Just as there are many different types of counseling and therapy, there are many different purposes to which clients may put their therapeutic work. Some are more conducive than others to positive change over the long haul.
There is evidence that various forms of therapeutic human interaction (e.g., “counseling” and “supportive communication”) date back to the early Hellenistic Period. And deliberate, structured, efforts to help people overcome psychological distress can be traced back to as early as the 8th and 9th centuries. But modern psychotherapy, which literally means “healing of the mind or soul,” arose out of techniques employed by various disciplines in the mid 1800s to early 1900s, and gained real prominence with the psychoanalytic orientation subscribed to by Sigmund Freud and some of his associates and followers.
Psychotherapy comes in various forms, some of which appear to have somewhat better applicability in different situations. Psychoanalytic techniques often focus on dream interpretation and free association to uncover unconscious concerns and conflicts. Other psychodynamically-oriented approaches focus on helping individuals become more consciously aware of the role unconscious conflicts play in current problems and symptoms of distress. Existential approaches address the inherent anxiety in feeling that one is alone in an indifferent universe and attempt to facilitate the process of finding meaning and purpose in life and defining values. Humanistic approaches, ever focusing on the worth of each individual, attempt to help persons develop their full potential and become maximally self-actualized. Cognitive approaches focus on the kinds of impact various thinking patterns can have on how we feel and how we behave. Behavioral approaches target habits that have become ingrained but which are nonetheless maladaptive, and cognitive-behavioral approaches utilize aspects of both cognitive and behavioral therapy.
Just as there are many forms of psychotherapy (and I have mentioned only a few of the major ones above), there are many reason why people seek therapy, and many ways in which they use the therapeutic process. Some folks come to therapy seeking relief from emotional or psychic pain of some sort. For one reason or another, they find themselves hurting inside and want to feel better. Still others seek the counsel of a therapist not so much because they are unhappy, but because they see the enterprise as a vehicle by which to grow and become even more fulfilled than they already are. Still others come to the process because they have been pressured to do so by others who see them as “broken” or dysfunctional and are determine to get them “fixed.”
During the years that I actively practiced as a therapist, I could not help early on but take note of two very different types of clients, each of whom appeared to have a distinct purpose for engaging in therapy. One type of client appeared not only actively engaged in the “process” of therapy during sessions but also in the endeavor of using insights and skills acquired during sessions to make a meaningful difference in their lives. The other type appeared to really relish sessions as an outlet for venting frustrations and concerns, allowing them to feel better for a brief period, but because they used the enterprise primarily as a vehicle for relief, they did not develop or maintain sufficient motivation for genuine positive change. And it did not take long for me to realize that I could easily become complicit in this ultimately self-defeating enterprise.
Affording folks the opportunity to gain relief while not actively encouraging positive change can be very good for business, but it’s ultimately not very good for anyone, especially a psychotherapy client. It’s a bit like providing someone with cholesterol-lowering drugs while they continue to pig out on “grease burgers” or re-balancing someone’s biochemistry with anti-depressants or mood stabilizers while they continue to engage in mood-imbalancing thinking or behavior patterns.
Ultimately, the decision of how to use the therapeutic enterprise lies with the client. But therapists have a lot to say about what kinds of agendas they will or will not enable or reinforce. In the end, every psychotherapeutic enterprise is a “contract” between the person seeking the service and the service provider. Over the years, it’s been very edifying for me to witness the power and benefits that can come from a thoughtful, principled contract that is specifically informed by what I’ve just outlined.
All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by Dr Greg Mulhauser, Managing Editor on .on and was last reviewed or updated by