A Guide to Psychology and its Practice

and Answers
About Psychotherapy


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Page Contents: A psychotherapistís lack of understanding and a lack of progress in psychotherapy.                    


I am not getting what I need from my psychotherapist. She does not remember what I tell her, and after nine sessions, has neither established a treatment plan or diagnosis. I am also a recovering alcoholic, with almost three months sobriety. I cannot believe that my mood swings are normal. My experience with psychotherapy has been limited to the nine sessions I have had with a psychologist. I seem to do all the talking. I have not gotten any real help. All [my doctor] has commented on is my childhood. I have severe mood swings, and episodes of anger. I do not want to take antidepressants. I am tired of living with these mood swings. I started psychotherapy the day before I stopped drinking. Terminating psychotherapy this early in my sobriety will be difficult, but I am really angry about my lack of progress, and my psychotherapistís lack of understanding.

Many practitioners of psychotherapy tend to agree that a recovering alcoholic should be firmly established in sobriety before attempting psychotherapy. Why? Well, psychotherapy requires you to scrutinize your entire life, examining all of your painful experiences—especially those of your childhood—and bringing to light the psychological defenses you have used unconsciously to hide your emotional pain. This process can be so emotionally disturbing at times that it is almost inevitable that you will relapse unless you are very strong in your sobriety.

Nevertheless, if both the psychotherapist and the client have a clear understanding of the risks, and if the client has strong social support (for example, a religious faith or AA groups) and the courage and the determination to face the dangerous reality of relapse, then psychotherapy can be possible. This is all an individual issue that must be clearly assessed before starting treatment.

In your case, you already have a very big clue about the nature of your own emotional pain: I am not getting what I need from my psychotherapist. Can you see it? Most likely youíre an alcoholic because you never got what you needed from your parents. Thus you have been living all your life with deep rage about this lack, and you have been using alcohol to hide—or drown—your emotional pain.

Keep in mind here a very important point: getting sober does not cure you of the personality defects that caused you to become an alcoholic in the first place. Most persons in self-help recovery programs, for example, encounter some of their personality defects along the path to sobriety, but the encounter is rarely as deep and profound as in psychotherapy.

So as soon as you started psychotherapy you brought your childhood issues right into the psychotherapy office, and voilà, you felt angry with your psychotherapist. Thatís called transference. And the continued pain of experiencing within your treatment—for one reason or another—the same emotions that you experienced about your parents will be the test of the treatment. Do you terminate and hide and drink, or do you face up to the depths of your despair?

Given all that has already happened, the best you can do now is talk openly with your psychotherapist and determine if you are capable now of doing the work or if you should wait a year or so to strengthen your sobriety.


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Raymond Lloyd Richmond, Ph.D.
San Francisco




A Guide to Psychology and its Practice



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