Latest Posts

Five Ways That Psychotherapy Helps People Change

Published by Michael Kinsey, Ph.D.

Ask a 100 psychotherapists how therapy works and you’ll get 100 different answers.  The truth is that no one knows for sure. Many theories are out there, each with loyal adherents.  Even though theories differ, the results are definitively that most of these differing perspectives produce similar results.  This phenomenon has been referred to as the “dodo bird phenomenon,” an Alice in Wonderland reference, meaning that all contestants receive prizes, no matter how different the theories and techniques.  Not only do a wide range of treatments yield favorable results, but it is also true that these treatments produce physical changes to people’s brains–not just their behavior, mind, and feelings of wellbeing.

If we assume our natural state is health, then we should be able to allow inner resources to take over once challenges have been clearly defined.

What makes things even more complicated is that a high percentage of therapists describe themselves as “integrative” in their approach, meaning that they mix and match different approaches according to their own view of how therapy can best promote positive change.  There is no reason to question whether pick-and-mix approaches to psychotherapy should differ substantially in their outcome. However, what does seem to be important is how much conviction your therapist has in whatever method they practice.

With this context in place, the following are a few of the ways that I believe therapy can help solve problems that other ways of changing one’s life don’t.

1. The therapeutic relationship:

Repeatedly, studies show that something about the relationship created between therapist and patient naturally promotes growth and greater feelings of wellbeing.  Repeatedly I hear patients communicate their assumption that psychotherapy works through catharsis; The therapist provides a safe place for place where patients can “get things out.” To the contrary, I interpret the repeated finding that the relationship creates change to mean that it is the give and take between client-clinician that does the work.  The directive received by patients to say whatever comes to mind as it comes to mind in particular therapies challenges people to bring more of themselves to a relationship. Merely the act of giving is only part of the equation. Receiving insights and observations from an attentive participant is an essential aspect of the therapeutic relationship.  Successful psychotherapy means both parties bringing their full awareness, attention, and participation to the fore is often much more than what people bring to their daily lives.  David Shapiro, a beloved mentor of mine describes moments of therapeutic impact in the client-therapist relationship far more succinctly with the phrase “making contact.”

2. Working through conflict:

In any relationship there is conflict, and the therapeutic relationship is no different.  “Ruptures” in a treatment can be extremely important in creating change if they are approached directly and “repaired,” rather than avoided.  Anxiety, which often at the heart of a presenting problem, stems from failing efforts to avoid some form of emotional distress. Confronting conflict, especially feelings of anger, set a precedent of approaching difficult emotions outside of therapy.  Moreover, conflict with a therapist is particularly useful since a good therapist is trained to 1. To listen and explore rather than react; and 2. Help understand the psychological reasons behind disproportionate anger, the origins of which lie outside the therapeutic relationship.

3. Improving capacity to express and tolerate emotions:

Anger that comes from conflict comes to mind as an especially difficult emotion for most people to tolerate.  The feeling of anger itself can feel both frightening and intoxicatingly powerful; however, past experiences, beliefs, and cultural taboos against anger specifically activate inhibitory mechanisms in our brain that turn a vital emotion into deadness.  Tolerating emotion means enduring the feeling itself, stomaching related emotions (e.g., guilt, shame, fear), and sufficiently regulating the emotion in order for it to motivate productive action. Some of us are great at using our anger to be productive, while struggling to sit with the vulnerability of sadness.  The opposite is often true. Many individuals are accustomed to receiving comfort in times of sadness and reproach when anger flares up as an oppositional force. The therapeutic relationship is one in which these tendencies can safely manifest, approached, discussed, and worked through. A good therapist should be well-versed in understanding and working with difficult emotions as well as using these emotions to enhance intimacy both in and outside of your psychotherapy experience.

4. Assuming a position of agency:

I have always found it astonishing how clients lament an upsetting pattern in their lives while simultaneously explaining that it occurred by a chance set of circumstances.  This amazement extends to my own way of denying persistent problems in therapy. If you are a passive observer to your problems, how on earth can you possibly prevent unnecessary repetitions? This type of defense can take many forms.  Suggesting depression is genetic, secondary to medical issues, entirely someone else’s fault, and/or due to an eroding social order are all different heads of the same hydra. While we may never know precisely how much our personalities (re)create painful scenarios, therapy seems to work best the more we own our role in unnecessary suffering.  No matter what your philosophical stance on free will is, the happiest people tend to be the one who feel the most effective in shaping a happy future.

5. Clearing obstacles impeding organic growth:

Some approaches to therapy work with the assumption that change requires an active, willful confrontation of behavior and thought patterns.  Others like my own, assume that once roadblocks to happiness have been identified, the best solutions can be found by the individual facing them. Solutions may be conscious or unconscious, but I believe each person must a solution that harmonizes with his or her own values, personality, and voice.  Irrational behavior is fairly easy to spot. The reasons behind acting irrationally (and continuing to do so) are not always obvious, nor are they easy to deconstruct. If we assume our natural state is health, then we should be able to allow inner resources to take over once challenges have been clearly defined.  With such an approach, I believe we achieve more satisfying outcomes and innoculate ourselves against falling into the same traps.

What I have outlined is far from an exhaustive or definitive list of ways that psychotherapy helps the modern individual through stubborn entanglements.  However, my aim in this brief and imperfect list of therapeutic factors in individual psychotherapy is to demystify what psychotherapists have in mind as they aspire to free others through cryptic conversation.

What Should I Talk About With My Therapist?

Published by Michael Kinsey, Ph.D.

The “golden rule of psychoanalysis” is to say whatever comes to mind, as it arises in your mind, without censorship.  I find this to be a useful guideline for people to keep in mind. With a small amount of reflection, you’ll realize that following this simple rule with absolute fidelity is impossible.  Our thoughts move quicker than our mouths, and many of our thoughts are censored without even knowing that they are being withheld from consciousness.

It can certainly be scary to know that many of the strategies we use to conceal ourselves do not work in the controlled environment of psychotherapy.

Impossible though it may be to absolutely follow this method of “free association,” Freud devised this strategy as a way of helping the elusive and mysterious contents of the unconscious to a realm in which the clinician can observe them.  He observed how thoughts that poured out with minimal censorship provided content that revealed hidden secrets of the unconscious. However to Freud, what was more important than the content in free associations was the flow and connection between the thoughts that formed a single stream of consciousness. 

 

Amazing though Freud’s discovery was, the fact is that the golden rule guideline is useful no matter how well you are able to follow it.  The time is yours to say or not say whatever you want! Flouting the guideline will reveal aspects of your mind just the same as following it religiously.  It can certainly be scary to know that many of the strategies we use to conceal ourselves do not work in the controlled environment of psychotherapy. However, the good news is that you needn’t feel pressure to use therapy “correctly.”   

It’s your therapist’s job to make use of whatever you bring to your session, and a good one will learn plenty about you no matter how you approach the golden rule.  As I tell my patients who struggle with speaking freely (and many do!): “No matter what you say, we will always get to the important issues.”

And even though it’s not your responsibility to guide the treatment, it can be helpful to know some of the ways that therapists learn about the inner workings of your mind.  Free association is only one of five main ways therapists draw conclusions about your conflicts, motivations, feelings, and complexes.  The main ways therapists learn about your unconscious mind are the following:

  1. Free Association (i.e., “the golden rule”
  2. Slips & Errors (i.e., so-called “Freudian slip”)
  3. Transference (& Countertransference)
  4. Hypnosis (later discovered to conceal the unconscious content after hypnosis has been used to bypass conscious defenses)
  5. Dreams (i.e., “the royal road to the unconscious”)

To learn more about the process of psychotherapy, you can contact Dr. Kinsey for a consultation session at low to no cost by reaching out via the form below.

Who Is Psychotherapy For?

Published by Michael Kinsey, Ph.D.

Psychotherapy is for anyone and everyone.  For some, psychotherapy is a luxury. Many continue in psychotherapy for years because they continue to find value in meeting regularly with a mental health expert.  Others come to treatment to work on a specific problem that is confined to a specific yet important area of their lives. Still others find that an underdeveloped sense of themselves and others has resulted in longstanding patterns of tumultuous and or unfulfilling relationships–perhaps extending into difficulties excelling at or maintaining a job.

Yet another amusing paradox of psychotherapy is that people often enter into treatment with the intent of addressing a specific issue, but engage with a course of therapy because it has so much value outside of that particular difficulty.

In my experience, people who overcome their apprehensions about psychotherapy and come in for one or more sessions are surprised at how much it can offer.  One irony I have discovered about those who eventually experience the benefits of psychotherapy is that internal conflict around needs and needing can even be the main reason why it takes so long for them to seek treatment.
While everyone can obtain benefits from psychotherapy, I must add a few caveats.  Psychotherapy is not an antidote to either societal problems or unfavorable life circumstances.  That is, psychotherapy does not substitute for activism, nor does it alleviate poverty. However, many do in fact discover that they are more effective at engaging with social problems, or find “luck” finding a job after beginning psychotherapy.  However, the distinction between working on your relationship to existential conditions like world hunger and personal tragedy are different than the states themselves–the former can be worked on in therapy while the latter is not best dealt with in the psychotherapist’s consulting room.
Yet another amusing paradox of psychotherapy is that people often enter into treatment with the intent of addressing a specific issue, but engage with a course of therapy because it has so much value outside of that particular difficulty.  When the presenting problem eventually gets resolved in treatment, clients continue to attend and profit from therapy while seldom attributing their success in resolving their presenting complaint to the course of therapy. While you might think this would discourage therapists, I believe this phenomenon is a great compliment to the art of psychotherapy; the benefits of a good-enough treatment are so broad and diffuse that patients feel its value to such an extent that the original problem becomes an afterthought.

Mindsplain Manifesto | Mental Health Blog | Therapist NYC

Mindsplain Manifesto

Published by Michael Kinsey, Ph.D.

Does the internet really need another blog on psychology, the mind, and mental health? I’ve noticed is that there is no shortage of interest in psychology, and self-help out there.  With exorbitant cost of therapy and medical care in general, alongside spreading fear that civilized discourse and social order are degrading rapidly, who wouldn’t want to learn how to help themselves preserve their own sanity!?  However, as the demand for applied mental health information expands, my concern is that the content has become generic, watered down, and less interested in the workings of the mind.

Something else has occurred in the last few years alongside the growth of psychological “lifehacks.”  As people have either become more mistrustful of “fake news,” or enraged by people labeling it as such, a groundswell of substantive, longform conversations and articles have begun to sprout up outside the mainstream.  What’s more, people are consuming it insatiably. While we can all do with a bit of outrage porn, whether your taste be the Fox News variety, MSNBC Flavor, or the CNN brand, I’m heartened to believe that people may be craving depth over “hacks.”  With the optimistic belief that people all over are hungry for content grappling with core aspects of our humanity, here are a few of the goals I have for mindsplain.com that, if achieved, I feel confident readers will find both valuable and beneficial:

1. Provide depth and thus value.

If you have achieved your goals using quick tips and tricks to help with debilitating psychological issues, then going deeper may not be what you are looking for.  However, my experience with standard mental health advice is that the larger the audience, the more diluted it gets, and the less useful it becomes. While no blog can provide total customization, I aim to provide ways of thinking about mental health challenges that enrich readers’ understanding of what is going on inside of them so they can work towards highly individualized solutions to their problems.  I believe greater depth engages more of our minds into intuitive understandings and solutions.

The mindsplain “voice” is one that I hope will resonate both at logical and intuitive levels of the mind.

Michael Kinsey, Ph.D.

2. Offer a unique voice.

I created the neologism “mindsplain” to capture both the playful stance with which I aspire to discuss our internal worlds and to harness the power of language to strike deeper into the reader’s unconscious.  Language, symbolism, metaphor are all tools to communicate through existing understandings and sensory experience (N.B. In the first sentence of the paragraph, the words “capture,” “stance,” “harness,” “strike,” and “deeper,” are visual/spatial metaphors that leverage sensory experience to enhance understanding.  We all use this figurative language and take for granted that it’s built upon physical experiences in the world. I believe that the more abstract problems become, the more we need this type of language to muddle through the mess.)

The mindsplain “voice” is one that I hope will resonate both at logical and intuitive levels of the mind.  I assume that thought is at least three dimensional, and we need to not only broaden, but also deepen our understanding to best leverage inner resourcefulness to move us towards enhanced wellbeing.

3. Make mental health playful (again?).

Depression, anxiety, and the component “symptoms” have become an epidemic in our social and cultural reality.  Undoubtedly, these modern “diseases” can have serious and deleterious consequences in our lives. But what if taking symptoms so seriously and humorlessly didn’t help anyone?  Would we still insist on labeling mental “illness” a type of malady (We’ll set masochism aside for another day)?

I believe playfulness is the cure to current scourge of depression and anxiety.  Play is a form of self-expression, a way we develop a sense of self, and the way we begin to feel comfortable acting without fearing consequences.  In other words, play–not happiness or contentment–is the opposite of anxiety and depression. Play is the way we achieve flow states, learn, optimize the use of our attentional resources, and negotiate interactions between our internal and external worlds.  And yes, adults play too. In this blog, I aim to strike a delicate balance between respecting the suffering inherent to mental illness, while also nurturing an environment wherein “symptoms” can be used as toys in the playroom of the mind.

4. Combat stigma.

If I have not yet made my point clear, I invite visitors to this blog to engage with their suffering, entertaining the idea that symptoms are important message worthy of respect and exploration.  We play with them here, because stigma arises out of pathology. If only for the time you spend here, I encourage readers to treat symptoms as urgent messages from an older, wiser region of our minds.  For example, treating anxiety and panic as an urgent (coded) message, a wake-up call, a call to action, a cosmic sign I believe to be more helpful than assuming we were born with a genetic defect.

I do not feel this is a polyannish construction of reality.  I see no reason to believe that health and flourishing are not our most natural states of being.  Again, this is not new age bullshit. The thought of our hominid ancestors not being able to get out of bed and having panic attacks is patently absurd.  Depression-like states are observable in the natural world, but are so obviously the exception rather than the rule.

If health and wellbeing is the norm, then suffering must then be considered a sign that we have deviated too far away from our natural state.  From my own personal and clinical experience, suffering is not just a sign that something is wrong. Inquiring into the nature and meaning of the signal usually provides valuable information about what needs to be restored in order to reclaim our wellbeing.

5. Demystify the process and benefits of psychotherapy.

The happenings within the analysts consulting room have long been shrouded in mystery.  Often rationalized as a way to promote “transference,” the intimate and confidential exchange between therapist and patient seem to have taken on the perversely eroticized connotations of the Catholic confessional.  I’ve noticed that pop culture portrayals of the therapeutic relationship tend to fall into one of two camps: the absurd (e.g., Monk, Analyze This, What about Bob?) and the erotic (e.g., In Treatment, Prince of Tides, Sopranos).

As a psychoanalytically-informed therapist, I am intimately familiar with context behind these portrayals.  Psychotherapy can feel powerful, gratifying, intense, shocking, primal, maddening, funny, erotic, and often incredibly weird.  It’s designed to be so. If you’ve been in this kind of treatment and don’t really know what’s going on (i.e., it has not been properly explained), it’s bound to feel either absurd or perverse!

Therapists are both rigorously trained and held to the highest standards of ethical conduct.  They are also flawed human beings who are not meant to be gurus or prophets. With the proper boundaries in place, therapist mistakes and patients’ expressions of primal emotion are not only acceptable, they are the very things leveraged to create change.  Psychotherapy does not have to be mysterious, in my opinion. We’d all be better off, less fearful, and yes, have better movies and TV shows about psychotherapy, if the inner workings of a psychoanalytic treatment were more accessible.

6. Emphasize the journey of growth.

If personal development is like sex, then using tips and tricks to quickly achieve a better life would be like premature ejaculation.  This is to say, these tools can be satisfying–especially when the need is most urgent–however growth, like sex, tends to be most enjoyable and satisfying when the process itself gratifies.  Exploring the mind is a way of life and does not have to be a mere means to an end.

Learners have become innoculated against psychoanalytic thought by brief exposures to the most outlandish ideas and phrasings, most of which contain shocking, decontextualized sexual taboo.

Michael Kinsey, Ph.D.

7. Spread interest and thus the benefit of depth psychotherapy.

Personal experience with psychoanalysis has transformed my life at both a micro and macro level.  My encounters with my unconscious drives, motivations, and imagery have been among the most poignant experiences I have known.  Freud has been marginalized to an intellectual quarantine, despite the fact that his biggest and most intuitive ideas have transformed the way we all think about ourselves.  Learners have become innoculated against psychoanalytic thought by brief exposures to the most outlandish ideas and phrasings, most of which contain shocking, decontextualized sexual taboo.  Has Freud been rightfully exiled from our canon, or does the dissociation of his ideas confirm a principle at the core of his work–i.e., that anxiety-provoking thought must be kept out of awareness?

The question is not merely rhetorical.  A case can be made either way (it should be obvious which camp I am in!), but I believe we would all profit from engaging with psychoanalytic thought more thoroughly before making up our minds one way or the other.   If you visit this site with a desire to better understand a problem in your life, a curiosity about the mind and/or human condition, or are even trying to be open-minded about the potential benefits of an examined life, my goal is to walk with you on your quest for a richer, deeper, and more meaningful existence.  Godspeed to all of us!