Question 1

What is psychotherapy?

Accepted Answer

Psychotherapy is not, in its essence, a medical intervention. It is often described in terms of diagnosis and treatment, but this belongs more properly to psychiatry. In psychotherapy, “therapy” is to be understood in its broader sense: taking care.

Psychotherapy, as I practise it, is a form of collaborative care for the self.

The self is the living entity which we are: it experiences, feels, lives, and only lastly thinks. Like any living entity, it has its own structure, its own needs, and its own ways of developing, becoming strained, or falling into difficulty.

The diversity of psychotherapeutic approaches reflects the fact that there are different ways of understanding the self, the existential processes in which it becomes involved, and the challenges it encounters.

In my approach, the self is a three dimensional entity, physical, social-cultural and personal (See Page Title). 
Psychotherapy entails taking care of these three dimensions and their relationship. This presupposes:
	1.	developing awareness and understanding of them, and
	2.	learning how to care for them in practice.

Therefore, psychotherapy is both a psycho-educational and a restorative process.

This process takes place within a relationship with a therapist. Within this relationship, which is characterised by trust, openness, reliability, confidentiality, acceptance, non-judgement, and depth, the self can be welcome, expressed, examined, and worked with.

I provide a form of guidance. One could say that I accompany my clients on their journey, bringing a clearer awareness and understanding of the terrain they are navigating. At times, this may involve offering unobtrusive direction. Generally, it involves strengthening my clients’ own capacity to navigate.

Question 2

What is the difference between psychotherapy and counselling?

Accepted Answer

The distinction between the terms counselling and psychotherapy is historical.

The term psychotherapy appeared earlier and was originally associated with the treatment of mental illness. A psychologist rather than a psychiatrist, Carl Rogers introduced the term counselling in the 1950s as he sought institutional recognition for his person-centred approach to psychotherapy.

Today, the distinction has weakened in common parlance and the terms are often used interchangeably. However, within the profession, the notion of counselling continues to be tied to a specific school of thought.

I personally use the term psychotherapy, as it more accurately reflects the nature of my work: providing care for the self.

Question 3

How do psychotherapists differ from psychiatrists and psychologists?

Accepted Answer

Psychiatrists are medical doctors. Their work is grounded in medicine and typically involves diagnosis and medication, sometimes electroconvulsive therapy (ECT) and psychotherapy.

Psychologists have their roots in academia and academic research. They concern themselves with the scientific study of human beings. However, historically and for cultural reasons (paradoxically unscientific), their work has shifted from the consideration of the soul and the self to that of the mind and the brain, a major shift in psychological theory which has largely led to a reductionist view of the human being.

Some psychologists practise clinically and may also offer psychotherapy, the style of which often bears the mark of their ideological background and their tendency to intellectualise.

In contrast, psychotherapists have maintained the age old and universal tradition of concerning themselves with the self, and working on it and with it through a relational and developmental process.

I combine the roles of psychologist and psychotherapist, alongside my work as a social scientist and historian of ideas. My two roles are complementary, as my scientific interest is in the study of the self, both in its individual and its socio-cultural aspects.

Question 4

What is the difference between psychotherapy and life coaching?

Accepted Answer

Psychotherapy and life coaching overlap in certain respects. Both can support change, provide direction, and help individuals move forward in their lives.

However, their orientations are different.

Life coaching generally approaches personal development in terms of management: setting goals, improving performance, and moving towards predefined outcomes.

Psychotherapy is concerned with the self itself: its structure, its development, and the difficulties it encounters. The work is not limited to what one does, but concerns what one is, and how one is organised.

Also, in psychotherapy, guidance is not directive in the same way. It arises from an understanding of the self and of the situation, and is integrated within a broader process of development and reconfiguration.

For these reasons, psychotherapy rests on a more elaborate theoretical framework and engages with a deeper level of human functioning.

If you wish to explore this topic further, a short article entitled “The Difference Between Coaching and Therapy is Greatly Overstated” published in Psychology Today is suggestive.

Question 5

What determines the success of psychotherapy?

Accepted Answer

The success of psychotherapy depends on several factors, but two are central.

First, the quality of the relationship. This relationship is not only supportive; it is the context within which the work becomes possible. Trust, openness, and depth are essential.

Second, the quality and depth of the psychological enquiry brought into the work.

This includes the therapist’s capacity to make sense of the client’s situation, to identify relevant underlying structures, and to guide the process accordingly.

Theory plays a crucial role here, but not as a doctrine to be learned and applied mechanically. It needs to originate in the therapist’s ongoing involvement in research and in their own development. See My Approach.

Psychotherapy is a partnership. The therapist brings structure, understanding, and guidance. The client brings engagement. Without this engagement, the work cannot unfold fully.

Question 6

Which therapeutic modality is best?

Accepted Answer

Psychotherapists often present themselves in terms of a particular modality or approach.

To find out what I think about this practice and its limitations, go to My Approach.

Question 7

How will I know that therapy is working?

Accepted Answer

Some changes are clear and noticeable. Others are more gradual and may pass unnoticed at first.

Part of the work consists in developing the ability to recognise these changes.

Indicators may include:

•	a clearer and more grounded way of thinking
•	a greater awareness of one’s psychological life and an increased ability to put it into words, and the ability to communicate and share it with others
•	the revision of assumptions that were previously taken for granted
•	a greater ability to make use of one’s feelings and intuition as a source of understanding, rather than relying primarily on the intellect, and to talk about them
•	a greater sense of freedom, coherence, and capacity to act
•	becoming less judgemental towards oneself
•	feeling more aligned with who one is
•	taking greater and better care of oneself
•	setting and managing boundaries more effectively
•	feeling more at peace

Feedback from others can also be helpful, as changes are sometimes more visible from the outside.

Question 8

How long does therapy last?

Accepted Answer

Therapy can last from a few weeks to several years. For many clients, it falls between 6 and 18 months.

Its duration depends on:

•	the nature of the underlying structures involved
•	the level of engagement in the process
•	the degree of openness or resistance
•	how far the client wishes to go in the work

Clients remain free to decide how long they continue. They may also pause and return at a later stage.

Question 9

Why does therapy take time?

Accepted Answer

Therapy can be quick. Usually, it requires time.

The self is a complex living entity set within an existential configuration that has its own inertia. What has been formed over time cannot be reconfigured instantly.

Understanding something intellectually is not sufficient. Change involves the development of a form of understanding that is bound to the parameters of one’s existence.

This requires time, continuity, and sustained engagement.

Question 10

Can I attend one session before deciding whether to continue?

Accepted Answer

Yes.

However, one session is rarely sufficient to assess what psychotherapy with a particular therapist can become.

First impressions are not always reliable in therapy. What matters is not only how a first meeting feels, but whether a meaningful working relationship can develop.

Psychotherapy is a process. The relationship evolves, and so does one’s perception of it.

The process is also collaborative. While you are assessing the therapist, the therapist is also assessing your readiness and your way of engaging in the work.

Question 11

Why are sessions weekly?

Accepted Answer

Psychological work requires continuity.

Weekly sessions allow for sustained processing and development. When sessions are too far apart, this continuity is lost, and the work becomes less effective.

For this reason, weekly sessions are usually recommended, particularly at the beginning.

Dr Guy Van de Walle

Psychotherapist & Psychologist | Chelmsford & Online (EN/FR)

Some answers to your questions