Psychotherapy and Humanism

If you had asked me twenty years ago what psychotherapy was about, I would have responded with abstract concepts: transference, countertransference, projection, identification, good enough mothering, neutrality. I had excellent training in psychoanalytic therapy at a world-renowned institution, and I learned the technical aspects of my profession well. But while I do not regret my professional start, life has taught me something much different about the work that, along with my family and dear friends, gives my life meaning.

First of all, everyone suffers - some much more than others, certainly. During our life, we all face losses - family, friends, our youth, our dreams, our looks, our livelihoods. There is no shame in suffering; it is part of being human. You can be certain you are not the only person on your block who is awake at 2:30 in the morning worried about losing something important to them. Of course therapists suffer, too. Therapists see therapists for therapy, who see other therapists, who see other therapists, and so on. At the end of this therapy chain is not one person who is supremely happy or confident, but rather, someone who, at times, has problems like the rest of us, and perhaps rues the fact that there is no one more senior he or she can talk to.

Second, while there are important psychological differences among us (between men and women, people with different diagnoses, etc.), and the daily challenges we face due to prejudice, bigotry, or discrimination differ, for the most part we are more similar than dissimilar. Fundamentally, we all want to be seen, heard, appreciated, and we protect ourselves as best we can if this does not occur. In many of the essays on this site I talk about the ways we protect ourselves, and what happens when our defenses fail. We all strive for voice, for agency, and not to feel helpless. Life presents many hurdles, some of which are too high to clear by ourselves, and when we stumble we are left with anxiety or despair. Often, we are uncomfortable making our fear or desperation known - we are similar in this respect as well.

I learned this not in any class, or supervision, but from life experience, though my personal pain and happiness. Sadly, my own three-year early therapy fit easily into the "pain" category. I learned much from it, mostly about disrespect and the misuse of power, and, over time, this has been exceptionally helpful to me in my work. Trying to raise three teen-age step children when I was still in my twenties (a difficult task at any age) also taught me a great deal, especially about voicelessness--their's and mine. Watching my own daughter grow up (see "What is a Wookah?") rubbed out many of the remaining abstractions of psychoanalytic psychology. As a toddler, she boldly stood up to Freud and in a clear and compelling voice, argued him down. This was a mixed blessing of course because in order to fight the managed care bully, the field desperately needed an intellectual base. Long term therapy was suddenly defined as ten sessions, and I was constantly arguing with insurance company gatekeepers. Was there still a career left for me in the field that I loved?

Of course, there was more joy. I watched my wife pursue a second, singing career with exceptional verve and, yes, voice. She is more satisfied with life than anyone I know, and I have learned a great deal from her. But I also watched my mother (also a singer) die of lymphoma, and my father suffer as a result. I know that grief is the worst that life has to offer, for which there is no remedy save time and an ear. Of course this leaves me feeling anxious about the future. The threat of death nips constantly at our heels. My beloved Golden Retriever, Watson, who is now grumbling because he wants to go out, is 11 years old and nearing the end of his life.

All of these experiences, together with years of working with clients, taught me as much about psychotherapy as my technical training.

So, if you asked me now what psychotherapy is all about, I would say it involves finding the vulnerable self common to all of us, nurturing it, allowing it to grow free of shame and guilt, providing comfort, security, and an attachment. Of course there is technique, but the best of it is mixed with and indistinguishable from humanness: listen more than you talk; make sure you fully understand everything you hear, wonder about it in the context of a unique personal history. This is the very backbone of psychotherapy. Seminars on the technical aspects of psychotherapy are stimulating and intellectually satisfying. But it is the outcome that truly matters. If your therapist does therapy well, and you awaken at 2:30 in the morning, you feel he or she is with you.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: Psychotherapy: Truth or Revisionist History?