December 04th, 2019

Here's My Problem, So What Should I Do?

Psychotherapy takes time. Periodically, a new client will come in for the first time, succinctly describe their perception of their problem, there will be a second or two of silence, and then they will say something like “so, what should I do?” At this point, rather than tell them what to do, I try to get the person to continue talking about themselves and their problem. If only the problems that we take to therapy could be solved in a brief conversation! But why isn’t it that simple?

First of all, neither I nor the client is likely to understand what is going on for the client in great depth after just one conversation. Even if I, as the therapist, had a pretty solid idea about what was happening and how the client could help themselves out of it, it’s not enough for me to understand. The person who really needs to understand the problem is the client and my job as the therapist is to assist the client in finding that understanding for themselves, primarily through deep listening and encouraging an exploratory attitude in our relationship and only secondarily through my expertise in how psychological problems happen and what tends to help people work through them.

In addition to understanding a problem, people come for help in figuring out what to do about it. Just as it is vital that the client come to their own understanding of their problem, they must also ultimately make their own decision about what to do about it. It is the client’s life and they must live it. Even if I knew the client’s problem well, and I had a workable solution in mind, by telling them what to do I would rob them of the chance to become better at finding their own creative solutions to life’s problems. And anyway, most things in life have many possible solutions, so who am I to be the one to decide how other people should live?

Leaving the ultimate decisions about how to understand and solve one’s problem to the client doesn’t mean that I don’t intervene in any way or that I keep all of my thoughts to myself. I will at times share thoughts I’m having about people’s problems, things people might try to better understand, manage, and work through their problems, and things that I know about psychology in general. The difference is that this is done in a tentative, exploratory way, as a collaborative conversation about what might be happening and what might help, rather than what I know is happening and what I know the client should do. I use my knowledge and skills to help other people find a more authentic and satisfying path for themselves.

In my experience, many of the problems which people bring to therapy are rooted in well established, unconscious patterns in the way that one relates to themselves and the world. One reason why therapy takes time is that patterns take time to emerge, be understood, and change. Old, stuck patterns are hard to see in ourselves, can be hard to talk about, and may involve great discomfort. The act of talking about our problems with another person can be difficult in itself, requires the building of trust, and that trust takes time to establish. The emotional discomfort that can come when we start to see through and attempt to change old patterns may take time to learn to tolerate and eventually work through.  What results from that working through is relief, understanding, and a shift to a freer and more authentic way of relating to one’s self and the world. While therapy may not provide the fast and easy solutions that we would all like to have, you may find with time that it provides a depth of answers you can really use.

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