Psychotherapy is a mysterious process to most people. It isn’t easy to explain how it works and how it can help with problems. When individuals come to therapy, they have almost always reached some sort of a dead end. They feel stuck. Their usual methods of coping are not working, but they don’t know what else to do to make things better. This is partly because their way of perceiving reality is being distorted by ideas and messages that come from the past and are not necessarily relevant or appropriate for what is happening in the present. Some of my job as a therapist is to help people see these distortions from the past so that they can correct them and perceive reality more clearly. When patients are able to see reality more clearly, they will usually make more effective choices about how to solve their problems. They become unstuck.

When patients first come to see me, I often use the analogy of a puzzle to describe the process of psychotherapy. In the first several meetings, individuals tell me their story. This is like throwing the pieces of their personal puzzle on the floor in front of us. I listen closely and begin to piece together the outer edges of the puzzle, the framework. I begin to understand what some of the motivating factors are for this person. Why they think the way they do. What their unique way of perceiving reality is. Then each week we work on the puzzle. Sometimes we will work on only one area for many weeks. Sometimes we will work on several areas in just one session. And, I am always working on the framework, filling it in more and more as I get to know the person better and better. Eventually the picture begins to emerge and we can step back and see it clearly. Some patients only want to work on one part of the puzzle, usually the part that is causing them the most difficulties. Others want to spend longer filling in more of the picture, uncovering areas of the puzzle that have been hidden for a very long time. Periodically, I point out some of the picture as it takes shape. Sometimes without my help, patients are able to see the picture as it develops before their eyes.

A young woman entered therapy because she had decided to divorce her husband. She was distraught about getting a divorce but she was adament that there was nothing that could be done to save the marriage. Her husband was a nice enough person, she said, but she was tired of being the strong one in the family. She felt she had to make all the decisions, take all the responsibility for running the household and initiate all the activities. Why did this woman feel so hopeless about her marriage? The answer came from her childhood. Her mother had been a very competent person who dominated her passive father. The marriage deteriorated into constant bickering and bad will between the partners. Her parents continued to live together in an uncomfortable truce that left both of them unhappy and unfulfilled. When this woman chose a partner, she unconsciously chose a passive man that she helped and encouraged to do better. Eventually, his passivity began to frustrate her. She didn’t want to be in an unhappy marriage like that of her parents. When she saw the picture in her puzzle take shape, she realized that she had been assuming that her marriage was just like her parents marriage. She decided to at least try some marital counseling before getting a divorce. By piecing these important parts of her puzzle together she had seen how her picture of her marriage was distorted by the assumptions she carried from her past and this freed her to choose another course that was more based on the reality of the present situation.

Dr. Parker is in private practice in Torrance. She is a member of the Independent Psychotherapy Network.

The author of this article, and founder of the Therapyinla.com website, Joyce Parker, passed away in 2011. To honor her we are keeping her articles posted at this website.

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