Cutting Through the Therapy Jargon to the Work of Healing
Dear Near and Dear Readers,
Most people have heard words like psychodynamic, relational, and somatic and have no idea what they mean. These words mean so much more in the context of therapy than even this blog can convey. More importantly, many people do not know why these approaches belong together or why so many people benefit from working with a therapist who allows all three to inform their work.
I have spent years studying different theories, modalities, interventions, and techniques. Like many therapists, I have attended trainings, read books, sat through workshops, and accumulated a small mountain of continuing education credits. Yet the longer I do this work, the more I find myself returning to something surprisingly simple:
We Heal by Becoming More Aware of Ourselves
We become more aware of ourselves through relationship, and we learn to trust that awareness by experiencing it in both mind and body. Psychodynamic, relational, and somatic approaches fit together naturally by looking closely at a different part of the same process. Our history or “stories,” our relationships to “other” and the messages of our sensory experiences of the body. We heal because by becoming more aware of how all three of these play out, we become more able to influence our own living experiences and create lives that feel worth living. It is only in relationship with another person that we can become more aware of ourselves in relationship and that beings often by sensing everything in our physical bodies. For some of us, this can be a journey that isn’t pleasant. Hence a good therapeutic relationship is highly recommended.
“The curious paradox is that when I accept myself just as I am, then I can change.” — Carl Rogers
Relationships Make or Break Us
Relationships shape us from the very beginning of life. “Live we learn, we learn, we love we learn, we choice we learn…” and often these lesson matter more in relationship to others. Much of what we know about ourselves was learned in relationship with other people for better or for worse. It makes sense, then, that a human to human relationship would be a basic requirement for healing. This is one reason I believe healing requires a human-to-human relationship, especially when the hurt come from other people but often even a tragedy in our lives a benevolent other can help us learn to live again. Therapist I believe strive to embody this benevolence along with boundaries, non judgmental, and promoting well being and growth. Not because therapists possess some secret knowledge that lets them be this way, but because these are the conditions in which we can finally see, in the presence of another, what has become invisible to us.
A good therapeutic relationship helps cultivate empathy for ourselves and others. It creates enough safety that we can begin looking honestly at parts of ourselves that we may have spent years avoiding, explaining, defending, or hiding. Carl Rogers captured this beautifully when he wrote: “The curious paradox is that when I accept myself just as I am, then I can change.” Change often begins with understanding rather than judgment.
History Lives in the Present
Psychodynamic therapy is often misunderstood as endlessly talking about childhood. In reality, psychodynamic thinking is about understanding how the past continues to influence the present with the understanding that sometimes we get in our own way to see it, after all, you wouldn’t need to “get therapy” if you could…
Many of the beliefs, expectations, fears, and assumptions that shape our lives were learned long before we were consciously aware of learning them and sometimes continue to be unconscious. History is more than just you’re a story, our histories can often live in the body and live in habits. Sometimes it can influence our expectations of others unbeknownst to us. It can live in the assumptions we carry into our relationships.
Sometimes our past influences us in obvious ways. More often, it influences us quietly. We find ourselves replaying familiar patterns without understanding why. We keep ending up in similar relationships or we react more strongly in situations that seems warranted. This seems to go on and on in different ways. As psychodynamic writer Stephen Grosz observed: “We repeat what we do not repair.”
Sometimes we when we can’t see the forest for the trees, when our defenses don’t let us see, well we end up with “symptoms.”
Symptoms as Guideposts
I tend to think symptoms are trying to tell us something rather than some list that some one made up in the DSM, though I do appreciate the time and efforts and even the symptoms listed there in a great deal, there is insight there. More importantly, your inner experiences and how you see your “symptoms,” are the guideposts I can help you look for and understand. Call me old-fashioned, but I rarely view symptoms as random defects. Instead, I often see them as signals and as an attempts to get our attention. Symptoms are often guideposts pointing toward something that needs understanding.
When we become curious about them instead of simply fighting them, they often begin revealing the story underneath.We start asking questions such as:
Where did this come from?
What purpose did it once serve?
Why does it still feel necessary now?
Understanding does not automatically create change but understanding often creates the possibility of change.
The Body Carries History
One of the most fascinating things about therapy is how often people understand something intellectually long before they feel it emotionally. This is where somatic work becomes important. The body caries all that emotional history that we were talking about that the relationship, the exploration of those stories and how you feel in this moment in side your own body to figure out together in relationship what is not in your awareness.
When it comes to symptoms I see them as a protective layer that pops up, like an emotional immune system response. For millions of years mammals have relied on an ancient danger-and-safety detection system and this works closely with our emotions to protect us from all kind of threats be they real or imagined!
When the autonomic nervous system functions well, it helps us respond to real danger.
When it becomes overwhelmed or dysregulated because we are struggling with things outside our awareness, or in it but looping, we may find ourselves living as though old dangers are still present. We eventually stop trusting ourselves and our own perceptions of what is happening around us leading to more and more stress and leaning onto old responses rather than adapting to what IS in the moment the alarm sounds.
Can you see how this might cause some “problems?”
The Power of “Both/And”
One of the most important things therapy has taught me is that human beings are more complicated than simple formulas allow. We are shaped by our past, yet capable of change. We are influenced by our history, yet not condemned to repeat it. We can be wounded and resilient at the same time.
The goal of therapy is not perfection. It is becoming more capable of empathy, authenticity, and self-understanding.
I believe Socrates once said, “The unexamined life is not worth living.” Perhaps those words are less a judgment and more an invitation. Maybe the task is not to decide whether life is worthy, but to examine it closely enough to discover the worth that has always been there.
Therapy, at its heart, is an act of examination—not to criticize ourselves, but to understand ourselves more fully.
Amy Ratkovich LMFT 124308, 2018-124
Are You Ready to Go Deeper?
How long healing takes depends on you, me, and us.
Therapy is ultimately a relationship, and relationships work best when there is a good fit.
This is one reason I enjoy consultation calls you can reach me at 510 269 4808 and I typically get back to people within 24 hours.
They allow us to determine whether we can do meaningful work together.
And if I am not the right therapist for your needs, I am happy to connect you with one of the many therapists I have come to trust—people who are thoughtful, ethical, respectful of autonomy, and deeply committed to understanding the people they serve. We are all here to help.
Kishimi, I., & Koga, F. (2018). The courage to be disliked: How to free yourself, change your life, and achieve real happiness. Atria Books.
Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.
Wallin, D. J. (2007). Attachment in psychotherapy. Guilford Press.
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