Is psychotherapy long or short?

How can three meetings with a psychotherapist change something in me? “Why talk about children’s fears year after year and pay crazy money for it? A long psychoanalysis is needed only by the analysts themselves! These polarizing opinions are heard more and more often as more people discover psychotherapy with all the variety of its methods. Let’s try to figure it out.

different priorities

Psychoanalysis is often contrasted with psychotherapy. It is long term in nature; involves exploring the vast continent of the unconscious. This very large-scale journey, which allows you to really “go far” in working on yourself, can last from four to seven years, or even more! Psychoanalysis is a «psychology of the depths» and its purpose is not to alleviate the suffering of the analysand, but to reconcile him with his own deep truth. In this regard, the founder of psychoanalysis, Sigmund Freud, spoke quite clearly. Healing (eliminating a symptom or improving quality of life) is not a priority. We must unravel the riddle of the symptom, and not try our best to eliminate it. First of all, understand, and then, if possible, change …

Non-analytic methods of therapy have a different goal: first of all, to improve the patient’s quality of life. First of all, change, and if necessary, then understand!

Eric Berne, the founder of transactional analysis, urged his colleagues to cure a patient … in one session. It is unlikely that his words should be taken literally, but the meaning is obvious: the psychotherapist from the first meeting should take care of alleviating the patient’s suffering.

• How much does psychotherapy cost?

Psychoanalysis gives priority to the past, therapeutic techniques focus on the present and the future. Of course, it is impossible to completely discard the past and start from scratch. But therapies consider the past only to the extent that its negative effects persist now and may threaten the future.

This difference in emphasis between psychoanalysis and other methods of psychotherapy makes one wonder whether such a systematic and obligatory return to the past really makes psychoanalytic work more effective. Here’s what you need to pay attention to:

• The idea that the longer and more expensive the therapy, the deeper and more effective it is, is a prejudice that transfers the laws of commerce to psychology (the more expensive the thing and the more sacrifices it requires to acquire, the more valuable it is in the eyes of the acquirer). There is another misconception in this, according to which the mental «birth» of something valuable must necessarily occur «in pain.»
• Defining the task in specific terms (for example, “I want to become more confident in myself” or “I want to learn how to say no”) speeds up therapy — knowing where you are going will get you faster. This is exactly what short-term or medium-term therapy offers (see table).
• The effectiveness of therapy or psychoanalysis depends more on the skill of the specialist than on the technique. In other words, there are no bad methods, only incompetent therapists.

The choice depends on the situation

So what to focus on when deciding to do psychological work? Schematically, our choice can be represented as follows:

• Ultra-short or short therapy (see table) is indicated when the problem is specific, clearly defined: I want to quit smoking, stop experiencing stress for no real reason, I want not to stumble when speaking in public.
• Short or long-term therapy is indicated during periods of acute crisis, in case of difficulties in sexual, marital, professional relationships or psychosomatic symptoms that greatly reduce the quality of life. And also in the case when there is a clear desire for change.
• Psychoanalysis, on the other hand, the longest psychotherapy, is especially indicated for those who are doing well in a social sense and who are striving for self-knowledge and finding out exactly how their hidden sufferings arose in their personal history.

Different methods can and should be considered as complementary. On the path to personal maturity, there is a time for awareness and a time for change, a time for understanding and a time for learning to live better. What time will come first? Each case is different.

However, one thing remains true: we all have to overcome difficult moments in life. And we will be better prepared to deal with them if we have time to heal the wounds of our past — and this is not solved with a few sweeps of the scalpel. But even ten years of psychic surgery is not necessarily needed here. In the end, the question is not the duration, but when the right time comes for me today.