What is psychotherapy?

If you had asked this question one hundred years ago the answer would have been simple: psychotherapy was just another term for psychoanalysis – Freud’s ‘talking cure’.  Since that time, however it’s become increasingly difficult to define psychoanalysis itself let alone psychotherapy, of which there are now literally hundreds of variants, and most of which have very little to do with Freud’s invention.

If you do an internet search on the word ‘psychotherapy’ you are likely to come up with a variety of definitions, most of which will revolve around psychotherapy being the treatment of psychological problems.  But what exactly does this mean?  Even if we accept that ‘psychological problems’ refer to things like anxiety, depression, stress, phobia, and perhaps even a range of more severe problems (often called psychosis by mental health professionals) it’s still not clear what the term ‘treatment’ refers to.  How, for example, does a psychotherapist treat depression?

Of course, we could start with the word ‘psychotherapy’ itself, which derives from the Greek words psykhe (psyche) and therapeia.   Now ‘psyche’ means, amongst other things,  the breath of life, the living being or soulTherapeia also has several meanings, one of which is a service rendered by one person to another.  More specifically, this can be a medical service, i.e. a cure or a healing.  It also means a body of attendants.   As a verb it can  mean to be attentive to.

It’s tempting, as far as the word ‘therapy’ goes, to think of it in terms of healing or treatment, which means that a therapist is someone who treats or heals another person.   However, I much prefer the emphasis on attendance, and more specifically to be attentive to. This is because an essential aspect of any form of treatment is actually about the relationship between clinician/therapist and patient/client, as any GP will tell you.

But attentive to what?  Obviously, attentive to another person, i.e. the client; but this could mean all sorts of things and could apply to all sorts of roles.  So what particular aspect of another person would a psychotherapist be attentive to?   This brings us back to psyche.  The references to ‘breath of life’, the ‘living being’, the ‘living soul’ suggests there we are talking about some kind of fundamental essence of human nature.  Some people  might call this fundamental essence the soul, others the self or the ego.  Others may prefer to think of it as their inner-most being, their true nature.

Whichever term you use, it’s clear that psychotherapists are engaging at a very fundamental level with their clients.  This is why there is a lot more to being a psychotherapist than simply being a good listener, although this is very important.  This is also why many people find it hard to engage with a psychotherapist, and why it can take a long time before things really start to change for them.  It is not easy to talk about things that have often been deeply buried for years or even decades, or to question fundamental assumptions about one’s life and relationships with others.

On the other hand, psychotherapy is probably one of the few places where a person can speak freely, in whatever way they like, and for however long they like, about the things that are really troubling them, about how they suffer in their lives – and, indeed, why they find it so difficult to change, why they find it so hard to let go of their suffering.