Why do patients come for help?
Patients seek help from a psychotherapist because they experience difficulties in life, relationships, work, and how they feel about themselves. They may feel stuck in some way that they may not yet be able to identify, or they may have readily identifiable psychological symptoms. It may be helpful for them to have someone listen to their story without judgment and accept them as they are. It may also be helpful if someone offers hope for change, clinical judgment, and a procedure to achieve relief from their emotional suffering.
Meanwhile, a psychotherapist attempts from the outset to make a particular kind of connection, in order to engage in a conversation about these difficulties. The therapist thereby determines the nature and severity of the patient’s problem, patterns of how the patient relates to others and how the patient sees him/herself, a formulation of the patient’s maladaptive personality traits and baseline psychological strengths, and a plan for how best to alleviate the patient’s suffering. Depending on the psychotherapist, this assessment may involve use of specific diagnosis, or it may involve the formulation of a more flexible and less defined narrative. Of course, eventually, this narrative includes some aspects describing how the patient relates to the therapist him/herself.
Nevertheless, typically in the first few meetings, patient and psychotherapist discuss how or why the patient’s emotional life has led them to consult a psychotherapist at this particular time. Ideally, patient and psychotherapist become collaborators in describing the nature of the patient’s problems and how best to recover from them. Moreover, patient and psychotherapist can revise or clarify any misunderstandings in how they each view these difficulties. When patient and psychotherapist agree on how to understand the problem and how to treat it, psychotherapy has the best outcome.