What Makes it Psychotherapy?
Years ago, I had a student who repeatedly asked me how psychotherapy works. “How is it different than a conversation?”
When I think of psychotherapy, I think in terms of the talking itself as being the aspect that helps– and yes, of course it can be used in conjunction with medications. I think of it as being structured–in terms of time and place and frequency– and being all about the patient. And whether or not it’s actually discussed, some of what works is about the relationship–most people don’t get better talking to someone they despise, and the warmth, empathy, feeling listened to and cared for, well, they’re all important. And I also think of it as being a process over time. These are all parts of my definition, however, and they may not be parts of yours.
So what about about a one-time event? If someone meets with a therapist once, has wonderful insights and feels better, is that psychotherapy? (–Clink, this is your cue to put up a post about the taxi driver in New Orleans). If someone meets with their priest/hairdresser/auto mechanic once or twice or 57 times and feels better, is that psychotherapy? If someone talks to a friend over coffee every morning while the dogs play, is that psychotherapy (…clearly, it is “therapy” because most things involving either chocolate or coffee have some therapeutic value)? If a patient meets with a therapist every week for an hour-long session for years on end, but never utters a single word, is that psychotherapy?
Some psychiatrists include education about illness and medication as part of their definition of psychotherapy. Others measure it by time—if it’s 20 minutes it’s a med check, if it’s 45 minutes, it’s psychotherapy….
Okay, so what makes it ‘psychotherapy?’ FYI: there’s no “right” answer.
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