What In The World Is Psychotherapy?
Updated: Jul 17
After completing my master’s degree as a therapist I did a two year internship at the Family Institute of Neve Yerushalayim. Dr. Yisrael Levitz, a seasoned psychologist, supervisor and trainer at the Institute, would often ask us during our biweekly meetings to define therapy. We had spent the last five or so years of our lives dedicated to learning the art of therapy, yet had a hard time answering his simple question.
By the end of the second year of these meetings most of us had more or less memorized Dr. Levitz’s definition: therapy is a process of exploration, understanding human motives, making the unconscious conscious, with the goal of broadening a person’s ability to exercise free choice, or bechira. Put simply, often in life we find ourselves behaving in ways that we ourselves don’t understand. Therapy can help us understand ourselves and make better choices.
My colleagues at the family institute were all intelligent, dedicated therapists. Perhaps the reason that we had a hard time clearly defining therapy was that therapy isn’t one solid thing that we sell. Good therapy is a process unique to the individuals involved: the client(s) and the therapist. Each client comes to therapy with unique needs and strengths. Irving Yalom, one of the generation’s leading therapists and a prolific writer, explains that a good therapist invents a unique therapy for each client. A therapist is not like a manicurist who can change the colors and shapes of her creations, but uses the same basic tools for all of her clients. In fact, there is a saying among therapists, “When you are a hammer, everyone is a nail,” meaning that a therapist who has only one approach to therapy will inevitably make the mistake of banging his approach over the heads of his clients.
Our tools are the human mind and soul, each one completely unique. In general, a ‘cookie cutter’ approach to therapy is not particularly helpful or successful. There are endless variables that affect the therapy, such as:
Does the client feel comfortable talking about the issues directly, or does it help to work also with music, art, therapy cards or other tools?
Does the client want to focus inwards and go deeper into her own experience getting to know more about her inner world? Or is she working on coming out of herself and building skills to communicate effectively with others?
Is the client depressed, anxious, traumatized or abused? Those issues will strongly impact the direction of the therapy.
Is she in therapy for the long haul looking to go deep and take big strides, or does she need to accomplish one or two goals in a limited period of time?
Is the client in therapy because of her own desire to grow, or has she been sent by her mother/husband/teacher/parole officer, etc.?
Is this individual, marital, family or group therapy?
There are over 200 established theoretical approaches to therapy, and while there is a good deal of overlap, good therapists must be familiar with at least a dozen approaches in order to be able to meet the needs of clients and not fall into the trap of trying to mold their clients to fit their approach to therapy.
Perhaps therapy is more like midwifery. Each woman comes to the birth of her child with different needs, preferences and desires. Her physical makeup is different, as is her baby’s. It may be her first birth or her twelfth. Sometimes there are multiple births, c-sections or breech births. The midwife’s job is to safely guide the mother and baby through the process, not to dictate it. She can support, encourage and create the right type of atmosphere that is conducive to a wonderful birth. She certainly can’t do the work on behalf of the mother. Perhaps we therapists are midwives of souls.
Sometimes I think of therapy as digging a well. Reb Avraham Yehoshua Heschel, the Opter Rebbe, wrote in his sefer, Ohev Yisrael that each Jew has within a well that flows with ‘living waters’ -wisdom, knowledge and understanding. Yet our wells can be stopped up with dirt and rocks making us unable to reach the flowing, healing waters. So perhaps a therapist is really a spiritual well digger. Instead of using shovels, we use words to go deeper, remove the blockages and reach the deep knowledge and resources within.
With that as a (rather lengthy) introduction, one of my clients recently graduated therapy after reaching the goals that she had come in with. (Yes! Therapeutic goals can be reached and people do graduate from therapy!) As a parting gift she gave me a poem that described her experience of our time together, and gave me permission to share it. I was very touched by her sentiment, and I’m sharing it to give a peek into what one client’s experience of the therapeutic process was like.
So here it is:
The obscure can be approached
When the secure is at hand
Feelings mingle, thoughts clarify
The situation can terrify
Ponderings lead to wanderings
Exploring different avenues
In the maze of relationships
No one can really guide you out
To tell you what it’s all about
Only one that radiates
Peace of mind – Shalvi
Who reveals the inner compass
Who lets you know
She’s willing to go
with you through places exotic
And sometimes toxic
Leaving personal judgments aside
Providing thoughtful questions to extract
Emotions, to enlighten trails of thought –
Still not ventured.
Shalvi, you were a messenger to stand me on my feet
Reality more bravely to meet.
With gratitude to HaShem and to you,
In deep appreciation.