Psychotherapy 101

Psychotherapy 101

By Melissa Richman, PSY.D, LCSW, DAPA

Psychotherapy is perhaps the most misunderstood practice in society today. Most people who engage in Psychotherapy truly have no idea what they are doing there each week. Those of us in my profession often hear patients say things like, “Psychotherapy is talking, but I don’t know how it helps,” or “Everyone else is in therapy, so I should be too.” These ideas are certainly true in many forms, but in my years of practice, my experience has taught me that most people cannot give a clear explanation of what therapy actually is.

So what is Psychotherapy? Quite simply, it’s just another relationship in your life. I like to refer to a therapist as a “corrective relational partner.” A good therapist learns to identify various aspects of their client’s personality, emerging from childhood, and then takes that client on a personal journey, to help identify and repair those critical aspects from childhood that have created an impasse in their ability to have stable, fulfilled, and/or solid relationships. As children, all humans require certain needs to be met by our parents. Since childhood is never perfect, most of us grow up with our needs having never been met or needs that were excessively met.

Then, as emerging adults, many people develop specific symptoms or protections against those neglected or over met needs, with behaviors that quite often get in the way of being able to develop and maintain fulfilled relationships. Many patients experience failed relationships, fear of intimacy, jealousy, or even symptoms as pervasive as anxiety and depression. The therapist and the psychotherapy must allow for the corrective relational experience to occur.

The problems that clients present to therapists are what I consider to be symptoms of deeper underlying psychic issues. These issues come from their psychological structure or memory, learned from childhood in their relationships with their parents. These symptoms can range in different clients from mild to severe, which then define the intensity of the treatment needed.

Symptoms protect us from feeling the deeper root of our pain. For example, anger is a less frightening emotion then feeling that hurt, shame, or pain. Depression is another symptom, one that masks anger turned inward. Any kind of an addiction is also a symptom; addiction just a fancy word for a compulsive process that takes one out of the reality of what is really going on. We all have symptoms, and a good therapist teaches their patient during their relationship how best to manage those symptoms to improve their life.

Psychotherapy is not advice, nor is it a form of “self help”. Self-help, and the quick, informal advice that may help in the moment, but does not foster a deeper shift that allows for one to have true change in his or her life. Through the corrective emotional relationship with the therapist, a patient is able to tread into the deep territories of one’s soul and fill up those empty holes. He or she may increase their self-esteem, and minimize their relationship symptoms, and hopefully resolve the initial problem that first brought the client to therapy.

It is important to understand that we all have relationship issues, aspects of ourselves that get in the way of truly feeling fulfilled in our lives. This is not to say that our parents are bad people or should have done a better job. Hey. That’s just life. Unless our parents have done their own work before they had kids, then less-than-perfect-parenting is sure to always occur. No one ever had a perfect childhood!! And that includes therapists too!

No one is perfect; there is no such thing as that. Therapy teaches the client to understand and learn how to manage their symptoms, not erase them, and how to have continuous improvement in life’s relationships. It is that simple. Effective therapy helps lower the intensity of the symptoms. As they get closer to the underlying psychological issues in the relationship with the therapist, many patients feel too overwhelmed, and may leave therapy prematurely, which can be detrimental to their emotional health. I tell my patients that this is the most important time to stay in therapy.

Psychotherapy should be your “Relationship 101” class. Who you are in the office with your therapist, and how you function in the rest of your relationships takes place right before your eyes during each therapy session. The only difference is that in therapy, you get to work these issues through with a relationship expert. A caring therapist ventures into a mutually beneficial relationship with each client, in the essence of hope and compassion, and will hopefully lead the client on a journey to a better place. My goal as a therapist is to alter one’s subjective experience through an improved relationship, improving my client’s life and relationships with the rest of the world. A solid corrective emotional experience between therapist and patient will allow the patient to find true resolve and peace in his or her life.


  1. Tell the truth; be authentic and genuine to the best of your ability.
  2. Treat Psychotherapy as another relationship in your life, with the therapist as your corrective relational partner.
  3. Who you are in the office is exactly who you are in life.
  4. Learning to have an honest relationship with the therapist will teach you to have healthy relationships with yourself and the world.
  5. Psychotherapy is not advice giving, nor a self-help class.
  6. Psychotherapy teaches you to have a healthier relationship by repairing those deeper things that may need fixing from childhood.
  7. Sometimes we got too much of our needs met in childhood, and sometimes we did not get enough of our needs met in childhood. These situations will trigger symptoms that bring you into therapy in the first place and become part of who we are in our adult lives.
  8. Know and identify your patterns and symptoms in relationships
  9. Know that Therapy can be painful but can be the safest relationship you will ever know.
  10. Therapy is a journey, with the end result being to have a happy relationship with the most important person of all, you!