Many psychologists practice psychotherapy.
Below are some questions often asked about psychologists and psychotherapy.
(Click on the question to be directed to the answer.)
People enter into therapy when they are unhappy, confused or stuck. They may be experiencing psychic pain from bad experiences. They may find themselves making the same mistakes but unable to stop doing so. They may be stuck in bad relationships, bad jobs, or bad habits. They may be unable to move ahead on projects, important life changes or even small things. Some people consult psychologists simply because they feel that their lives are missing something and they are unable to figure out what that is. In any case, the right psychologists can you release yourself from being frozen and help you find meaning and fulfilment in your life.
- How does a psychologist differ from a psychiatrist?
Psychologists are distinguished from psychiatrists in that psychologists are trained to help people using a variety talk and behavior therapies tailored to the needs of the patient. On the other hand, most psychiatrists prescribe medications as the front line of treatment. Some patients benefit best from treatment pairing talk therapy and medication while others benefit from talk or medication, alone. While most psychiatric medications have side effects (often requiring additional medication to control them) this is not true of psychotherapy.
Psychologists work in different ways. There are many different techniques for therapy which psychologists will adapt to the particular patient and/or concern. Psychologists can help people gain insight. They can help people solve problems or understand why they are stuck and can't solve problems. They can help people heal from emotional pain. They can teach people how to relax or, on the contrary, how to work harder. They can help people organize their priorities. They can help people get along better with others including children, parents and spouses, friends, co-workers, supervisors and other people in their lives.
Sometimes simply talking about a problem can result in a new perspective that allows the patient to make the necessary changes in behavior or simply to feel better. Talking to a professional who is not a family member or friend can be liberating. Unlike close friends and family, your psychologist has no interest but yours in helping you. Psychologists work to help patients feel safe, comfortable and willing to talk about difficult and even embarrassing topics. We are trained to make patients feel that they are understood. In an unhurried psychotherapy session, you have the freedom to share whatever is meaningful to you.
There are three general categories of concerns that bring people into therapy. These are Psychological Problems, Health and Lifestyle Management and Existential Despair.
Psychological problems include: Depression and suicidality, anxiety and excessive worry, fears, loneliness and isolation. Usually, a person suffering from one or more of these problems is having difficulty functioning in their daily lives or in enjoying them. Some patients are suffering from more severe mental illness. With the proper supports, these patients can live happy and productive lives.
Health and Lifestyle Management is a big focus in psychology today. Mind-Body Health is concerned with helping people to live more healthfully, balancing their lives so as to include rewarding and nurturing experiences, minimizing or eliminating the effects of poor health habits (e.g. alcohol and drug addiction, poor diet, cigarette smoking, excessive stress) and managing medical regimens properly. It can also include helping patients to take a more active role in their health care and to feel empowered working with the medical and insurance establishment.
Existential Despair, most often, but not always, found toward the end of life, usually results from losses and disappointments that begin to surface as people retire, lose close relationships to death or distance, lose independence and lose health. It is characterized by any of the following: depression, anxiety, withdrawal, bitterness, anger, and feelings of inadequacy, incompetence, or uselessness)
Relationship building helps patients to develop trust by showing them that close and trusting relationships are possible, and gratifying. Relationships are essential to our lives and therefore having them work well for us is important.
Insight-oriented psychotherapy helps people understand their lives and their behavior. It aims to help people avoid repeating the same mistakes, getting into the same awkward situations or living through the same bad relationships.
Stress reduction and relaxation. Anxious patients can be taught non-chemical (non-drug) techniques which they can use to reduce fears and worries which would otherwise make them act out impulsively and inappropriately. Chronic stress leads to depression and eventually to the deterioration of physical health. It is not inevitable and can be fixed.
Cognitive-Behavioral Techniques can be used to help people change the kind of ineffective thinking which leads to relationship failure, feelings of powerlessness, loneliness, and the sense of being stuck. Cognitive-behavioral techniques also include visualization, hypnosis, and progressive relaxation.
Psychoanalysis is a more intensive type of therapy in which the person explores their life and relationships in great detail to better understand and sometimes to change them. Psychoanalysis can be effective for people who keep repeating the same mistakes in their relationships, jobs or other parts of their lives. It can be helpful for people who feel that their lives are meaningless or empty and for people who have trouble connecting with others and establishing meaningful relationships. Psychoanalytic treatments usually consist of 2-4 sessions per week and takes place over a longer period of time, due to the intensity of the work to be undertaken.
The length of therapy differs for different people and for different goals. Some treatments can be relatively brief, that is, 10-20 weekly sessions. Others can last much longer depending on the severity of the problem and on how the work is progressing. Sometimes, an easily solved problem can lead the person to decide to continue their therapy in order to delve more deeply into other issues. These goals and outcomes are best explored with a therapist you trust. The ending of therapy (termination) works well when both the patient and therapist mutually agree.
Life Review is a technique in which the patient learns to make sense out of the events of his or her life; to create a narrative and find meaning in what one has done or not been able to do. In the process, individuals celebrate their successes, face and mourn significant losses, express regrets over mistakes and accept the past and future as they actually are.
Medical Compliance involves helping the patient understand and adhere to medical regimens. Many patients find themselves confused after visits with physicians. Physicians don't always have the time or inclination to explain things thoroughly or in a manner which the patient can understand. Many older patients feel afraid to question their medical doctors or nurses or to confess failures to follow orders or resistance to doing so. I have worked with many patients to help them better understand what is being suggested by their doctors and to help them express doubts and problems which they might otherwise not bring up but could sabotage their compliance.
Cognitive Rehabilitation can be useful when patients are in the early to middle stages of dementia. They can gain a better understanding of what is happening to them and how to deal with it. There are techniques for living with memory loss and cognitive decline. Family members and home health aides can also be enlisted in helping patients to delay or stave off decline or to deal better with it.
Identifying and reducing depression is critically important as many depressed seniors are mistakenly diagnosed as demented. Distinguishing the two clearly can help the patient and the medical team better treat what is actually happening.
Occasionally, people return to therapy months or years after a successful completion for a "tune-up." This follow-up usually lasts a shorter time. Sometimes, people decide to return to therapy to work on a problem they weren't able or didn't wish to face the first time around.