Psychotherapy (also known as "therapy" or "counseling") has been called "the talking cure." Therapy is indeed mostly talk, but it's a special kind of talk rarely possible with friends and relatives.
Why a Therapist?
With a therapist, (me, for instance) you can talk with a high degree of privacy, and no concern about appearing foolish, about very personal matters. You can discuss a problem at great length with no concern about boring the therapist. I have no stake in the outcome, so you can trust my objectivity. Most therapists, me included, do not impose advice on their clients, because most therapy clients don't want advice. What most people want is to be helped to solve their own problems in a way that works for them. I occasionally give advice when asked.
There are two more important advantages to talking with a therapist instead of a friend or relative. One advantage is that some therapists have been doing it all day, every day, for many years. (In my case, I've been doing it all day, every day for about seventeen years.) There is no substitute for the kind of practical wisdom a therapist can accumulate in this way. The other advantage is that most therapists use specialized treatment methods. These still involve talking, but it's a special kind of talking done in a special way that few non-therapists would know how to do.
A Range of Options
Therapists employ a staggering variety of treatment methods. Some are generally accepted as safe and effective, based on scientific research. Some methods are extreme, or just silly, with doubtful safety and effectiveness. Most traditionally accepted treatment methods are probably safe, while they may or may not be effective. Most therapists mix and match treatment methods to suit different clients and problems.
In routine cases involving anxiety, depression, and related problems, I generally use "cognitive" treatment methods, often called "cognitive therapy" or "cognitive behavior therapy." The effectiveness and safety of cognitive treatment methods are well supported by careful scientific research. In my experience, the vast majority of clients are happy with these methods.
The cognitive treatment approach arises from the understanding that many ideas and beliefs represent habits of thinking. Some habits of thinking encourage good cheer and good judgment, while others can be deeply discouraging or frightening, or can perpetuate bad habits and self destruction. Clients learn to reconsider habits of thinking that cause them needless suffering, and develop new habits of thinking that lead to higher quality of life and better functioning. In my opinion, this approach produces a cheerful and hopeful mood in therapy. Cognitive methods can be adapted to a wide variety of other problems, including anger management, substance abuse, and so on.
Like most therapists, I often provide "supportive psychotherapy ." In other words, some clients just need a patient, thoughtful person to talk with in privacy, without any particular treatment method. There's nothing wrong with this, and it can be very helpful.
In addition to cognitive therapy, I use a variety of specialized treatment methods, according to the needs of clients. Some of these include:
- Debriefing traumatic incidents
- Practical problem solving
- Cultivating serenity about problems unlikely to change
- Reviewing painful childhood experience
- Anxiety management training
- Systematic desensitization of phobias
- Pain management and habit control with self-hypnosis
There are a few treatment methods I DON'T use. I generally avoid psychoanalytic methods involving detailed recollection of early childhood events. I do not help clients "recover" forgotten memories of early childhood trauma. I do not emphasize treatment methods that require many months or years, in order to produce ill-defined benefits. I avoid treatment methods intended to help "reconstruct" a client's personality.
Most health insurance companies require me to keep treatment as brief as possible, and they limit benefits accordingly. Most clients prefer to solve their problems as quickly as possible. Accordingly, I try to use treatment time efficiently, and I favor brief treatment methods when possible. However, not all people can be helped by brief methods, and some insurance companies have unrealistically limited treatment benefits. I always keep in mind that my primary duty is to the client, not to the insurance company.