Category Archives: Therapy

Why Talking to a Psychotherapist is Not Like Talking to a Friend (And Other Misconceptions)

Recently I came across an excellent video on some of the common misperceptions many people have about psychotherapy that might stop them from ever seeing a therapist.

As the short video below from my colleagues at the The School of Life in London illustrates, these myths include:

  • Psychotherapy is only for people who are strange, abnormal, or deficient in some way

  • Psychotherapy is only for people who don’t know how to solve their own problems

  • Psychotherapy is nothing different than simply talking to a good friend

  • Psychotherapy is not affordable and is not worth the cost

In this article I will tell you why these four statements are misconceptions, and why you should not be so quick to dismiss the benefits of meeting with a well-trained professional psychotherapist.

But before we get there, first watch the video:

As you can see from the video, psychotherapy is frequently not what people think it is…

Let’s examine some of the myths about therapy a little further:

4 Myths that Might Stop You from Seeing a Psychotherapist:

Misconception #1: Psychotherapy is for People Who are Abnormal

green frog representing abnormality
Psychotherapy can make us feel like a misfit of society

One of the most liberating ideas I was presented with as a student of psychotherapy was the idea that all humans struggle. As the famous psychodynamic therapist Nancy McWilliams has pointed out, the question to ask yourself and others is not: Are you crazy? But rather: How crazy are you? and crazy in what way?  

This is in many ways the basic premise of psychodynamic psychotherapy: We all have our little neuroses, traits, or peculiarities that get in the way of living the life we wish we could live. We are all a little crazy and a little irrational at times. We all have some fears that other’s don’t. And we all get into situations that overwhelm us, make us fall short, or make us doubt ourselves.

Maybe we find ourselves dating the same type of ill-suited partner over and over or making the same relationship mistakes.

Or perhaps we find it hard to express our needs to anybody in authority, which creates problems at work, or make us sabotage our own success by turning assignments in late.

Whatever the situation may be, we all have something we struggle with that works against our better interest.

The only thing that distinguishes a person who seeks out psychotherapy from someone who doesn’t is therefore their willingness and courage to face the inherent struggles of their human existence.

The distinction is therefore not between someone normal and someone abnormal, but between someone who chooses to hide their abnormality behind the semblance of normality, and someone who recognizes that abnormality is normal and therefore gives themselves permission face their life as it is, not as they wish it to be.

Misconception #2: I Should Be Able to Solve My Own Problems

two pieces of a puzzle
We can often feel like we have failed if we cannot solve our problems of our own

Okay, so now that you have recognized that all humans struggle, you no longer need to distort your own reality to try to fit in to some illusory idea of what is normal.

However, you may still feel a little ill at ease about asking somebody else to help you with your problems.

Why? Because our culture in general often ascribes strength to the ability to fix-it-yourself.

Many people feel like it is a sign of weakness to not be able to handle whatever issues they are facing on their own. Instead of going to see a psychotherapist many people will therefore instead try out self-help books, or resort to self-made coping mechanisms such as alcohol and drugs, avoidance techniques, or putting on a forced smile.

However, a psychotherapist can accomplish something with you that it would be difficult if not impossible to accomplish on your own.

In fact a psychotherapist will not just listen and try to offer up new suggestions or solutions. Instead they will help you discover new thoughts and feelings that you have not been paying attention to or may have pushed out of your awareness. In this way they will help carry you beyond your own conscious knowledge of your problems, and will help you see and experience yourself in a new way.

In many ways, psychotherapy is really a process of standing back from your problems to see the bigger picture. Rather than offering solutions to the problems you think you have, psychotherapy helps you view your problems in a new way, so that the solutions you think you wanted, may not actually be the one’s you want.

Psychotherapy is therefore not a linear process of solving a problem, but a transformation of the very way to you experience yourself and your problems. It changes the context within which you view yourself, so that your very desires, needs, and wants may change.

The idea that you should be able to solve your own problems does not apply when it comes to matters of your psychological existence. The solution here is not one you can arrive at simply by applying logic to a known problem.  Instead, it involves a dialogue with someone who can listen in a different way based on parallel thinking, association, and the logic of the irrational, and can help you expand your awareness of things you didn’t know before.

Misconception #3: I Might as Well Just Talk to a Friend

two people holding hands
Can’t I just talk to a friend in stead of a therapist?

A friend and a psychotherapist are two very different characters.

We all can benefit from talking to friends. However, as many people often instinctively know, friends frequently don’t really offer the kind of listening and attentiveness that helps us feel comfortable opening up about our deepest fears and most embarrassing quirks.

This is why one of the first training goals for new students of psychotherapy is to unlearn their instinctive ways of responding as a friend.

Friends often do well-intentioned things that psychotherapists have learned are not really helpful.

As friends we often offer encouragement to help others not feel so bad about things. We try to cheer them up by telling them that things will be fine, or giving them reasons why they they should not feel sad, or guilty, or what have you. However, this inadvertently sends the message to the other person that we can’t tolerate or don’t want to hear about their pain, and that their pain is “irrational” or silly.

As friends we also often offer advice based on our own experience of what has worked for us, but such advise is often premature and ill suited for a person with other values and inclinations than our own. If you are honest with yourself, how often do you really find other people’s advice helpful? Most of the time, only when a part of you was already kind of thinking about doing the thing you friend has suggested. More often, however, advice simply feels invalidating and infantilizing. If our problems were so simple that we could simply solve them by following some piece of advice, we could probably have thought of the solution on our own.

An excellent video that illustrates why advice and encouragement is really not that helpful is Brene Brown‘s video on the difference between sympathy and empathy:

Finally as the video from The School of Life illustrated, friends most likely don’t have the deep understanding psychotherapists have about the complexities of human nature and the “normality of abnormality”. Friends therefore often have more limited views of what is acceptable, normal, and good and less tolerance for what is outside the cultural norm in our society or our immediate friendship groups. It therefore often does not feel that safe to admit to feelings or thoughts that may not be in line with what we think others deem to be acceptable or normal.

A psychotherapist on the contrary has a discipline to how they listen, how they respond, and how they make sense of what we say. They don’t make premature conclusions, don’t offer premature advice, and don’t shut down explorations of the aberrant or what lies outside of cultural standards of good and bad. This means they can meet us where we are, tolerate a wider range of our emotions, and help us expand our own knowledge and awareness of what we really think, feel, and want, even when we can’t quite accept these things about ourselves.

Misconception #4: Psychotherapy is Too Expensive

piggy bank with christmas lights
Is psychotherapy really worth the investment?

It is true that psychotherapy can often be quite costly. This is both because good psychotherapists need a lot of training, and because psychotherapy by nature is a very time and labor intensive process.

When it comes time to consider whether therapy is really worth the expense, it is often helpful to consider the value you place on living a life of greater self-knowledge and awareness. For some people this kind of life is not really a priority, and for those psychotherapy will almost always feel too expensive.

If, on the other hand, you value living a more conscious life, you will feel less hesitant to see it as a worthwhile investment and will almost always be able to find room within your budget to see a psychotherapist.

At the end of the day it is often not the price of psychotherapy that is prohibitive, but the value you place on it.

Some people will easily spend thousands of dollars on a vacation, or will not hesitate to get Lasik surgery for their eyes, or Invisalign for their teeth, but will not want to spend the same kind of money on their mental and psychological well-being.

However, as the video from the School of Life makes it clear, life is not a skill we instinctively master, but a skill we have to learn. This in my book, makes psychotherapy an essential ingredient of any person’s quest to live a more fulfilling life.

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., psychologist and psychodynamic psychotherapist in Houston, Texas. I help people get to the root of the problems that are causing them distress so they can live more fulfilling lives.

 

Why Is It So Difficult to Change?

When people come to therapy it is usually because they have identified some behavior, some feeling, or some aspect of their life which they find problematic and want to change.

Yet psychotherapists have long known that clients usually resist the very changes which they consciously claim they want.

For example, I know I should not procrastinate in school or at work, but even though I can list all the rational reasons why procrastination works against me, I still cannot simply make a rational decision not to procrastinate anymore.

Resistance to Change:

In therapy this force within me that is working against myself is referred to as my resistance.

My resistance confronts me with the fact that I am not always the master of my own house. It tells me that all the logic, reason, and will-power in the world often isn’t enough to bring about change. It reveals to me the presence of motivations within me that do not fall under the purview of my rational self.

These motivations that work against me oftentimes do their work outside my conscious awareness. They are not parts of my personality, which I identify with. It is this that makes them my most formidable adversary, for how can I win a battle against forces that are mostly invisible to me?

The Benefits We Derive from Symptoms:

The part within a person that resists change is considered by psychodynamic therapists to be motivated by secondary gain. It derives comfort from the very symptom the rational part of me wants to get rid of.

When looked at from the perspective of the rational mind this of course does not make any sense. Why would I for example not want to stop procrastinating? What possible benefit could I get from sabotaging myself?

The secret to understanding this conundrum is to begin to unlock the unconscious logic that makes procrastinating a successful bulwark against greater fears or threats to a person’s psychological safety.

Could it be that I am afraid to succeed because I at some level don’t believe I am worthy of success? Could it be that I am afraid that if I truly try and ultimately fail, I will get affirmation of this fact? Or could it be that a part of me resents the fact that I have taken on a career or a field of study which I thought would make my parents proud, a fact that I cannot openly acknowledge to myself, or which would require me to live with the guilt of openly disappointing my parents?

From the perspective of the unconscious, these would all be excellent reasons to procrastinate. My resistance to change is here the last bulwark against an unconscious and unacknowledged conflict, which must be kept out of my awareness to spare me much psychological turmoil and anxiety.

Keeping Unconscious Conflicts at Bay:

Oftentimes when we seem to not be able to wrest ourselves free of a depression, or change a self-destructive habit that keeps us stuck, it is because of the presence of an underlying unconscious conflict, which motivates us to resist a change to the current status quo.

Although being depressed, for example, is pretty miserable, it is often unconsciously preferable to being assertive and risking other people’s rejections or wrath, or confronting the realization that I need to change career or get a divorce. Depression sometimes keeps me from drawing the unpleasant conclusion of a realization that would cause too great of an upset to myself or to others.

It is often safer to stick with the devil we know.

And so it is that approaches to change that only address the conscious rational side of a person are almost always destined to fail. Although willpower and logical reasoning can get us far in life, they cannot win the battle over our secret fears and unacknowledged conflicts. To truly change oneself is thus ironically to first truly accept oneself: to honor our resistance and let our resistance reveal its logic to us, which means to become more aware of who we truly are and what is truly motivating us not to change.

Perhaps we should become a little more like Soeren Kierkegaard who instead of declaring warfare on his symptoms, acknowledged with a degree of self-compassion: “My depression is the most faithful mistress I have known — no wonder, then, that I return the love”.

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist and psychodynamic therapist in Houston, TX. To read more about my approach to therapy, please visit my website: www.bettertherapy.com

 

At the Edge of Your Experience: How Therapy Creates Change

What happens in good therapy is hard to explain to someone who has not yet experienced it.

Why is that? Because the person who enters the therapy room often isn’t the person therapy will reveal her to be. Her very goals and definitions of who she is belongs to her pre-therapy self.

If she is like most people she is used to the idea that life consists of a series of problems to be solved. She views herself as a kind of processing machine that takes in information or challenges, uses logic and planning to tackle these challenges, and produces an output or performance. Her score card is life. She asks herself: Am I married? Do I have a good job? Can I deal with stress at work? Am I happy in my relationship? And if the answer is no, she extrapolates, it must be because she isn’t doing things right, isn’t using the right logic, doesn’t have the right attitude.

She feels like a machine that is broken; a person who cannot deal as effectively with life’s problems as the the next person. She feels deficient, lacking skills that others seem to have, and needing knowledge that will help her deal with life in ways that will make her feel effective and successful again. She needs to get fixed!

However, this is the person’s ego speaking: the ego who believes she is the queen of her own castle, who problem-solves, who plans, and who thinks she is in control.

Therapy, however, is not for the ego.

Encountering a Different Self:

Therapy does not focus on who you are and what you want. Instead it seeks to give you an experience of who you do not know that you are and what you did not know that you wanted.

Instead of focusing on providing knowledge about well-defined problems, therapy seeks to take you to the unclear edge of what you do not yet know. Here at the edge, your own experience can teach you something new. Here you can access feelings you had not previously been aware of, or rediscover fragments of your experience which you had previously forgotten.

Here at the edge of your own experience, you encounter a different you; a “you” that is larger and more complex than your well-defined ego, or image of self. And as you bridge this abyss between who you have been thinking about yourself as, and what you are becoming, change happens to you: Therapy becomes therapeutic.

Will You Trust Me?

It is hard to explain this process of metamorphosis to someone who thinks the solution to their problems lies in techniques, knowledge, or wisdom that they can receive and implement in some rational and planful manner. Because what I am saying, this part of the self cannot understand.

And so you must trust me enough to dare to leave your preconceived notions to the side. You must take me up on my invitation to speak freely, to speak what you do not want to say, to speak about that for which you have no words, that which is farfetched, childish, has no form, makes no sense, or is slightly beyond reach. And here at the edge, is where new experiences take shape; where the self is in the making.

The Role of the Therapist:

Your therapist is there to help you stretch beyond your own capacity, push you towards insights that is slightly beyond reach, notice where the body betrays a consciously held view, where the voice stammers, where emotion hides, or where novelty lurks.

Therapy is not the doing of the therapist, nor the doing of the client. It is the happening of the unseen, the unsaid, and the unfelt from a place “between” the two; the arising of something that neither could have produced on their own.

Therapy is also not the linear execution of a solution to a predefined problem. Change in therapy is not something you implement, it is something that happens to you. And it happens to you always from a place that was initially outside your awareness.

What is Good Therapy?

Therapy is therefore about welcoming in experiences that lead to a revision of previously held understandings or that help you discover something about yourself from a place that was not previously accessible.

Therapy is about growth, revision, becoming. It is about gaining contact with an aliveness and self-evidence in your own experiential depths that will change how you feel about yourself and who you can become.

We don’t know the answers, nor the outcome, before you enter therapy. Therapy itself is the pursuit of these answers. It is through therapy that the mysteries of your existence, of your choices, and of your hang-ups shall be unraveled. Not from a place of universal knowledge, but from an experience of your own personal truth.

Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychodynamic therapist in Houston, Texas. To read more about my approach to therapy, visit my website: www.bettertherapy.com.

 

The Power of Story-Telling in Therapy and in Life

On my recent trip to Nicaragua, I learned at least two things: 1. That when looked at from a Venezuelan/ Nicaraguan socialist perspective, the US is a country of police brutality and moral decay, and that, 2. Spirit Airlines are not stingy with their amenities, they are just engaging in “frill control”. Funny how reality changes when you tell a story differently…

A Cultural Lesson on the Power of Story-Telling:

Nicaragua is currently a country that receives a lot of financial aid from the Venezuelan government, due to their mutual sympathies toward a kind of socialism practiced by the now deceased political leader, Hugo Chavez. For that reason, you can find posters that pay homage to the former Venezuelan in places all over Nicaragua. You can also, I discovered, watch unadulterated TV transmitted straight from Venezuela.

When I would settle in at night after a long day of sightseeing in the tropical heat, I would turn on the TV in my air-conditioned hotel room, and would find myself fascinated by one particular Venezuelan station and the entirely different world-view presented there.

The US was on this channel depicted as quite morally depraved. The evening’s news included a segment on police brutality against civilians in various places in the US, presented as if it were breaking news.

The news was followed by a theme show featuring all the wonderful socialist initiatives of the Venezuelan government: First you saw how many modernized apartments were being built through the decree of the government, and then coverage followed of other government initiatives: workers would now be able to pay fair prices on everyday goods due to government intervention, the environment was now being saved through nation-wide programs to plant trees…. The initiatives were seemingly never-ending…

Every segment introduced one hopeful initiative after another, and the clips were always of people doing things together – collectively – making political decisions about what kind of society and destiny they wanted. This was a society that valued people and community over and above raw capitalism, and it reminded me a little bit of the Obama campaign’s “Yes, we can!”, which had that same kind of optimist spirit, before it lost its fizzle.

After watching this Venezuelan station for just 30 minutes I was left with an indelible impression of optimism, although a part of me of course knew that this was quite a different spin on reality than the one I had typically been presented with. From a North American perspective, Chavez was always depicted as somewhat of a selfish dictator, and socialism, of course, always depicted as bad.

However, crossing cultural boundaries, not just geographically, but mentally, is quite eye-opening. It made me think of the power of stories as a mediator of the reality we experience, the emotions we feel, and the actions that become conceivable. It also made me think of the tendency of stories to hide their story-like nature behind a presentation of facts.

The Venezuelan news station was not consciously telling stories, but merely reporting facts, and many of the stories we tell in the US media, to ourselves, and to others, have that same pretension to transcend their story like nature.

The Story of Psychological Disorders

The idea of the unadulterated fact is, however, itself the product of a story: the story of the enlightenment or of science. According to this story, we can access reality purely as it is in itself outside of the logic of a certain story line and pre-understanding. And yet, as hermeneutic philosopher Hans Georg Gadamer has pointed out, even science takes place within a prior understanding of the world. There is never such a thing as approaching the world without making certain pre-judgments or assumptions about it.

A research study about the effectiveness of a certain therapy for Bipolar Disorder for example, may seem like it is only reporting facts (looking at quantifiable variables and measurements of probability), but it is assuming an illness model of psychological distress which is not itself part of what is studied. An illness model, of course, is a story about why people suffer that attributes the suffering to a disease process or cause underneath the actual life of the person, and is by no means the only possible story.

The medical or biological view of psychological distress has a particular strong-hold in our current North American and European zeitgeist. People are always wondering: Do I have ADHD? Am I Borderline? Do I have a psychological disorder? …As if assigning a label and naming one’s suffering as a generic underlying “thing”, solves the problem, and alleviates the discomfort of figuring out why I suffer in some more human or existential sense.

And yet, these “entities” which we like to label ourselves with are themselves largely the product of stories. What appears to be science and is presented in an officially sanctioned diagnostic manual (DSM) as if it were, is really the product of a political process of debating different research studies, naming conventions, and inclusion criteria. Psychological Disorders are voted into existence. The other side of a disorder is all the contentious opinions that had to be tabled in order for the construct to appear as an independently existing noun.

Therapy as Story-Telling

Rather than try to fit people into categories of a medical story, therapy offers a space where alternative stories can be told. Therapy as a “talking cure” is really about telling your own unique story. A person is helped to unearth memories, feelings, and experiences that sometimes pose challenges to existing stories, and require the reorganization of one’s understanding of oneself and of the world. The medical narrative is here often a hindrance that disallows people from pondering the idea that symptoms exist for a reason, that feelings contain useful messages, and that our bodies express that which we cannot yet say.

* * *

And so it is that a trip to Nicaragua made me wiser about the power of the stories we tell and about the need to examine the stories we live as our own personal and cultural truths.

The Venezuelan government has their story…

Spirit Airlines has theirs…

What’s your story?

About me: I am a psychologist in Houston, Texas who likes to think outside the box and is committed to helping people find their unique personal truths. Read more by visiting my website.

A Beautiful Truth: Why Good Therapy is Like Art

The Beauty of Therapy:

My many years of experience as a therapist have taught me that therapy is a beautiful experience.  People change by finding connections between memories, thoughts, and feelings, forming beautiful new patterns out of the fragments of their life.

Suffering on the other hand is ugly. It is a sign of a pattern that has not yet emerged, of a thought has that been severed from a feeling, or a feeling that seems isolated and without meaning.

Beauty has flow; suffering is disharmonious.

Good Therapists are Artists:

Good therapists are more like artists than technicians. They don’t seek to produce a predetermined outcome through their interventions, but seek to join with the client, to help the musical harmony of the client’s life come to expression.

I often think of myself as a jazz musician who has to jump into a musical piece that is already being played, the goal being to add a guitar string here, and add a drum there. I think of my therapeutic interventions as producing resonance, along the lines of French philosopher Gilles Deleuze, who said, “You should not try to find whether an idea is just or correct. You should look for a completely different idea, elsewhere, in another area, so that something passes between the two which is neither in one nor the other”.

What is needed in therapy is not an accurate interpretation of facts, but movement in a client’s capacity to think new thoughts and access new experiences. The words and observations of the therapist have to make new connections possible. The most skillful way to do this  is to insert a new element into the client’s speech or experiences that makes something resonate in a way that wasn’t possible before.

The therapist must hear something between the lines or outside of the client’s conscious awareness; something that has fallen outside of the structure of the clients conscious story line.

A client might be speaking in a way that repeats the significance of the word “eight”, which seems to pop up in multiple contexts unbeknownst to the client. The client has been in a relationship for eight years, the client likes the brand of mint chocolates After Eight, and the client complains of being overw-eight. The therapist hears the refrain that has fallen out of the clients awareness, and asks the client to talk about what happened around the age of 8. If this question resonates, the client will be able to access new important memories or feelings. Maybe his parents got divorced when he was 8. Maybe she was eight when her cousin sexually abused her. Or maybe nothing at all comes to mind, in which case the intervention would fall flat.

The point is that the therapist’s job is to listen for the music that is being played, and to re-introduce elements that might make new thoughts possible. When such connections are made, beauty or harmony is the result.

A Joint Master-Piece:

The therapist is not some master mind who offers universal truths and prescriptions, but someone who knows how to jam with the client. The therapist must receive the beauty from the client’s life story, and help the clients play their music.

Good therapy is never about applying eternal truths and knowledge to universal problems, but about creating something unique and new from out of the always particular elements of a particular person’s life.

As a result, good therapy happens not as transfer of knowledge from the therapist to the client, but as a veritable co-production.

Therapy as Creation:

In therapy, as in life, there is no clear sense of the end goal from the outset. One must discover what is possible by being open to what happens. What happens is never something that can be predicted in advance; it represents a possibility beyond one we can control and plan for. Turning towards this “unknown” happening, and cultivating it by paying attention to it, is probably where the real work of therapy happens. It is where client and therapist each become capable of receiving something new, which they had not known before. It is the place of pure creation: therapy as art rather than science.

Therapy as art allows us to receive a future that is not conditioned by the past, and to envision new goals of which we were not in possession prior to the actual therapy.

If you would like to read more about the connection between therapy and art, read my article: On Cultivating the Therapeutic Moment. To schedule a therapy appointment please visit my therapy website.