Chatting With a Purpose: Understanding the Talking Cure

By Dr Sumayya Ebrahim (registered psychologist)


11697118_lAre you looking for a safe space to speak your heart and mind without fear? A space where you can speak without judgment? A space to get some fresh perspective and rethink your problems? Then maybe you should consider some time on the ‘therapists couch’.

Psychotherapy is commonly thought of as the talking cure and, as the term suggests,psychotherapy is essentially seeking a treatment for psychological distress purely through talking. However, this is not merely talking or chatting, as we would to a colleague or friend, in therapy we are talking for a purpose.  And that purpose is to alleviate ouremotional and mental stressors.

From preliterate shamans to sophist philosophers in ancient Athens, people have been practicing psychotherapy in one form or another.  From an Islamic perspective the roots of Arabic interest in psychology, as it is understood today, can be traced back to medieval times (R Ahmed and M Soueif, 2001, Psychology in the Arab world: Past, Present and Future. International journal of group tensions, Vol 30, 3, pages 211-240). The etymology of psychotherapy comes from the Greek word ‘psyche’ which conveys the meaning of soul, spirit or being, while therapy is derived from the word ‘therapeutikos’ which means attendant or one who takes care of another.  So in essence psychotherapy is a process of attending to and healing an individual’s inner world.


  • Who is eligible to provide psychotherapy?

Psychotherapy in its truest and strictest sense is only administered by psychologists registered with the Health Professions Council of South Africa.  Currently, there is a trend to find therapeutic services being offered across the board by stressmanagers, lay counsellors, life coaches etc.  However, the services offered by psychologists are very different.  Psychotherapists are unique, as apart from their rigorous and extensive academic training and practical experience,an additionaldifferentiating factor is the emphasis on the therapeutic relationship.


  • How do you know when you need a therapist?

There are various reasons that a person may enlist the help of a therapist.For one, a person may have difficulty coming to terms with aspectsof themself.  Secondly, psychotherapy may serve as a support structure during times of difficulty or adjustment, for example, a career shift, trauma, adjusting to motherhood, marriage or divorce.  A third common reason is as a treatment adjunct for psychiatric illnesses such as depression, anxiety, bipolar mood disorder or personality disorders.

The talking cure as mentioned, is indicated for a variety of reasons, one of the most pertinent points to consider though, is that if the problem at hand iscausing distress, thesheer presence of that distress ought to be sufficient impetus for a person to seek therapy. However, there is no harm in going into therapy even if you are not completely sure you would benefit from it.  Indeed it is the remedy of choice for millions of people around the world as it is one that is the least invasive and its efficacy has been proven time and again.


  • How does psychotherapy work

The therapeutic relationship that is built between the individual and the therapist is usually based on mutually agreed upon problem-defining andproblem-solving with specific goals in mind.  Again, this is what differentiates our chats with other people in our lives from talking to a therapist; as in therapy we are chatting for a purpose.

Apart from the strength of the therapeutic relationship, there is a significant role that the individual needs to play when in engaging in therapy.  Firstly, their expectation of the process needs to be realistic.  Unlike medication that treats a physical illness, or a surgical procedure, relief may not be instant. Therefore, it is essential that there are realistic expectations.  Secondly, the individual concerned needs to be fully invested in the process.  Indeed, the success of therapy hinges strongly on the individual pursuing the therapy voluntarily, and ideally they need to have a strong desire to change, as resistance to change is bound to hinderpositive outcomes. However, skilled therapists are proficiently able to work with this resistance so that ultimately the individual’s goals are still met.


  • How to choose a therapist

There are many different types of psychotherapy.  The difference often lies in the academic or theoretical background of the therapist and their repertoire of skills, which will depend on their specific paradigm. Briefly, there are few basic orientations commonly accepted to be part of psychotherapy in the traditional sense.

There are some therapists who see the root of psychological distress as lying in the first few years of life and on the unconscious mind.  There are other therapists who emphasise our thoughts and behaviours as both the problem, and solution in restoring our psychological wellbeing. Some psychotherapeutic orientationshighlight the client as an expert in his or her own life and the therapy then takes on a collaborative style. Finally, there are those that prefer an integrated or eclectic approach.

Despite the different orientations, there are a few common threads that run through all types of therapy.And when deciding on the suitability of a therapist, more than the theoretical orientation or qualifications of the therapist, a better gauge will be how you feel after having spent a few sessions with the therapist.  Feeling safe, heard and understood by your therapist is essential as these elements are meant to be the core of the therapeutic relationship.


  • Difference between psychologist and psychiatrist

Any discussion about psychotherapy cannot be complete without some engagement around the difference between a psychiatrist and a psychologist, as the two are often misunderstood.  Put simply a psychiatrist is a medical doctor, whose main area of speciality is the diagnosis and treatment of psychiatric illnesses using medication,as the root of the problem is considered to be biological.  While psychiatrists may have some essential counselling skills, their main focus is on using psychopharmacology to treat psychiatric disorders.  Most psychologistsin contrast, use themselves, and their academic skill and therapeutic techniques in collaboration with the individual, to illicit a cure for psychological distress that is not necessarily diagnosed as a disorder.


  • Back to the couch….

There are manypeoplewho are reluctantto enter into therapy and see it as a last resort.  However, if you remain committed to the process, the decision to pursue the talking cure, is both commendable and highly recommended, as thebenefits of psychotherapy, even if it is just having a safe space to talk without restraint is priceless.

Thetherapeutic relationship could prove to be one of the most fulfilling, unconditional and potentially lifelong relationship you could ever enter into.  It ispossibly the only no-strings-attached association you could ever engage in, as it is most likelythe only space that you have in your life that is just about you!


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