An Open Letter to My Students I: What Therapy Is All About

Hello!

So you’ve decided to become a therapist. I hope that it is as fulfilling as you hoped it would be when you enrolled. For me therapy, at times, has been filled with magic. I mean that in the most literal sense of the word. Therapy is magic and practicing therapy well makes you a magician, but as with all magic there is a cost. Therapy will break your heart. I once heard a wise man say that you give advice not to avoid struggle, struggle is inevitable, but to help someone find their way through struggle. I hope these letters are a light in dark places.

As a therapist, researcher, scholar, and student, I have found a few fundamental truths. The first thing I’ve learned is that we know a lot less than we say that we know. Twenty years from now most of the “latest” and “greatest” discoveries will not only turn out to be duds, but actually actively harmful, like how we used to irradiate appendices to reduce their size and ended up giving thousands cancer, or how we would blood let people to get ride of disease, or drill holes in to peoples heads, or would remove the eyes of blind people which disrupts their sleep cycle, and so on and so on. “Progress” has made lots of costly mistakes.

However, I’ve also learned a second thing. In every field there are fundamentals that nearly everyone agrees on. These fundamentals often have high upsides and small downsides. I’ve made it my life’s mission to not do the fancy therapy I read about in textbooks but to simply master the fundamentals. Ironically, the more I simply pay attention to the fundamentals, the more I find myself enacting magic.

In our field of psychotherapy there are a few fundamentals. One of these is that first and foremost psychotherapy is about helping people to manage their emotions. That’s it. That’s all we do. We do not give advice. We do not try to convince or change a client’s mind. When someone comes into therapy your only job is to help them managage emotions which they would rather not feel.

That’s it.

Others will say that therapy is about “cognitive restructuring” or “self actualization” or “finding solutions.” They are wrong because when people can manage their emotions they find themselves thinking differently (