All better now– thanks!

Sigmund Freud, founder of psychoanalysis, smok...

Sigmund Freud, founder of psychoanalysis, smoking cigar. Español: Sigmund Freud, fundador del psicoanálisis, fumando. Česky: Zakladatel psychoanalýzy Sigmund Freud kouří doutník. (Photo credit: Wikipedia)

Last week I saw someone for what may be the last time. She had originally come in depressed, and after a few sessions, she wasn’t depressed any more. So we cut back from every week to every other week, and then we were done. It’s something that people forget about in the world of counseling and psychotherapy. Sometimes it ends. And it isn’t impossible for it to end relatively soon. We’re still a bit influenced, I think, by the original Freudian model of psychoanalysis. Freud saw his patients four or five times a week over long periods (years).  There are still psychoanalysts around, and they don’t consider psychoanalysis to be only (or even, necessarily, mainly) a therapy. Check out the web site:

But in an era when life moves fast and health care is “managed,” the process of psychoanalysis– or even long term, insight-oriented depth psychology– is not for everyone. But relief from suffering is. At least that’s my opinion. One thing we know from the study of personality types is that some people are much more results-oriented than others. Some people are not particularly introspective. Some people are not psychologically oriented. Yet all types of people can have problems of living.  Therapy is more focused on specific goals and alleviation of specific conditions, rather than on an open-ended voyage of self-discovery.  It is neither good nor bad, right nor wrong, in my opinion. To use the new American spiritual mantra, it is what it is.  The original model of cognitive therapy developed by Aaron Beck & most commonly used now is designed to run about twelve sessions, or if you prefer, three months. This model has been validated in clinical trials where it provided as much relief as medication for conditions such as anxiety, depression, and obsessive-compulsive disorder

Does this mean that my therapist is no good if it takes longer? Hardly. Some things, especially personality disorders, are definitely longer term projects. For some people, too, the beginning of a process of psychotherapy is an uncovering that does lead to a longer voyage of self-discovery. There are also wellness goals– you might want to move beyond easing of symptoms to a higher level of wellness in both feeling and functioning. There are a wide range of problems, goals, processes and outcomes in psychotherapy. But it doesn’t have to be a long drawn out, process. Sometimes, it can be short and to the point. copyright James Matter 2013


About jamesmatter

Marriage and Family Therapist (MFT) in private practice in San Francisco. I work with adults, adolescents, and couples, with focus on substance use and abuse and co-occurring disorders (having both a mental illness and an addiction).
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