Starting Psychotherapy
Therapy: Healing vs Symptom Reduction
“Therapy” comes from the Greek word therapeia, which means to "serve" and to "heal." In ancient times, healing was largely a holistic approach. Modern health sciences, however, tend to equate treatment with symptom reduction ("has your anxiety lessened?"), which deviates from the idea of healing the person ("do you feel good about yourself and your life?"). Such distinction is relevant when choosing your treatment modality, as the therapeutic work that ensues will look quite different. For example, behavioral therapy will treat depression via behavioral modification (e.g., prescribing pleasurable activity 3 times a day), whereas family therapy will restructure family dynamics as a way to alleviate depression in a family member. The former is a symptom reduction model, the latter a healing model.
Psychoanalysis & Psychotherapy: Then and Now
The work of Sigmund Freud (1856-1939) marked the birth of talk therapy. Through conducting psychoanalysis, he provided evidence for the then-revolutionary idea that talking can cure. In the TV series COUPLES THERAPY, modern-day psychoanalyst Dr Orna Guralnik documents the healing power of psychoanalytic work.
It is estimated that there are now between 400 and 500 types of psychotherapy being offered. Cognitive Behavioral Therapy (CBT), Psychodynamic/Psychoanalytic Therapy, Humanistic Therapy, and Family Therapy are among the longest-established ones.
How Do I Know Which Type of Therapy Works for Me?
That’s a great question. But there is no one-size-fits-all answer (as in "if you have an allergy you take an antihistamine"). Some people start with researching about a particular modality (like CBT or DBT), and see if that approach makes sense to them. Some people would watch youtube videos to find out what it is like to experience a particular approach.
Goodness of Fit between a Patient and Therapist
Research suggests that the best predictor of therapeutic success is the relationship between a therapist and a patient.
According to Helen Veazey,
“Goodness of fit refers to the alignment between a therapist’s therapeutic approach and style and a patient’s needs and values. Such an alignment will likely make a patient feel more comfortable with and understood by their therapist. The goodness of fit contributes to a strong therapeutic alliance, or emotional bond between patient and therapist, and is a key factor in treatment success.”
How Do I Find My Fit?
Some therapists offer a 15 mins free phone consultation. (I don’t provide that.) That’s a pretty risk-free way to experience a therapist. Apart from the time and energy, you really have got nothing to lose. However, the duration is far too short to properly evaluate a goodness of fit. But still, it's a place to start.
People who decide to work with me tend to say there is something about the writing on my website that resonates with them. They also say they have seen other therapists before me. I think it is safe to assume that most people will see a few therapists in their life time. So, if you can’t find your fit at the first go, rest assured that’s well within the norm.
How Do I Evaluate if It's a Fit?
Some core questions to ask are:
- Do I feel comfortable talking to my therapist?
- Do I feel understood and connected?
- Do I feel my therapist cares about and is invested in me?
At the end of the day, I think for most people it boils down to a gut feeling, a sense of hope that borders on faith, that this person can help me and I can trust this person.
The second pointer to bear in mind in the beginning phase of a therapeutic engagement is “Am I having a new experience?” This new experience doesn’t necessarily mean change, as change takes time. But it could mean, “Oh, so, this is how it feels to be seen!” or “This is what that meant, huh, interesting!” In other words, the therapeutic encounter opens up something in you: it can be a new found curiosity, a new perceptive, a new sentiment or attitude. An example would be, “I thought I was an angry person. I didn’t know it comes from a place of wanting to protect. Knowing that, it makes me sad rather than ashamed.”

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