Demystifying Psychotherapy: What Is the Essence of Psychotherapy?

A dizzying array of theories, modalities, and approaches makes up the vast field of psychotherapy. Humans have counseled, supported, and reassured other humans since the dawn of humanity. We are social beings who are not only capable of extraordinary empathy, but also derive comfort and joy from meaningful connection. The formal discipline of psychotherapy was propelled into existence by Sigmund Freud and his “talking cure” in the 19th century. Countless theorists, researchers, and clinicians have shaped the practice since then, sparking controversy, passion, excitement, and heated debate. The field continues to evolve and respond to the old and emerging challenges of living in the 21st century.

Psychotherapy is a relational, collaborative, and dynamic process that unfolds between the practitioner and client to guide and support the client in the effort to manifest their unique definition of a well-lived life. Psychotherapy is bound by the rules of professional conduct and ethical obligations on the part of the practitioner. It entails practices and interventions which are informed by the practitioner’s chosen form of psychotherapy and their evolving understanding of the client’s history, goals, and needs. The client is an active participant who enters into this endeavor upon giving informed consent, which means the client learns about and accepts the responsibilities involved.

The client may bring to psychotherapy their wounds, traumas, insecurities, and shame. As relational beings who need to feel loved just as desperately as we need air to breathe, humans often find that the source of pain that has wreaked the greatest havoc on their lives is relational in nature: being neglected or abused, misunderstood or bullied, abandoned, broken up with, assaulted, made to feel “less than,” lonely — the list goes on.

We hurt in relationships and we heal in relationships. The relationship between the therapist and the client is what breathes life into psychotherapy. To be witnessed and seen, welcomed, respected, and supported by another whose sole purpose is to apply themselves to render caring assistance is a powerful catalyst for personal growth and recovery.

The quality of the client-psychotherapist bond has been shown to be the key predictor of the outcomes of psychotherapy. After all, psychotherapy entails an intimate exploration of the client’s subjective, interpersonal, spiritual, and embodied experience, their past and present, their hopes and dreams. This work requires a great deal of trust and vulnerability.

Without trust, regard, and genuine connection, therapy interventions derived from the very best and most solidly-researched protocols will have limited impact. Every client is different and therefore every relationship built over time between the therapist and the client will also be unique. It will also continually evolve and shape the work the therapist and the client are doing together. When people reflect back on successful psychotherapy experiences, they tend to emphasize the depth of the bond and caring they experienced with their therapist over recollections of specific skills and insights they gained, even if the latter helped them very much. The therapeutic relationship is the essence of psychotherapy, a key ingredient without which the powerful outcomes of this endeavor cannot become a reality.