The What and Why of Psychotherapy

Musicians' Assistance Program

Volume CIII, No. 4April, 2003

Leslie Cardell, CSW

Most of us experience emotional problems at some point in our lives, and while we’re often able to muddle through on our own, sometimes we need to ask for outside help. Family and friends can make us feel better, and they may be able to give us valuable support and advice, but this differs in many ways from what happens between a client and a therapist.

Psychotherapy is a partnership between an individual and a licensed professional (such as a clinical social worker or a psychologist), someone who has been trained to help people understand their feelings and assist them in changing problematic behaviors. Therapists know how to listen in a very particular way, to what you say and how you say it, as well as to what you don’t say. They know the kinds of questions to ask that can help you understand your feelings, and look at the problems in your life in a new way.

The relationship between a therapist and client is based on therapeutic principles, and is strictly professional. The therapist is only there to help you, and expects nothing in return except payment for his or her time. Everything you say is completely confidential; there’s no need to worry that what you say will be repeated, or affect your other relationships.

Some issues are hard to talk about with friends. We may wonder what they’ll think of us, or worry that we’ll hurt or offend them. Sometimes a subject just feels too personal, or it’s difficult to get objective feedback. No matter how caring our friends and family are, they don’t always have the skills and knowledge to help untangle confused or disturbing thoughts.

That’s what psychotherapy is for. It’s a safe place to say things you’ve never felt comfortable telling anyone before. There aren’t the burdens and responsibilities of a friendship. There’s no need to be concerned about “pleasing” the other person, or taking care of their needs. You can say whatever you feel and think, and have your thoughts heard by someone who isn’t going to judge you, or fire you, or swear they’ll never ever speak to you again.

Sometimes just the process of putting into words those thoughts you’ve been keeping hidden can take a lot of their sting away, and feel greatly relieving. When you begin to examine unsettling thoughts, they often don’t seem as scary or overwhelming as they once did. It’s like turning on the lights in a House of Horrors; suddenly it’s just not that frightening anymore.

People consider psychotherapy for a wide range of reasons. Here are some of the more common ones:

  • They feel anxious and unable to cope or concentrate.
  • They have persistent, troubling feelings of emptiness, sadness, and helplessness, and they lack hope in their lives.
  • They have difficulty making or sustaining relationships, or repeatedly become involved in unsatisfying or destructive relationships.
  • They’ve had difficulty coming to terms with losses such as bereavement, divorce or loss of a job.
  • Their actions are harmful to others or to themselves. They may drink too much alcohol and become aggressive.
  • They lack confidence, and feel unable to achieve their goals.

We all develop habitual behaviors over time and ways of dealing with the world around us. We may have learned certain lessons a long time ago, responses to the curves life threw at us, that we’re completely unaware of. Perhaps that was the best we could do at the time, or there weren’t better options available to us. As we grew older, those habitual ways of responding stopped being necessary, and may even have become counterproductive or harmful to us. Now, the old lessons no longer apply, but because they’re so ingrained, we don’t recognize their continued affect on our behavior.

Psychotherapy provides an opportunity to look those old habits, and the roles they’ve played in our lives. Until we begin to recognize destructive or unproductive behaviors, we can’t help but repeat them. Therapy is a process of examining the underlying assumptions we’ve made about how the world works, and provides an opportunity to reconsider them. Once we understand the roots of our behavior, we can begin to consider alternatives.

Psychotherapy is not necessarily easy; there’s no quick fix or simple answer. It can be quite unsettling at times, and even painful. Once we become aware of self-defeating behaviors, it can take a while before we’re able to change those old habits. Gradually though, we discover new ways of responding, and begin to have the freedom to make different choices. We develop the capacity to live in the world as it actually is, not as it once was, nor as we wish it would be.

If you think you might benefit from psychotherapy, please don’t hesitate to contact the MAP office for a free, professional consultation, and referral for appropriate treatment.

Some of the material for this column was drawn from these Web sites: and