Robert Snell

What is psychotherapy?
How can it help?

Psychotherapy is a boundaried, confidential conversation which can help us to reconnect with ourselves and others - to make new kinds of emotional sense.

People seek therapy for all kinds of reasons. Perhaps there is suffering which has never been properly shared or acknowledged. There may be anxieties around relationships, overwhelming feelings or else a lack of feeling, loneliness, or just a sense of something missing. Such states sometimes manifest themselves in particular symptoms or behaviours.

Psychotherapy can bring the relief which tends to flow from a better understanding of our difficulties, and this in turn grows out of the living relationship with the therapist. Fundamentally, it is a way of meeting our common human need for recognition, belonging and meaning.

Although the topic of conversation is the patient's world and experience, psychotherapy is a joint venture. Both patient and therapist are active participants. It can last as long as it needs to: this might be a matter of a few weeks or months, or therapy might be undertaken on a much longer-term, open-ended basis. It might involve meeting once or up to four times weekly. All this is for patient and therapist together to decide. For each therapeutic conversation is unique.

…some further thoughts

Most of us come to therapy with a story, an account of ourselves shaped by our anxieties, traumas and disappointments as well as our hopes. In the therapeutic space such stories can be aired, listened to and treated with respect. Psychotherapy also works to loosen up these stories, so that, over time, room might be found for future, perhaps as-yet-unknown possibilities.

Why ‘existential’? Why ‘analytic’?

Existentialism is an embrace of experience whatever it is. From an existential point of view, psychotherapy consists of two people who agree to get together, for the primary benefit of one of them, to explore meanings which might help with living - rather than an encounter in which the therapist, armed with 'expert' knowledge, does something to the client.

Existentialism encourages an awareness of how far we are free to choose how we live our lives. But an 'analytic' understanding may also be necessary to help us negotiate some of the hidden obtacles, the unconscious forces and constraints, which can stand in the way of choosing.

Our present difficulties often have hiddden roots in the past. Past conflicts and patterns of relating find expression in the present. A lot of what can trouble us – depress us, keep us awake at night, get us into familiar difficulties, madden us – does so because the conflicts which underlie it are not conscious to us; they are not yet available to be thought about. They can, nevertheless, generate impulses and feelings over which we can feel we have little say, and which can drive us to keep on repeating ways of thinking, behaving and relating which may be destructive in our own and others' lives.

The live relationship with the therapist will often replicate these patterns. In the security of the therapeutic setting, this relationship can be explored as it develops and unfolds, and old patterns be brought into consciousness and modified. This is one important way, among others, in which therapeutic change comes about.

At the same time this 'unconscious', which can seem both to resist being known and to want to be known, is the source of our creativity. Psychotherapy is challenging; yet its demands and rewards are also those of creative activity.

Psychoanalytic (or 'psychodynamic') therapy in particular is an invitation to both participants to pay attention, through speech, to everything that comes to mind, to dreams and all that is located on the margins and edges of day-to-day waking life, where what is less conscious might emerge.

If we can be open to this, and to what in ordinary social life might be considered 'negative' feelings and experiences, like rage and hurt, then instead of merely trying to side-step and 'manage' them we may just possibly be able to turn them to more creative account – to allow them, along with our other emotions and desires as we get to know them better, to guide and inform us.

In this way it might be possible for us to develop alternative stories about ourselves, in the place of a fixed or single viewpoint. Psychotherapy can be a way of replacing monologue and a need to stay in control - for which, once upon a time, we will have had good reasons - with dialogue, the possibility of play and inter-play, of relationship, responsiveness and respons-ibility.

The word 'analysis', it may be useful to remember, is derived from a Greek verb which precisely means 'to undo, unloose, loosen up'. British analysts have often have a penchant for metaphors from gardening or farming – analysis as turning over the soil. The therapeutic space allows thoughts, feelings, fantasies, ideas which might feel unacceptable anywhere else to turn up. In the process it becomes a fertile space for growth.