As a psychotherapist, one question I am often asked is “what is psychotherapy?” This is often followed by “and how does it differ from psychology and psychiatry?” These are very good questions to consider when thinking about how to decide on a course of action to address your mental health. To be sure, addressing one’s mental health is not always about dealing with difficult issues. It can also be about optimising one’s potential. It is good to remember that there is certainly no “failure” in having challenges in life.
Life is difficult for everyone for many different reasons. However, paying attention to your mental health can be one of the most promising and rewarding ways of dealing effectively with life’s inevitable challenges. So how to do that?
The root word shared by these three distinct professions is the Greek psukhe which means, variously, “mind”, “soul”, “breath” or “character”. All three work with this dimension of the human being yet do so with different approaches. Psychiatric training comes at the end of a medical degree and thus it is rooted in a biomedical framework, or paradigm. This means that it is concerned with the physiological and neurological conditions that give rise to clinically diagnosable disorders of mind. Psychiatrists are trained to scientifically classify disorders of mind and prescribe medicine to treat these disorders when they are diagnosed. Psychiatrists work with diagnostic criteria which help to delimit the experience of the patient into workable categories, which then can be treated as one would any other kind of illness or disease. It is very effective for disorders that may have at their root a neurological disorder. Psychology, on the other hand, understands mental health as a complex mix of cognition (thought), emotion (bodily affect), and behaviour. By studying the way thoughts influence emotions and behaviour, a psychologist can help a patient attend more carefully to their thoughts and emotions and see how these are either helping or hindering effective behaviour. This approach is very productive when it comes to helping people whose behaviour, emotions, or thoughts have become dysregulated in some way.
Finally, we come to psychotherapy. Psychotherapy is more relational than both psychiatry and psychology, and indeed it is an approach which harnesses the qualities of relationship that support and enhance mental wellbeing.
It is often referred to as “talk therapy” for this reason. However, rather than diagnose one’s experience, or observe and monitor one’s thought and behaviour, psychotherapy is about exploration of one’s whole character. It is about understanding oneself more realistically and completely as a fallible, mortal human being with gifts great and unique, full of foibles and folly.
The goal of this exploration is ultimately a sense of freedom, however that looks for the client. This might be liberation from one’s past, one’s “hang-ups” or fears, or it could be the ability to create the life of one’s choosing. The therapeutic setting is the place for such exploration, and as psychotherapists, our goal is to facilitate the sense of safety and relational integrity this requires. For psychotherapists, no matter whether our clients seek to overcome severe difficulty, or optimise their greatest potential, ultimately, we aim to assist the client to find and enact the ways of being they deem most desirable for a contented love of life.