Psychotherapy

Psychotherapy

I have been thinking about the best way to describe psychotherapy and I think the way I want to do it is through my own experience. My training program encouraged psychiatric residents to do their own psychotherapy. We were told that this would help us understand what patients go through in psychotherapy but it was so much more.

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I was cautiously curious about psychotherapy because I come from a culture where talking about oneself was done in indirect ways and often done in a group setting if at all.  So this idea of having a one on one experience was exciting and terrifying.

Like many of you, I started psychotherapy with vague expectations and vague purposes.  The working theory was that psychotherapy would make me a better psychiatrist because

  • I would have an understanding about what my patients go through in psychotherapy
  • I would learn to see the impact of my own feelings on clinical decisions and thus separate myself

What I learned was that psychotherapy is really tough.  It does not have to be tough but for me it was.  It was weird knowing I was paying for someone to listen to me. That was the basis of our relationship. This seems so artificial, not like real life but it was amazing that what came out of it was a true reflection of how I live and how I think.

Psychotherapy was a laboratory where I was invited to scrutinize how I conduct myself.  In the “real” world, we just don’t do this on a deep level so psychotherapy was a way to stop time a little and really observe.

I really listened to how I introduced myself to the psychotherapist, how I told him about me, how I answered or asked questions. As I was graduating, I learned how I tended to say good-bye.  I paid attention to what I was really thinking versus what would come out of my mouth.  I observed what would make me feel uptight, defensive, vulnerable.

The experience made it clearer to me how I approached other people, certain expectations I had about how they should act.  As I understood better how I approached life, I understood better how life approached me.  I learned what I felt comfortable asserting myself and when I felt I had to hide my own wants.

No matter what kind of psychotherapy you do, I want you to think of psychotherapy as a safe set of 4 walls where you can be totally yourself.  It is a place for you to explore how you tick:  what propels your forward in life and what holds you back.

How does this information better your life and solve your problems you ask ?  Life is all about managing  yours and others expectations.  It is about getting your needs met.  It is about dealing with the responsibility when those expectations are met and reacting to disappointment when the unexpected happens.  Psychotherapy helps you to be brutally honest with yourself about patterns in your life.

Once you see certain patterns and maybe why those patterns exist, you can then decide if there is anything you want to do about them.

This question of whether you are going to do anything about your newly learned information is the side effect of psychotherapy.  Side effects with regard to medications refers to unwanted effects such as nausea or weight gain.

In psychotherapy, the side effect is insight.  Once you have insight, it’s tough to ignore.  Gaining insight does not meet you need to change.  People tell me they avoid psychotherapy because they don’t want someone telling them they should leave their husband or kick their son out of the house.

What people don’t tell you about psychotherapy is that you will be coming to your own conclusions and however, you act on them is okay.  For example, let’s say you come to the conclusion that you should leave your husband but you do not.  That’s fine because by the time you have real understanding of your situation you will have understanding and not judgment.

Here’s a brief Primer on different kinds of psychotherapy.  Most psychotherapists will incorporate aspects of multiple kinds of psychotherapy throughout.

Cognitive Behavioral Therapy (CBT) focuses on how your thoughts, feelings and behaviors are related.  CBT usually involves homework between appointments that help you apply the techniques or gather information about your issues.  You then can understand what drives you and you can also start to understand that others are like minded or different in their way of thinking.  As you understand that people come at issues from different thoughts, feelings and behaviors, you can learn to communicate better with yourself and others.

Psychodynamic Psychotherapy is also known as insight-oriented psychotherapy.  It focuses on helping you understand how your past influences your present day values and how these them lead you into the future.  Having an understanding of your own history, your own story can help you accept and modify your situation so you will participate fully in creating your future.

Family or Couples Psychotherapy focuses on looking at family or couple as a system and the goal is to make the system work optimally.  This can be done in the context of stable relationships, separation, divorce, blended families, etc.  Blame, pointing fingers is not a therapeutic technique because every member is vital to the system’s stability or conflict.

Ketamine Associated Therapy (KAT) is a specialized psychotherapy with someone or a group who are all feeling the effects of this rapid acting medication.  This therapy uses these effects to guide you through the issues in your life that make you feel “stuck.”  Its transcendent properties can elevate mood and often there is a feeling of separation from your ego that helps you see situations more clearly. It may be hard for many to see how this can transform their lives so quickly but this treatment can open your mind and senses. We are the first office in this area to offer KAT.