I had been working with Annie for 3 months. Her symptoms of anxiety, insomnia, and frequent bouts of crying had improved, but not to the extent either of us would have liked. Annie began to wonder whether difficulties in her marriage were implicated in her symptoms, and she decided to invite her husband Matt to join her in therapy. Matt agreed, but reluctantly. After the introduction he said, "I'm here, but I don't believe in psychotherapy".
As I said to Matt that evening, I don't believe in psychotherapy either. Psychotherapy involves a knowledge base, a skill set, and a relationship, and hence is not something to "believe in". It requires knowledge of human behavior, interpersonal and family dynamics, emotional wellness and illness, and an awareness of the impact of culture and economic systems on people. It requires communication skills, along with a capacity for insight, intuitive understanding, the ability to suspend judgment, and a knack for making connections between seemingly unrelated events, behaviors, and feelings. The knowledge and the skills needed for the practice of psychotherapy qualify it as a science.
As a relationship, psychotherapy is also an art. While certain principles underlie therapy as a particular kind of professional relationship, like boundaries, ethics, and non-reciprocity, it can't be learned from a book or even by imitating other therapists. Relationships must be experienced and felt, and too many rules or road maps diminish them.
When I sit down with Annie and Matt, I can't forget what I've learned or the skills I've developed. Paradoxically, however, I have to bracket them time and again to e receptive to these unique human beings, and to open myself to a brand new relationship. Empathy, which is the ability to walk a bit in someone else's shoes, so that they might possibly walk farther or more easily, involves both a commitment and an aptitude.
I suggested Annie and Matt think of therapy like a house, a house being important, even essential, but not something to believe in. The foundation, the framing, the siding, and the roof make up the science of psychotherapy. Everything else is art.
Susan Donnelly has been a practicing psychotherapist for over 30 years, and presently maintains a private practice in Ridgewood, NJ. she has held clinical and administrative positions in public and private agencies and has recently completed a term as Chair of the Bergen Country Mental Health Board. You can visit her website and blog at www.ridgewoodtherapy.com.