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How to Recognize Good Psychotherapy

Peter Michaelson · May 18, 2015 ·

Effective psychotherapy uncovers inner conflict, defenses, and emotional attachments.
Good therapy uncovers inner conflict, defenses, and emotional attachments.

Psychotherapy can be very helpful—and, in some cases, essential—for success, self-fulfillment, and future happiness. But it can also be a waste of time and money if you don’t have a good therapist.

Regretfully, a majority of psychotherapists practice superficial methods that fail to uncover inner conflict, emotional attachments, and psychological defenses. I say this not to be critical but to provide some perspective concerning the current state of psychological services.

People seek psychological help because they’re troubled by moodiness, stress, anxiety, depression, and lack of self-regulation. Often they’re concerned about indecision, procrastination, lack of purpose, self-sabotage, and work or relationship failure. For the most part, these difficulties are produced by inner conflict in our unconscious mind or psyche.

To understand inner conflict, let’s consider the plight of people who are, to a chronic degree, moody or mildly depressed. Such individuals frequently harbor feelings of being disrespected or seen in a negative light. Often they’re having relationship problems. Their inner conflict produces this impasse: consciously, they wish to be admired and respected, but unconsciously they are attached to (and prepared and even compelled to experience) feelings of being seen in a negative light, as an unworthy person undeserving of respect. Unless this conflict is resolved, such individuals are very likely to continue to be troubled.

Effective psychotherapy reveals how an individual’s defenses—blaming, anger, self-pity, projection, transference, injustice collecting, and so on—cover up his or her identification with a suffering self. The inner conflict, though largely unconscious, creates in the sufferer a familiar sense of self that is associated with lingering emotions involving guilt, shame, helplessness, doubt, confusion, and fear. At a deep level, one’s identity or sense of self can be entangled in these negative experiences. Though the condition is painful, the individual feels strong resistance to letting go of what is so familiar. Even though this familiar sense of self is associated with misery, the feeling is, “Who will I be if I let go of my suffering self?” Letting go of the troubled self can truly feel like a form of death. It feels as if the precious “I, me, or ego” will be lost forever. (Read, Free Yourself from Inner Conflict.)

Most psychotherapists don’t penetrate into the core of this conflict. They frequently rely instead on client validation. This approach consists of an apparent sincere and heartfelt recognition and affirmation of the client. The client is treated as someone special who is worthy of being listened to with full attention and respect. Of course, such graciousness is appropriate. Yet, to a large degree, this ardent validation is, in itself, the major component of the technique. There’s no meat and potatoes—only a thin broth of advice and recommendations—behind the psychotherapist’s friendly, charming façade.

Author and physician Ronald Dworkin, who happens to favor this superficial modern approach (sometimes called client-centered or person-centered therapy), describes it this way:

Psychotherapy is no longer an intellectual movement today as it once was. . . in the form of modern professional “caring,” it has assumed a new role, which is to provide a peculiar sort of substitute friendship—what we might call “artificial friendship”—for lonely people in a lonely age. . . In the past few decades, a new breed of therapist has emerged—sympathetic, friendly, lighthearted, warm, and caring. His therapeutic style . . . is the outcome of efficiency and practicality . . . of the preferences of society and of the necessities of unhappy people. Once a consecrated priesthood, therapists today walk along the smooth road of ordinary duty. They help people with their everyday problems. They speak in a casual manner and even crack jokes. They are friendly. They smile. They differ neither outwardly nor inwardly from the clients they serve, for whom therapy has become a useful organization, a convenient and respectable appendage to existence, a sometimes necessary form of artificial friendship.

Indeed, the client often finds a psychotherapist’s friendliness and validation to be quite reassuring and pleasant. That’s because, in part, the client is relieved that the psychotherapist is not probing too deeply to uncover what the client is unconsciously fearful of exploring. Instead, the psychotherapist appreciates the client, neurosis and all, the way a baby is embraced for its very existence. This acceptance is fine for babies, but being babied is not helpful in psychotherapy. A superficial psychotherapist is saying, “There’s nothing to fear. All you need to do is speak from the heart. You’re in the hands of someone who will protect and validate your sense of reality.”

A superficial psychotherapist provides his or her client with an unconscious defense, enabling to client to claim: “I’m not looking to feel disrespected and be seen in a negative light, nor am I attached to self-criticism. Look how pleased I am that my therapist sees me as such a great and wonderful person. I really can connect with this therapist.”

Unfortunately, this approach ultimately reinforces the client’s suffering instead of teaching the client how he or she is unconsciously producing that suffering. Such a therapist operates like a lawyer who always gets a guilty client off the hook. The client’s corruption (neurosis) continues unabated.

Though superficial therapy can bolster the client’s sense of self in the short term, the client remains dependent on external respect or validation to feel self-assured. Above all, the client doesn’t become more conscious or astute about the inner life. When the client’s emotional attachment to feeling disrespected is not exposed and addressed, it will reassert itself at a later time and place, and it might produce different, more troubling symptoms. Ongoing failure in relationships is one particularly painful symptom.

It’s true, of course, that talk therapy and the therapeutic relationship can be helpful in alleviating symptoms and reducing anxiety, at least temporarily. Talking can have some cathartic benefit. For lasting benefit, however, the “talk” in talk therapy has to uncover or illuminate the client’s inner conflict, emotional attachments, and psychological defenses.

Good therapists are teachers and healers, not hand-holders or cheerleaders. Of course, good therapists are not part of a “consecrated priesthood,” unwilling, as Dworkin implies, to smile or be friendly. It’s true—we are not interested in becoming the client’s newfound buddy. We maintain emotional distance and professional detachment. We’re in possession of our own authority, and this benevolent power enables us to penetrate the client’s resistance and defenses. We know that clients, in their unconscious resistance, would like to demote us in order to undermine our effectiveness. Instinctively, they’re resistant to seeing their unconscious participation in their suffering. If we’re just another friendly face, they don’t have to take too seriously the insightful knowledge we’re imparting.

Superficial psychotherapy also fails to recognize the difference between real and phony aggression. Many psychotherapists encourage passive clients—who often are chronic injustice collectors with a self-pitying sense of victimization—to become more aggressive. But appropriate or natural aggression requires inner strength, and inner strength requires the resolution of inner conflict. When inner strength is lacking, a client’s aggression is likely to be inappropriately reactive. Most neurotic aggression is contaminated by negativity, irrationality, and inner passivity. Such aggression is likely to be blaming, off-balance, and self-defeating.

In the face of their clients’ resistance, psychotherapists need to maintain an authority that is based on their expertise and integrity. If they don’t possess and maintain authority, the likelihood is that they themselves are passive. If they’re operating from a passive position, they won’t recognize and address their clients’ underlying passivity. Inner passivity is a deep unresolved identification with weakness that triggers feelings of inadequacy, failure, self-pity, self-criticism, and self-rejection, along with a perpetual sense of being victimized. The therapist needs to be in possession of inner strength to help overcome his or her clients’ resistance to the process of self-development.

A depth psychotherapist is a benevolent authority figure. She knows her stuff. She is a guide, teacher, and expert. She teaches her clients what they don’t know about themselves and—at a deep resistant level—what they don’t want to know about themselves. In sessions, therapist and client examine unconscious conflict in reference to the client’s everyday experiences. The conflict is dissolved as self-awareness or self-knowledge empowers the client’s intelligence. This depth psychologist helps her clients to accept and assimilate what they have been resistant to knowing and accepting about themselves.

People can certainly learn—on a mental or intellectual level—about the inner dynamics of the unconscious mind. The challenge is to integrate the knowledge on a deeper affective or emotional level—and that takes time. There’s a big gap between knowing something about oneself as an interesting—even vital—fact, and knowing it as a life-changing truth. A first step is to try to feel some degree of satisfaction or pleasure simply because you have pointed yourself in a good direction.

The therapy I practice is not a panacea, of course. For one thing, many people are too resistant, dysfunctional, or neurotic to work at this deep level. For a variety of reasons, some people have more resistance and are more inwardly conflicted than others. For instance, people with borderline personality or narcissistic disorders are highly neurotic—heavily conflicted, resistant, and defended. Yet most everyone who goes to a psychotherapist ought to be presented with an opportunity to work at a deeper level in case it is what they can indeed handle and assimilate.

In summary, I’m convinced that many individuals can be helped by the depth psychology I practice even when all they are doing is reading about it and making an effort to assimilate it. Knowledge is power. Trust that when you read about your inner dynamics, you are assimilating the knowledge on an unconscious level, even though the painful symptoms of inner conflict might still persist. Be patient and vigilant. (Try practicing The Two-Minute Inner Workout.)

For those who are trying to learn these deeper principles, above all be patient. Watch out for your inner critic. It will concede that you might be making progress, but it will fault you for not making progress fast enough. If you buy into this rubbish from your inner critic, you’ll become impatient—and then discouraged and disappointed in yourself.

Watch out for your tendency to gravitate toward negative thoughts and feelings. If you are studying this depth psychology, you’ll start catching yourself in the act of “going negative,” and you’ll be able to shift back into neutral or positive feelings or outlooks. A growing attentiveness produces new powers of self-regulation. Inner conflict tries to hang on for dear life, but it eventually succumbs to the healing power of deep insight.

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Filed Under: Consciousness, Depth Psychology, Psychoanalysis Tagged With: client-centered therapy, effective psychotherapy, feeling like a victim, feelings, inner conflict, negative thoughts, psychological defenses, resistance, talk therapy

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