Psychology, psychotherapy

Questions & answers:

1.- What type of psychotherapy do you practice?

I integrated several theoretical perspectives (psychodynamic, systemic, cognitive-behavioral) into a personal integrated approach where the starting point is clarifying your goals. I work through a constructive dialogue where you know everything about yourself and I only know where to look for answers as well as information and techniques to produce the change you long for.

2.- Why do I feel bad if everything in my life is perfect and others have it far worse?

There is an extremely wide array of difficulties troubling normal people at any age, regardless of outward signs of wealth, success and well-being. It is an underestimated challenge for everyone to face modern occidental life with its load of high expectations, high demands, emphasis on individualism and materialism, denial of other needs, high levels of stress, disjointed family and social support networks, increased migration and instability, changing roles, clashing communication patterns and values …to name only a few external factors related to inner trouble.

3.- I have good friends, how would talking to a psychotherapist make a difference?

What happens between a psychotherapist and a client is different. The psychotherapist does not - as much as humanly possible - involve you in his or her problems. The time you pay for is completely dedicated to you. The psychotherapist focuses on you with no preconceived opinions or judgements. He does not intend to make you do things you don’t want to. His role is only to make a specific process happen (the psycho-therapeutic process).

4.- To contact a psychotherapist, does it mean I’m crazy?

To contact a psychotherapist does not mean you are crazy. It means you are healthy enough to know you need help.

5.- What if I become dependent on psychotherapy?

You remain free at all times to book appointments or not. If you feel you enjoy psychotherapy it is essentially because it has become helpful. You need not fear dependency for at some point when you've reached a level of comfort within what you were looking to solve, you will wish to take a break.

6.- What if the psychotherapist judges me?

The psychotherapist’s training and job focuses on shedding light, understanding and unravelling what seems to make no sense, what seems irrational and unacceptable. In order to do that, the psychotherapist adopts a neutral and non-judgmental attitude.

7.- What if the psychotherapist tries to influence me?

It’s not the psychotherapist’s job to give advice or try to make you do what he considers fit. He may express an opinion in certain circumstances such as related to your safety but he will make it clear that you remain the boss at all times.

8.- What if I don’t like the psychotherapist?

One of your main tasks at the beginning is to find someone with whom you feel comfortable, respected and listened to. Psychotherapy will not occur if you constantly hold ill feelings towards the psychotherapist. Trust is essential. Make appointments with several professionals and stay with the one you prefer.

9.- What if I don’t want to dwell on my past?

You are expected at all times to say only what you feel the need to say. You are neither required to say everything nor requested to dissect your past. Eventually, you will feel free to express the flow of thoughts and feelings as they come up. You will discover that often, it is what seems to be silly, trivial and unrelated which helps shed new light on situations.

10.- How will I know psychotherapy is helpful?

The best indicator of psychotherapy being useful is when symptoms gradually disappear and/or you feel you are back on track on the path which leads you towards your goals. This won’t happen immediately though, especially if you’ve been suffering for years. This is why there is another good indicator you need to pay attention to: your subjective experience. Do you “feel” the sessions are useful? Do you feel you are gaining clarity, understanding and new insights? If not, if you feel repeatedly angry and resentful towards the therapist, if you feel you are stagnating, either you have wrong expectations as to what can be achieved in therapy or you plainly need to look for another psychotherapist. Discuss it over and proceed to change.

11.- I'm scared the psychotherapist will determine I'm mentally ill!

Psychotherapists are trained to focus and enhance resources, capacities, talents and strengths. Everyone has positive sides. It is the constructive side of you which is going to get you where you want to be. Personally I will not diagnose you unless you ask me to, nor write a report on you without your permission. Also, in my practice, every report is reviewed and approved by the client/patient before being sent to anyone. This should be the absolute rule, always and everywhere, in order to prevent mistakes and falsehood being written about you. In Switzerland, you are entitled to copies of all medical reports written about you. My recommendation is to always ask for a copy upfront.

In Switzerland, if you wish to be reimbursed by your private supplementary insurance or your international health insurance, be aware that after a certain period of time, they will ask the psychologist-psychotherapist for justification in the form of a report and a diagnosis based on the WHO classification of mental illnesses. This is a condition of reimbursement by the Swiss basic insurance from the very first session.

12.- What is expected of me?

Talk about whatever you feel comfortable talking about and what makes sense to you.

Attend settled appointments unless you're sick of course.

Pay for reserved time slots (except if cancelled a week prior).

13.- How come psychotherapists also seem to have at times problems in their own personal life?

Psychotherapists are normal people tangled up in life like everybody else. It is commonly expected from them to be magicians, wise know-it-all men & women. But to be a psychotherapist remains first of all a job. They are mainly meant to know a method to make a process happen that will make YOU get where you want to get.

Psychotherapists do not hold the secret to eradicate life’s difficulties altogether!

14.- How many types of theoretical approaches to treatment are psychotherapists meant to know?

Psychotherapists are required to specialize at least in one recognized approach in order to be allowed to practice. However most experienced psychotherapists, respectful of the diversity of clients and situations, have studied an array of theories and techniques which they have integrated them in a meaningful, coherent and personal style over the years.

15.- Do all psychotherapists treat all disorders?

It is the psychotherapist’s responsibility to know what he feels comfortable and experienced enough to treat. He will discuss this with you, usually at the beginning.

16.- Can clients rely on the ability of the psychotherapist to choose what approach and methods are best for them?

Certified psychotherapists have the training to lead psychotherapy. However, your input remains essential at all times to inform the psychotherapist as to whether you feel comfortable with the psychotherapist’s ways.

17.- What is requested in Switzerland to be legally allowed to call oneself a psychologist-psychotherapist ?

A master's degree in psychology (5 years) and additional certified training in psychotherapy (such as the 3-year Master of Advanced Studies) are required. This allows you to obtain certification as a psychotherapist from the Swiss Federation of Psychologists, authorization for independent practice from the cantonal health department, and, if requested, registration on the list of healthcare providers recognized by health insurance companies and their umbrella organization, Santé Suisse..

18.- What is the difference between psychologists, psychotherapists, psychiatrists, psychoanalysts counsellors and coaches?

In Switzerland:

Psychologists are professionals who have completed the equivalent of master's level (or more) studies in psychology. It enables them to work in any field where scientific knowledge about human behaviour is necessary. It is however insufficient to work as and call themselves psychotherapists.

Psychotherapists are master's level professionals with years of additional certified psychotherapy training, hundreds of hours of supervised work with patients, and advanced psychotherapy work on self..

Psychiatrists are medical doctors specialized in prescribing medication for mental health issues. Some of them practice psychotherapy. General practitioners are not psychotherapists but are reimbursed somewhat by medical insurances for the time spent listening to you when related to your medical condition.

Psychoanalysts are psychotherapists who practice a very specific type of long term approach called psychoanalysis based on derivatives of the original theories of Sigmund Freud or Carl Gustav Jung's and others who focus mostly on our inner conflicts as the source of anguish.

Counsellors and coaches come from different backgrounds, nursing, social work, physiotherapy and also completely unrelated fields. It differs from psychotherapy in terms of lenght and goals pursued. Some of them do a very good job, however and for your protection, you need to check whether they are authorized to practice as such locally.

In Switzerland, anyone who handles your health is meant to request and obtain the authorization to practice by the canton’s Health Department.

19.- What is psychotherapy?

Psychotherapy is a specific process which happens between a client and a psychotherapist. In adults, psychotherapy is an investigation between you who holds all the information and the psychotherapist who has the knowledge to lead the process towards the clients' desired results through questions and specific interventions. In children and with me, parents are always included in the process.

Psychotherapy gradually leads to the profound personal changes you desire. The exercise of describing your difficulties is only the first step in successful psychotherapy. It inexorably leads to awareness and consolidation of the forces of renewal that reside within you despite your wounds. If the sessions are not perceived as useful by the patient and no progress is observed after a few months, it means that other factors are at play and/or that psychotherapy is not taking place.

Psychotherapy is a process that differs from writing reports and establishing diagnoses of mental illnesses. Psychotherapy liberates and sets in motion, while diagnosis categorizes. The two approaches generally require completely different specializations.Psychotherapy, as I practice it, makes no distinction between prevention and treatment. Indeed, it addresses both by addressing our innermost being. It focuses on desired change, possible evolution, and a reconnection with our evolving essence. It draws on various theoretical and technical perspectives depending on their usefulness to your quest. It prevents and treats psychological suffering by refocusing you on your energy, your speech, your strength, and your aspirations. It focuses on the present, the future, and the past if necessary, your dreams, and your actions. It leads to change through the integration of forgotten, dissociated, repressed, minimized, projected, denied, and intellectualized elements. It takes into account everything that determines you but also believes in your freedom of choice. The duration of psychotherapy depends on your personal goals: 10 to 30 sessions for specific goals, years for complex or serious difficulties (trauma, abuse, chronic illnesses).

Mental health diagnoses are useful in helping us understand that we are not alone in experiencing certain symptoms. They allow for medicalization and hospitalization when necessary, but can freeze us into the idea of a "sick" object that must be "treated," perhaps for life, potentially a victim of genetic vulnerability or other damage to which we must become accustomed.* What is crucial for progress to occur during psychotherapy is the definition of the problem, the established connection and trust, the psychotherapist's attentiveness and skill leading to the verbalization of the unspeakable, and the initiation of a characteristic interpersonal process of introspection leading to insights. This takes time.Exploring daily life and sometimes the past with the psychotherapist allows for the relief of repressed emotions often experienced in solitude, as well as discoveries, changes in perspectives, and integrations that bring about change. This is achieved through questions, clarifications, definitions, suggestions, interpretations, and exercises. The setting is confidential.

20.- Is the type of psychotherapy chosen essential to the outcome?

Regardless of theoretical backgrounds, it has been shown that psychotherapists who are felt to be “good” lead the process in similar ways, make similar interventions and share the same ethics. There are more than a hundred types of psychotherapies. Psychotherapists have different personalities, experience and styles. The main factor in the outcome is the therapeutic quality of the relationship established.

21.- How long does it take to get better?

The length of psychotherapy varies. It is unrealistic to expect to get better in a couple of weeks if you have suffered for years. Quick fixes are appealing but may not last. Very long and intense approaches requiring 3-4sessions/week over several years are meant to aid one understand and overcome deep and profound disabling inner psychological variables but are known to be unsuited for some disorders. In all other cases, the length varies according to your level of need, the complexity of your situation and the goals you wish to achieve.

22.- What happens in psychotherapy?

Psychotherapy evolves in three phases: the start is essentially focused on information; the middle phase feels as though one is evolving from insight to insight and the third phase emerges when a relatively stable comfort zone has been reached. Insights are elating for they touch mind, heart, body and impact behaviour. They give a sense that evolution and progress is possible. They differ from intellectual knowledge.

23.- Once the client has completed a psychotherapy, is he cured ?

A completed psychotherapy does not immunize for good against the impact of new difficulties. As life unfolds in complex, unpredictable and unexpected ways, new situations may overwhelm again. Besides teaching humility, each difficulty can be faced as a learning opportunity. There is no shame in asking for help again.

24.- When should you seek psychotherapy?

When it feels urgent to you to find a private and neutral space to sort things out, for example in order to:

OVERCOME blockages, anger, sadness, fears, resentment, burdens
FIND passion, enthusiasm, joy, sense of worth, meaning
MATERIALIZE dreams, goals, values
MANAGE complex situations, difficult partners or life daily relationships
COMMUNICATE effectively

25.- Who needs psychotherapy?

Anyone who feels the need for psychotherapy needs it. A need is a subjective feeling, not always related to obvious difficult external circumstances. It is an alarm signal telling us that something real is disturbing us. It requests to be paid attention to. Some people feel the need for psychotherapy but are guilty to ask for it because nothing seems to be wrong in their life; on the contrary, everything seems to be promising. On the other hand, some people who have terrible life circumstances or profoundly disabling behaviours refuse to contact a psychotherapist. Only those who ask for help can be helped.