A Guide to Psychology and its Practice

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About Psychotherapy


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Page Contents: Why does psychotherapy take so long, and what is the goal of it all?                    


I have been in therapy for two years and it has been extremely helpful, in fact, life changing, but I continue to have feelings of depression and thoughts of suicide. . . . I have let go of the guilt I have carried as a result of sexual promiscuity in my college years. I have not explored being raped by a casual acquaintance in college. . . . I feel confused as to why it has taken two years and I still feel horrible at times, and was wondering what the process is, so that I would know if there was something I was doing, or not doing, that was standing in the way of feeling ok. I began therapy to get rid of anxiety attacks, so there was a goal and I knew when it was met. Now, I feel like I’m in a sea of thoughts, feelings, topics, and they all float in and out of therapy all willy-nilly. I don’t know how to navigate to the goal. My therapist keeps saying I’m doing a great job, but I’d like an instruction manual to follow.

You bring up an issue that gets right to the heart of the psychotherapy process. Most psychotherapists—at least those with specialized training in psychodynamic theory—understand the process so well that they almost take it for granted. But for the average client, especially for those who have been traumatized as children by family dysfunction, the whole process may seem to be a frustrating mystery.

Part of the frustration relates to the need for honesty in psychotherapy. But if a client comes from an alcoholic family, for example, where secret after secret is buried before their eyes every day, then honesty itself can be difficult. When you say, “I have not explored being raped by a casual acquaintance in college,” you admit to holding back on an important element of your inner experience. So honesty actually has to be learned through the therapeutic relationship in order for you to be able to speak about things you would rather hide.

But there’s also something else that contributes to your frustration. Sometimes clients “hold back” things not because they want to but because they simply can’t “see” what they need to be talking about.

For example, consider a rather benign illustration of this “not seeing.” Have you ever had to proofread a long document? You read it a couple times, you notice a spelling error or a punctuation mistake here and there, and then it looks fine. But if you set it aside for a while and then look it over again, you might find other mistakes you didn’t even see on the earlier readings. They were right there all along; you just didn’t see them. It happens all the time to me when I make major additions to this website. As I look over old work, I often find little things to correct, and I wonder how I could have missed these things before. Well, that’s the frustration of psychology.

So in psychotherapy you have to examine certain material over and over. You can’t just say, “OK. I talked about my alcoholic father. So how come I’m not cured?” There’s a big difference between knowing something intellectually and actually experiencing the emotions it causes. If you take the intellectualizing approach you’re likely to run right into the brick wall of frustration and come to believe that something is wrong with you, that you’re not capable of doing the work, that you’re somehow inadequate or a failure, and that your psychotherapist will get tired of your lack of progress and will abandon you. And so you will likely hide those feelings of failure from your psychotherapist.

And by hiding that secret you make a big mistake. You make the whole problem worse. Of course, you are only doing what you were probably “trained” to do somewhere in your family: hide secrets. But that’s a suicidal, dead-end solution. The only real solution for when you feel stuck like this is to talk about the feeling of being frustrated and stuck. As you talk about your feelings, your psychotherapist can pick up new clues about how your current feelings bridge back to old wounds. And then you can go over and over those wounds again and again to free up hidden emotions, previously invisible to you. After all, it’s the invisible poison in those invisible wounds that keeps you feeling miserable.

The English painter J. M. W. Turner, speaking about painting, once said, “It’s a rum thing.” In British English, rum means odd. Years ago, when I was studying art, I thought that Turner was the best painter there ever was, and I still think so. His works are vague and nebulous yet profoundly awesome. And so I would say of psychotherapy, “It’s a rum thing.” And I fully sympathize with those who find it to be, well, “all willy-nilly.” Because that’s it exactly.


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Raymond Lloyd Richmond, Ph.D.
San Francisco




A Guide to Psychology and its Practice



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