degree of personal care that, as an individual paying customer, you are less likely to receive in counseling provided by agencies. You become part of a therapist's own practice, so it is natural for him or her to devote special attention to you. ”

“ The therapist believes that, in time, and with proper treatment, {172} people who are imprisoned within walls of their own habits can rally the determination and faith to tear them down and to gain a measure of personal freedom. ”

“ They focus their energy and attention on pushing clients to confront the worst fears and catastrophes they can imagine. All the while, clients are aware both that the intense anxiety they experience is an intended goal of therapy and that the therapist is convinced they are much stronger than they have thought. ”

“ Their professional training and preferences in favor of one or several approaches to therapy also vary significantly.
As a result, what works for one patient will not necessarily work for another. What helps and who helps in one person's situation may not help in another's. Yet all three of the factors on which effective treatment depends—a patient's goals and problems, his or her personality traits, and the approach of the therapist—in many cases can be matched intelligently. You, as a prospective client, know a great deal about yourself ”

“ Because of their differences in training and personal or theoretical preferences, the distinct classes of therapists represent a diversity of approaches to therapy. There are numerous schools of psychoanalysis, psychotherapy, behavioral therapy, group therapy, and marriage and family therapy, and a range of approaches to personal adjustment, including exercise therapies, relaxation techniques, forms of meditation, and drug and nutrition therapies. ”

“ We have discussed the psychological tools with which the psychotherapist has to work but we have not spoken as yet of psychotherapy itself. All that we have studied has been by way of preparation; and yet the right preparation is almost the most important factor for the right kind of work. ”

“ But along will come some mental specialist, who in a half hour's talk with the patient, by a simple change in the patient's ideas, will completely make over the patient's life, and set going a new vital process which will restore the body to its former health. A religious enthusiast may do this, a psychotherapist may do it, a moral genius may do it; and the physician with all his learning will find himself like a man on the outside of a house, peering in through the windows and trying in vain to find out something about the life of the family and its guests. ”

“ Therapy involves a three-fold relationship among a helping professional, the approach to therapy used by him or her, and, what is most important, the outlook of the individual client. In this book we will examine each of these three dimensions of therapy in some detail, but here we will concentrate on the one therapists generally agree is the most important: you—the kind of person you are, what your attitudes and outlook are, and, of course, how much you really want to develop or change. ”

“ Yet before we analyze some typical symptoms, it might be wise to review the whole series of means and tools which the psychotherapist finds at his disposal. [Pg 184]
VIII
THE GENERAL METHODS OF PSYCHOTHERAPYContents
The psychological work of the physician does not begin with his curative efforts. Therapy is always only the last step. Diagnosis and observation have to precede, and an inquiry into the causes of the disease is essential, and in every one of these steps psychology may play its rôle. The means of psychodiagnostic are not less manifold than those of psychotherapy. ”

“ Often, when former patients are asked who helped them while in the hospital, instead of mentioning the therapist, they name a {255} member of the nursing staff. Psychiatric nurses have received special training in psychiatry and often are a major source of human warmth and caring. ”

“ The unprejudiced psychotherapist will be perfectly able to find room for such cures and, if it is the duty of the scientific physician to make use of every natural energy in the interest of the patient's health, he has no right to neglect the overwhelming powers of the apparently mysterious states. ”

“ Therapists can make specific recommendations, they can help a couple or family become explicitly aware of destructive patterns, they can point to and illustrate constructive ways of interacting, and they can sometimes use therapeutic strategies to break old habits and make room for care and sensitivity to the needs of wife, husband, and children. ”

“ Your attitudes will determine, probably more than anything else, what variety of therapy you will most benefit from.
Therapists, like teachers (which they really are) , find that their clients or patients can be divided into two groups: active and passive learners. When you go to a doctor with a broken arm, your relationship to your doctor is a passive one: you need only to cooperate as he examines your arm, perhaps administers an anesthetic, and sets the break. ”

“ Therapy is an intrinsically human process, one that is especially sensitive to the human dimensions of therapists. Later we will look at objective evaluations of the effectiveness of various approaches to therapy and weigh them against the emphasis that clients place on the personal qualities of therapists. ”

“ Therapists themselves claim that certain approaches favored by them have been shown to be useful for treating certain problems, for realizing certain goals, and for clients with certain personal qualities. ”

“ Implosive therapists make use of an equivalent technique with human beings. Patients are asked to imagine, as vividly as {166} possible, that they are facing the very thing they chronically have tried to avoid. ”

“ In the past twenty to thirty years, there has been a gradual shift away from a medical, illness-based orientation in therapy to one that focuses on personal growth. By no means everyone enters therapy because of emotional pain. Increasingly, therapists are seeing clients who enjoy psychological and emotional good health but believe that therapy can help them lead fuller, richer, more satisfying lives. ”

“ Group therapy is frequently offered, for example, by psychoanalysts, client-centered therapists, Gestalt therapists, transactional analysts, rational-emotive therapists and general cognitive therapists, existential-humanistic {189} therapists, reality therapists, Adlerian psychotherapists, emotional flooding therapists, and behavior modification therapists. ”

“ Above all, as the psychotherapist sees at once, it will occupy her mind, keep down anxiety and lessen pain in many natural ways, besides encouraging concentration of attention on muscular effort instead of on painful sensation. ”

“ Duration of treatment under a clinical or counseling psychologist is similar to that of a social work counselor. The best way to proceed is to ask prospective therapists how long they believe it will be necessary to see them. Most professionals will be open and candid; if the client's goals are specific and lend themselves to "brief" therapy, a psychologist will make this clear. And, as we have already observed, much depends on the type of therapy practiced by the psychologist. Behavioral therapies tend to be of shorter duration; psychoanalysis is longer-term. ”

“ You doctors, all of you, constantly practice psychotherapy, even when you do not know it, or do not intend it, but it has one disadvantage, you leave entirely to the patient the psychic factor of your influence. ”

“ Place of Psychotherapy in Treatment.—The role of psychotherapy, then, in heart cases consists in the recognition of the part that the mind, the will and the emotions play in their influence over this important organ. These psychic factors may produce disturbed conditions of various kinds. The more experience the physician has with cardiac cases of all kinds, organic as well as functional, the more powerful does he recognize the influence of the mind over the heart to be. The expression that a man is living on his will is no mere figure of speech. ”

“ This is what must be done with regard to psychotherapy also. Just now its importance is being exaggerated by ardent advocates. In every department of therapy this has always been done by enthusiasts. The business of the practicing physician must be to select what is best, and above all what is sure and harmless, from the many suggestions offered, so as to build up a practical body of applied truth. ”

“ It has remained for modern psychotherapy to strike the balance—to treat the whole man. Solidly planted on the rock of the physical sciences, with its laboratories, physiological and psychological, and with a long record of investigation and treatment of pathological cases, it resembles the mind cure of earlier days or the assertions of Christian Science about as much as modern medicine resembles the old bloodletting, leeching practices of our forefathers. ”

“ The great physicians employed psychotherapy very commonly, and on that account many of their disciples were inclined to think that they were neglectful of medication and other remedial measures. At all times physicians have had to be large-minded and have had to recognize the limitations of medicine in {3} their own time, to turn to other agents and to appreciate how much their own influence on the patient and that of the patient on himself meant for the relief of symptoms and the increase of resistive vitality. ”

“ Wherever a psychical factor enters into the calculations of the physician either by reason of its own abnormality or by its relation as effect or as cause to a diseased part of the body in the brain or without, there we have a psychomedical task, and as far as it is therapeutic, we have psychotherapy. ”

“ You cannot apply treatment from without and expect that the patient will get better. The situation is much more complex than this. The patient—let's shift at this point to calling him or her the client—is much more actively involved in the process of psychotherapy than is a patient in medicine. ”

“ To some physicians a patient will present only conventional symptoms, while a follow practitioner will discover the elements of an interesting case. Above all, the painstaking physician, interested in psychology, will find mental and other personal manifestations in his patient that distinctly modify the course of the disease. We must know all that is possible about the patient's attitude of mind toward his malady, and all the ideas that he has acquired with regard to it, either from previous relations with physicians or from what he may have read or heard from others. ”

“ The patient understands every suggestion, he concentrates on the problems that the treatment requires him to solve, reminiscences and ideas flood his mind. The physician is surprised by the certainty and depth of these interpretations and notices with satisfaction how willingly the sick man receives the new psychological facts which are so hotly contested by the healthy persons in the world outside. An objective improvement in the condition of the patient, universally admitted, goes hand in hand with this harmonious relation of the physician to the patient under analysis. ”

“ Just in the same way, our psychotherapy must be dosed out according to the special need of each individual, the form of the affection and the particular kind of mind that is to be dealt with. To learn the place of mental influence in healing, so that we shall not be attributing to other therapeutic factors what is really due to the mind, will be a great advance in therapeutics. ”

“ Success in mental healing depends upon proper mental conditions, just as success in healing by physical agencies depends upon proper physical conditions. This is a self-evident proposition, which the average mental healer is slow to understand and appreciate.
The success of the physician depends as largely upon his knowledge of the idiosyncrasies of his patient, his personal habits, his mode of living, his susceptibility to the influence of medicines, etc., as upon a correct diagnosis and medicinal treatment of the disease. ”

“ According to the Patient. The treatment varies according to the nature of the trouble, and is somewhat dependent on the mentality of the patient. There are many people who would only be confused by being forced into a study of mental phenomena. Not being students, they would be more bewildered than helped by the details of their inner mechanisms. Others, of studious habits and inquiring minds, are encouraged to browse at will in a library of psychotherapy and to learn all that they can from the best authorities. ”