What Is Psychotherapy?

Psychotherapy is the treatment, by psychological means, of problems of an emotional nature in which a trained person deliberately establishes a professional relationship with the patient with the object of

  1. Removing, modifying, or retarding existing symptoms,
  2. Mediating disturbed patterns of behavior, and
  3. Promoting positive personality growth and development.

This formulation requires additional elaboration:

Psychotherapy is the treatment: No matter how much we attempt to dilute what we do in psychotherapy, it constitutes a form of treatment. Such terms as reeducation, helping process, and guidance are merely descriptive of what happens in the course of treatment and do not really disguise the therapeutic nature of the process.

Psychological Perspective: psychotherapy is a generic term covering the entire spectrum of psychological treatment methods. These range from designed maneuvers of the therapist-patient relationship to indoctrinations fashioned to change value systems, to tactics aimed at intrapsychic processes, and to conditioning techniques that attempt to alter neural mechanisms. The repertoire of strategies is thus legion, and formats are varied, e.g., individuals, couples, and groups. They are all, nevertheless, dependent upon the establishment of adequate communication, verbal and nonverbal. Excluded are such modalities as somatic therapies (drugs, convulsive therapy, surgery, etc.) and “trial action” therapies such as occupational therapy, dance therapy, music therapy, psychodrama, etc. that, though psychotherapeutic in effect, are not, strictly speaking, forms of psychotherapy.

Problems of an emotional nature: Emotional problems are diverse, influencing every facet of human functioning. They are manifest in distortions in the individual’s psychic, somatic, interpersonal, and community life. Manifestations of emotional illness are thus multiple, involving the total human being. In view of this totality of disturbance, it is arbitrary and unsound to dissociate psychic from interpersonal, social, and psychophysiological difficulties, aspects of which are usually concurrent, though not always obvious.

A trained person: In search of relief, the individual is apt to involve oneself in a relationship with a friend or authority. The motivations that prompt such a relationship are disabling symptoms or a realization that one’s happiness and productivity are being sabotaged by inner forces that one is neither able to understand nor to control. Sometimes the consequences of this relationship are registered in a restoration of homeostasis, a product of healing forces liberated by the helping process. At other times, particularly when attempts are made to handle the sufferer’s emotional turmoil in depth, the relationship may become disastrous to both participants. Dealing most adequately with an emotional problem requires a high degree of skill that may best be acquired through extensive postgraduate training and experience.

Deliberately establishing a professional relationship: The relationship, the core of the therapeutic process, is deliberately planned and nurtured by the therapist. Unlike nonprofessional relationships, which are part of the social nature of man, the therapeutic relationship is a collaborative undertaking, started and maintained on a professional level toward specific therapeutic objectives. More than one therapist (co-therapist, multiple therapists) may work together.

The patient: An individual in psychotherapy receiving treatment is best called a patient rather than some other designation such as a client. The therapist may relate capably to more than one patient during a session, as in marital or group therapy.

The object is removing existing symptoms: A prime goal in therapy is to eliminate the patient’s suffering as well as to remove the handicaps imposed by symptoms.

Modifying existing symptoms: Despite our wish for complete relief, certain circumstances may militate against this objective. Chief deterrents are inadequate motivation, diminutive ego strength, and limitations in the patient’s available time or finances. These will impose restrictions on the extent of help that can be rendered and make for modification rather than cure of the patient’s symptoms.

Retarding existing symptoms: There are some malignant forms of emotional illness, such as certain fulminating schizophrenic and organic brain disorders, in which psychotherapy, no matter how adroitly applied, serves merely to delay an inevitable deteriorative process. This palliative effect is eminently worthwhile, however, often helping to preserve the patient’s contact with reality.

Mediating disturbed patterns of behavior: The recognition in recent years that many occupational, educational, marital, interpersonal, and social problems are emotionally inspired has extended the use of psychotherapy into fields hitherto considered provinces of the psychologist, teacher, sociologist, religious leader, and lawmaker. Realization that the character structure is involved in all emotional illness has broadened the objectives of psychotherapy from mere symptom relief or removal to correction of disturbed interpersonal patterns and relationships.

Promoting positive personality growth and development: The final use of psychotherapy is as a vehicle for personality maturation. This has introduced a new dimension into the field of psychotherapy—a dimension that deals, on the one hand, with problems of immaturity of the so-called normal person and, on the other, with characterologic difficulties associated with inhibited growth previously considered inaccessible to treatment. Here psychotherapy aims at a resolution of blocks in psychosocial development in order that the individual may aspire to a more complete creative self-fulfillment, more productive attitudes toward life, and more gratifying relationships with people. The goals of psychotherapy thus extend from the limited objective of helping to control symptoms to the liberation of the rich resources of the human mind from neurotic obstructions that thwart its purpose and stunt its growth.

Other Definitions of Psychotherapy:

The comprehensive definition of psychotherapy given above has many advantages. However, other explanations of the meaning of psychotherapy exist that may be interesting to review. The sundry published definitions of psychotherapy agree on one point—namely, that psychotherapy constitutes a form of approach to many problems of an emotional nature. They do not agree on other aspects, such as the techniques employed, the processes included, the goals approximated, or the personnel involved. Typical definitions are these:

“Psychotherapy is the formal treatment of patients using psychological rather than physical or chemical agents, principally verbal communication.” (Menninger & Holzman, 1973)

“Psychotherapy may be defined as the treatment of emotional and personality problems and disorders by psychological means.” (Kolb, 1968)

“We shall define psychotherapy as any type of professional interpersonal situation between a therapist and his patient designed to help the patient to resolve emotional problems.”(Chapman, 1967)

“Psychotherapy is primarily a transaction between the patient and his therapist.” (Cameron, 1968)

“Psychotherapy is … a developing transaction between two people, one suffering from some type of distress or exhibiting disordered behavior, the other offering amelioration as part of his professional activity.”(Group for the Advancement of Psychiatry (GAP), 1969)

Psychotherapy consists of “techniques derived from established psychological principles, by persons qualified through training and experience to understand these principles and to apply these techniques with the intention of assisting individuals to modify such personal characteristics as feelings, values, attitudes, and behaviors judged to be maladaptive or maladjustive.” (Metzoff & Kornreich, 1970)

“For a very simple realistic definition, one could say that psychotherapy is the utilization of psychological measures in the treatment of sick people.” (Romano, 1947)

[Psychotherapy endeavors] “to alter the behavior and change the attitudes of a maladjusted person toward a more constructive outcome.”(Rogers, 1970)

[Psychotherapy alludes] “to the entire collection of approaches attempting to influence or assist a patient toward more desirable ways of thinking, feeling, and behaving.” (Thorner, 1948)

“By psychotherapy is meant the use of measures which it is believed will act upon the patient’s mind and thereby promote his mental health and aid his adjustment to the particular problems which have disturbed his happiness or adaptation.” (Noyes, 1948)

“Psychotherapy is a form of treatment in psychiatry in which the psychiatrist, by his scientific thinking and understanding, attempts to change the thinking and feeling of people who are suffering from distorted mental or emotional processes.” (Polatin & Philtine, 1949)

Psychotherapy “aims to help the impaired individual by influencing his emotional processes, his evaluation of himself and of others, his evaluation of and his manner of coping with the problems of life. It may also include changing his environment … and simultaneously increasing his potentialities of mastery and integration.” (Maslow & Mittelman, 1951)

“[Psychotherapy includes] a multitude of psychological methods, all having one thing in common—the intent to help a suffering individual through psychological means.” (Grotjahn & Gabe, 1950)

“Psychotherapy is a planned and systematic application of psychological facts and theories to the alleviation of a large variety of human ailments and disturbances, particularly those of psychogenic origin.”(Fisher, 1950)

“In general, psychotherapy can be defined as the provision by the physician of new life-experiences which can influence the patient in the direction of health.” (Levine, 1942)

“Psychotherapy is the art of combating disease and promoting health by mental influences.”(Whitehorn, 1948)

“[Psychotherapy] connotes the use of definitive psychological techniques designed to relieve demonstrable disturbances in psycho-social adjustment.” (Lowrey, 1950)

“Psychotherapy includes all kinds and ways of utilizing psychologic means to achieve beneficial psychobiologic changes.” (Diethelm, 1950)

“Psychotherapy consists of any considered and competent medical endeavor directed toward the improvement of the emotional health of the individual, based upon the understanding of the psychodynamics involved, and of the need of the individual under treatment.” (Deutsch, 1949)

[Psychotherapy is the] “treatment of mental or emotional disorder or of related bodily ills by psychological means.” (Webster’s New Collegiate Dictionary, 1975)

[Psychotherapy is] “the use of any psychological technique in the treatment of mental disorder or maladjustment… . The term carries no implication about the seriousness of the disorder … the duration or intensity of treatment, or the theoretical orientation of the therapist.” (English & English, 1958)

[Psychotherapy is] “an emotional exchange [process] in an interpersonal relationship which accelerates the growth of one or both participants.” (Whitaker & Malone, 1958)

“Psychotherapy is … a cooperative enterprise for clarifying purposes and modifying attitudes in the direction of greater integrity of personality.” (Whitehorn, 1956)

“Psychotherapy is a certain kind of social relationship between two persons who hold periodic conversations in pursuit of certain goals: namely, the lessening of emotional discomfort and the alteration of various other aspects of client behavior.” (Shoben, 1953)

“Psychotherapy may be defined as the treatment of emotional and personality problems and disorders by psychological means… . Types of psychotherapy fall into two general groups. One may be described as genetic-dynamic, the other as supportive, suppressive, non-exploratory, or non-specific.” (Noyes & Kolb, 1963)

“Psychotherapy: The generic term for any type of treatment which is based primarily upon verbal or nonverbal communication with the patient, in distinction to the use of drugs, surgery, or physical measures, such as electroshock or insulin shock, hydrotherapy, and others.”(Deutsch & Fishman, 1963)

“Psychotherapy is a process in which changes in an individual’s behavior are achieved as a result of experiences in a relationship with a person trained in understanding behavior.” (Stein, 1961)

“In its classic sense, psychotherapy is defined as the restructuring of the malfunctioning personality.” (Beliak, 1963)

“Psychotherapy is a form of help-giving in which a trained, socially sanctioned healer tries to relieve a sufferer’s distress by facilitating certain changes in his feelings, attitudes, and behavior, through the performance of certain activities with him, often with the participation of a group.” (Frank, 1961)

“Psychotherapy is a form of treatment of a client by a therapist for disorders of emotional adjustment, with the purpose of bringing about his readjustment so that he will become more comfortable in his emotions, thoughts, and attitudes, and so that his social relationship will be improved.” (Symonds, 1956)

Reference:

  1. The Technique of Psychotherapy, written by Lewis R Wolberg