What is Psychotherapy?

During psychotherapy, you and a professional person try to find out what burdens and weighs upon you, and you both try to work on your ability to live life as you personally want to live it. This can mean the relief of all your symptoms, but it can also mean to learn to accept them and live with them in a healthy way.

There are different forms of psychotherapy, and it depends on your needs, your symptoms, and your possible diagnosis, which form suits you best. Diagnosis means that, via examinations and conversations, you and your therapist find out whether or not a psychological disorder lies at the root of your ailments. This is very important, as it helps treating your psychological problems by comparing it to past scientific experience with similar cases.
Some disorders are treated with a combination of therapy and medication. For example, a depression can be caused by the imbalance of specific chemicals in your brain – your neurotransmitters -, and medication can bring this chemical household back into balance.
But whatever the individual problems are, all forms of therapy have one thing in common: its goal is to help you; and it is trying to do so in a trusting and goal-oriented cooperation between you and your psychotherapist.

Be open and honest

Psychotherapists would never judge you, no matter what you tell them. That’s why it is important for the success of therapy, to be honest and don’t be afraid to speak about anything that might be on your mind. Especially in the beginning of therapy, it can be very strange and difficult to tell personal things to a person you don’t know – but you will quickly see that it’s the best way in order for your therapist to know how to help you.
Think about it: When you have a broken leg, you won’t fear that a doctor might judge you for it, right? It seems obvious and self-evident that you’re going to the doctors to get the help you need, and you can be sure that it is her or his main interest to heal your leg. After all, it’s a doctor’s job. And it’s the same with psychotherapists, only for mental disorders and problems.

Everything you say is safe

Psychotherapists – like doctors – are obligated by the pledge of secrecy, which is taken very seriously in the medical world. This means that doctors and psychotherapists are not allowed to talk to anyone about how you feel and what you have told them. Of course, you can arrange with your therapist to bring someone else to therapy. You can also allow your therapist to tell someone specific about your ailments. If that is not what you want, you are always allowed to say so. The therapist will only ever give general information to your contact people if they should ask about it. Or perhaps, she or he will give out broad tips to your family and friends on how to support you best on your path toward mental healing.
Even in your first session you can ask which information could potentially be given to whom. The therapist will give a reliable answer.

The first step needs courage

To begin therapy can cost a lot of willpower, even if it is the best way of getting help. In Germany, every person has a right to get support for mental health problems – so don’t hesitate to claim this right. It is very brave to take the first step and get ready to talk about what weighs on your mind. It is no sign of weakness to get help and start a therapy – on the contrary, it shows how you are strong enough to deal with your own problems and care about your mental wellbeing. You don’t have to worry about being misunderstood or having to work with someone you don’t feel comfortable with. We will explain to you in a moment, how you can find the professional help that suits your individual needs.

What Forms of Therapy are there?

The four types of therapy that the german insurances pay for are Behavioural Therapy, Depth Psychology-based Psychotherapy, Psychoanalysis and Systemic Therapy. They work with different methods, meaning they view the possible mental problems of a person from different angles. Depending on the form, the sessions and the conversations between patient and therapist can look very different.

Behavioural Therapy

During Behavioural Therapy you learn how to deal with things and especially situations that are difficult for you. It’s a very practice-oriented form of therapy, meaning it is very tied to daily life and includes practice routines and questions about regular activities. It is less about digging through your past to look for the root of your psychological problems, but rather about managing daily life on your own and without being restricted by what’s weighing on you. It is important to observe your own habits, like automatic reactions to things, automatic thoughts, and constant self-images and to learn how to work on them.
Still, you and your therapist will talk about who you are and how you feel – and of course what it is that burdens you. This is the basis of determining the aim of the therapy. For example, it could be to not be afraid of spiders anymore or getting your aggressions in specific situations under control. Even if it is difficult to put the problem into words, like for example, a constant feeling of sadness with no particular trigger, a behavioural therapy can still help.

After the therapy’s aim is worked out, you and your therapist will work on a treatment-plan. What should be achieved? Which obstacles can be overcome step by step to get to the goal? What are your strengths and special abilities? – it is easiest to work with them, as they are already inside you and you only have to learn how to use them to your advantage to overcome your problems.
Oftentimes during a behavioural therapy, there will be some sort of “homework” to practice the handling of challenging situations at home to apply what you’ve learnt in the context of daily life. You might reach certain personal limits, but your therapist will ensure that these will not overwhelm you. You can deal with challenges step by step and learn that you can indeed overcome them.

Systemic Therapy

You and your therapist are working not only on your inner world of thoughts and feelings, but also on your relationship with, and the dynamics between, you and the people surrounding you. Relationships to other people can be challenging for the mental health too – and accepting this is not in any way meant as an offense to someone. Every person thinks and feels differently and sometimes communication just doesn’t work as well as we’d want it to – even with people we love. Misunderstandings, differently interpreted situations, and the subsequent tensions between us and our surroundings can be weighing heavily on our mental wellbeing. But when all the people involved work together to learn how to treat each other and understand one another more thoroughly, these problems become solvable.
Friends, family, and partners are all very welcome during a systemic therapy. The sessions that take place together with these important people are planned by the therapist. During these sessions, the people who are close to you and with whom the problems are connected will be brought to an understanding of what is going on within you and how they can support you.
If you don’t yet want to confront your close social environment, the systemic therapy works also with just you and your therapist.

What is important is that you will feel better soon. You and your therapist will therefor first talk about what burdens you and how you feel, and what your individual needs are that need to be taken care of. It is important to observe how you perceive and judge things, and whether this differs between you and the people around you. This is how you find out to which situations and topics you are sensitive and how misunderstandings and tensions arise. This is important, so that you learn how to react within a relationship and healthily deal with any problems – this way, you can get closure with difficult situations instead of ruminating about them afterwards, which may lead to the mental distress you are in therapy about.

Psychoanalysis

Psychoanalysis – sounds like a deep look into the human psyche. And that’s exactly the goal of this form of therapy: A thorough investigation of what makes you, and what current and past problems affect your wellbeing. That is why it is important to be ready to talk to the therapist about anything that might weigh upon you, as well as talking about your past and the problems you have faced then.

In psychoanalysis, before you can learn how to deal with the mental problems and conflicts you are facing today, you will first need to dig for the root of these problems and conflicts. This root is often found somewhere in childhood, but that is not meant to be held against your parents or your family. It’s just that our past oftentimes influences our present behaviour more that we might think: The relationship to your parents can be of immense importance for the way you are experiencing other relationships, as well as affect your way of acting in them. A stressful experience in the past can have led to fears that subconsciously built themselves into your daily life and start dictating it. Or a lack of confidence today may be rooted in having been shy as a kid - this being interpreted as a given and unchangeable fact of personality or role. These are all just examples, but they showcase how many possible directions there are to take when considering the root causes of psychological issues.
Many of the conflicts that may have led to the psychological challenges we face today are often buried so deep in our subconsciousness that we don’t really remember them – or we might have even suppressed them over time. We oftentimes don’t realize that certain situations of our past might have influenced us as profoundly as they actually did, and that they might have something to do with the development of a psychological disorder. That’s why psychoanalysis gives the opportunity to freely roam all the different fields of memory and confront you with situations and conflicts that might have to be worked on in order to move forward. Connecting, interpreting, and understanding are the tasks that you and your therapist will work on together. For this, you have to be ready to face your own past and to talk about difficult subject matter, too. Furthermore, it can feel uncomfortable to have the therapist make assumptions about you from what you’re saying – but exactly this confrontation with possible interpretations of yourself, as well as the way you are dealing with this confrontation is what helps in determining what burdens you and which effects this has on you.

During psychoanalysis, you will often lie or sit comfortably without seeing the therapist. This is done so, so that the mimic and reactions of the therapist doesn’t affect you in your recollection of your past. This creates an atmosphere in which you are professionally supported, but are still free in talking, remembering, and expressing feelings – in your own tempo and just as you want it in that moment.

Depth Psychology-based Psychotherapy

This form of psychotherapy has a lot in common with psychoanalysis, as it developed from it. They both belong to the so-called psychodynamic procedures. The main focus here is also on what things and situations burden you know and have burdened you in the past. You and your therapist will approach them together and learn how to deal with them and get closure – just like in psychoanalysis.
A big difference, however, is the way that you sit facing the therapist during your conversations. So, instead of you freely associating and remembering in your own tempo while laying on your back, your therapist will sit opposite of you and ask questions when he or she senses something important. It is a conversation in which you take steps together and search through your memory for solutions to your current problems.

This depth psychology-based psychotherapy is considerably shorter than psychoanalysis. This means that your past experiences and conflicts are still important, but the main goal is the managing of current problems and difficulties.

If you wish to get direct advice from your therapist on how to deal with problems and conflicts, behavioural and systemic therapy is probably more suitable. Depth psychology-based therapy and psychoanalysis are more so designed for you to get to know yourself more thoroughly and understand where your problems come from. That’s why the latter forms of therapy give you more room to talk more deeply about your past and present experiences.

How long does Therapy last?

How often therapy sessions take place depends on the form of therapy, the specific problems that are addressed, and the psychological disorder that might be at play. And, of course, the achievements that are reached on the way and if they result in less need for continuous help of a therapist. On the other side, a therapy doesn’t have to end when its aim is reached. Oftentimes the sessions will still take place, but with longer periods of time between them so that you learn, in the long run, how deal with problems on your own.

One cannot expect deeply rooted psychological issues to be worked through in just a few sessions. A therapy needs time, trust, and the will to change things. Some fears can be treated in a matter of weeks, so that the affected person is no longer influenced by the fear. But some psychological disorders that are rooted in past situations and experienced need to be treated carefully and thoroughly which may result in a successful therapy to take years.

The probable length of the therapy, as well as how often sessions will take place is often talked about in the very first sessions. This also depends on your time for it and how often you could manage to go to a therapy session per week. You and your therapist will take your daily and weekly activities, your private life, as well as the urgency of your problems into account to come to a balanced solution of how often and how long you will need therapy.

Where does Therapy take Place?

Therapy can take place in a therapist’s office or in a therapeutic hospital (clinic). We differentiate between ambulatory (Outpatient), stationary (Inpatient), semi-stationary (day care) :

Ambulatory therapy – the affected person goes to the therapy sessions and leaves afterwards. This is helpful for the treatment of illnesses that still leave room for daily routines, that may benefit from the affected person being at home or in her or his normal environment, and that does not pose an immediate threat for the patient or for others.

Semi-stationary – therapy and daily life (from Monday to Friday) takes place in a therapeutic hospital or office, but the patient goes home for the evenings and sleep. This is helpful when the affected person is no threat to her or himself or others, and when daily sessions of therapy are necessary for the successful treatment – in a safe environment, with specific people, and specific offerings of activities.

Stationary – throughout the duration of therapy the affected person lives and sleeps in a therapeutic institution. This is helpful for illnesses that need daily treatment, and for people who cannot handle daily life on their own, or who pose a threat to themselves and others.

Generally speaking, you are able to decide for yourself under what circumstances you want your therapy to play out. It depends on your ability to manage daily life, and whether this is what you want and you perceive your home as safe environment. If you might endanger yourself or others, then this choice might be taken from you for so long as the danger exists.

Not to forget are self-help groups, rounds of talk for loved ones and relatives, as well as service centers (or helplines) where you get information and support. Fortunately, these offers exist, as they can be a great support for a therapy or the overcoming of psychological problems in general. They do not replace professional therapy, but they can accompany you on your path to and through therapy. Even if you are not sure which path to chose and which kind of therapy is right for you, do not hesitate to contact these helplines and contact points – they will always try to help you.