The practice psychotherapy is many things, not least of all humbling. As such, the paradoxical title of this series, Mere Psychotherapy, is intentional. I first encountered the phrase in Bruce Fink’s Against Understanding and it immediately sparked a thought of C.S. Lewis’s Mere Christianity. I am neither a christian or a psychoanalyst, but have always been incredibly fond of both authors’ work.

“Mere” has two common definitions:

  • “No more than”, but also
  • “an expanse of understanding”

Fink appeared to be referring to mere psychotherapy in the former sense. However, I’d offer that in the same sense we cannot reduce psychotherapy to “mere counseling.” Doing so may not be “wrong” or even necessarily unhelpful or ineffective, but it certainly does not convey the same “expanse of understanding.”

My sincere hope is that these reflections offer a glimpse into “the other side of the couch” as the expanse of human suffering in our world surely needs no introduction. I hope these reflections provoke many more questions than they answer and provide an illustration of the intersection of patient’s and therapists’ lives in such a way that bring both scrutiny and compassion to ourselves and our (younger and future) colleagues.

Persistent throughout my career I have always tried to remain mindful of two streamlined principles. “What help have I to give” (1) is the question I’ve written on every notebook I’ve owned since working as a therapist. It’s an important question I’ve asked myself countless times and will surely do so countless more.

Tentatively, though, I have also written the following concepts from Steve Howard’s The Heart and Soul of the Therapist:

  • Show up
  • Pay attention
  • Tell the truth
  • Don’t be attached to outcomes

If I can achieve all four of those things in every session with every patient I’ve become some kind of mythical Ubermensch of therapists. On average two or three are more realistic. Though, admittedly some days achieving one is a struggle. Isn’t struggle where therapy starts? Perhaps, even the reverse is true; that therapy is where struggle starts.