Love, Awareness, and the Purpose of Therapy

At parties, when people learn that I am a psychotherapist, I am asked, a bit too often to my taste, “Are you analyzing me?” (the words seem to always be the same). I believe that what I am really asked is: "Are you judging me?" I usually experience embarrassment in the moment, but afterward I feel some sadness because I believe that this is a fundamentally poignant human question. And I worry that the belief behind that question may prevent some people from seeking support. This has led me to wonder about the image of our profession and, beyond that, the purpose of therapy.

As a professor, I was sometimes asked by my students to share an overview of our field. Although not a theory specialist, I have been exposed to several therapy modalities (at varying levels of depth). One way I could make sense of these different modalities was to map them, albeit at the cost of over-simplification, to three abstract schools of psychotherapy (in practice, there may be overlap). In the process, it dawned on me that an integration of these schools may be possible. What I would like to do today, is to start a conversation on such integration, how it may help us with our understanding of the purpose of therapy, and with the ways in which we practice, as well as render some of the fears about our Service moot.

Schools of therapy

The first school of therapy states that psychotherapy involves making the unconscious conscious (that is, the part of the unconscious that is verbally accessible in a meaningful way). This addresses the internal tensions that are generated by the misalignment between conscious and unconscious, the main cause of emotional distress. This was started most famously by Freud, and it is perhaps the most iconic. A simple example could be: “You are reproducing in your marriage how you witnessed your parents interact with each other.” I will use the label “unconscious school” (#1) for this approach. Depth and psychodynamic therapies come to mind. On a personal note, the experience of receiving psychodynamic therapy as a teen impacted my choice, twenty-five years later, to become a therapist (that, and the experience of becoming a father).

The second school is interested in non-“unconscious” phenomenon and techniques (in the sense understood by the unconscious school (#1)). Distress is the result of faulty cognition, or dysregulation of the autonomic nervous system (hyperarousal or hypoarousal). Change occurs by cognitive or behavioral interventions. Examples include disputing irrational beliefs, mindfulness, breathing exercises, and neurofeedback. For lack of a better term, I will use the label “cognition-physiology school” (#2) for this orientation. Elements of cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), for instance, can be mapped to this school. I will share that I am a trained and practicing mindfulness meditation instructor and use EMDR in therapy.

The third school of therapy is concerned with providing clients with the experience of being deeply accepted and welcomed as the main vehicle to reduce distress. I will label this school the “relational school” (#3). Carl Rogers’ person-centered approach maps closely to this school. My favorite class in my counseling program as a student had a strong Rogerian orientation.

All three schools offer something deeply valuable. And different people will be attracted to them differently (and maybe at different times). I, personally, have benefited, and continue to benefit from elements of each of them.

Purpose of therapy

So how do we integrate them? I think that one way to integrate them is to state that the purpose of therapy is to help people welcome Self. Welcoming Self, in this framework, has two “components:” developing awareness of Self (a) and forming a warm relationship with Self (b).

The unconscious school (#1) provides wonderful tools for the developing awareness portion of welcoming Self (a). The cognition-physiology school (#2) also contributes to the developing awareness portion and can be particularly helpful in terms of reducing the noise of the cognitive machinery (and the limbic system) – without which no other work could be done. And the relational school (#3) is centered on the importance of the forming a warm relationship component of welcoming (b), albeit with an accent put on the relationship between client and therapist.

I am proposing welcoming Self as purpose of therapy also because, with every client I have worked with thus far, we end up discovering that Self, at the core, includes love. When a new client comes to therapy (and that applied to me as well when I started therapy as a client), they either have the notion, implicitly or explicitly, that something inside should not be approached too closely, or is bad. In my practice, none of these perceived qualities of Self end up being true. But we carry those beliefs because along the way, we received messages, sometimes directly, often times implicitly, that something about ourselves may be defective (I am thinking of abuse and neglect, but also of environments which, while materially caring, lack emotional acknowledgment).

I believe that awareness of Self and the quality of relationship with Self are deeply interwoven. To be anchored, a warm relationship with Self needs to be done in understanding of Self. Else, there may be doubt: am I really embracing Self, or am I only embracing the parts that I see, leaving off the parts of Self that I implicitly deem as unacceptable? (If so, then I don’t really welcome Self.) And developing awareness of Self needs the support of a warm relationship with it. Else, why would I want to consider looking at those parts of Self which I do not accept (yet)?

What I notice is that we still experience external stresses when we get to welcome our Self (presumably because of our cognitive abilities, our sentientness, and our mortality). But these are dampened by the foundation that a warm internal relationship with Self provides. We no longer have to deal with the internal stress of feeling inadequate. The capacities for vibrancy, courage, risk assessment, empathy, and meaning become freed. We get to feel at home inside.

Forming a warm relationship with Self

How do we help our clients form a warm relationship with their Self? I mentioned that Self at the core includes love. I observe that it also includes resonance - by resonance, I mean the ability to be in a similar state to that of another entity. Our client’s Self will experience warmth if it perceives (through its ability to resonate) a fellow Self (the therapist’s), in resonance and being welcome (here, by the therapist). In my practice, I notice that I tend to experience warmth as tenderness (particularly those in instances involving attachment wounds – more on this later).

In childhood, when self-awareness abilities are not yet developed, or with clients who do not wish to use words, I believe that this relational aspect of therapy is the core of therapy. Talk and awareness are secondary.

I find it important to modulate the way I, as a therapist, let my warmth transpire in accordance with the client’s developing level of comfort with it. Some clients may readily welcome warmth, while others may initially associate warmth with boundary violation or misalignment with their perceived self-image. Conversely, some clients may interpret warmth as a green light to merge with their therapist.

Developing awareness of Self

When awareness capabilities are online, awareness needs to be brought on board. Awareness needs to get in touch with the nature of what it is to welcome: Self. I find it important to have a special attunement to shame. Proposing something that subtly (or not so subtly) highlights to the client their perceived shortcomings reinforces shame. This is particularly true if that proposition is made from a position of authority. Shame, in this framework, is the unwelcoming of Self. If not repaired, or repeated too often, shame is the opposite of therapy. I have a special thought for those of us who have historically experienced connectedness in association with shame and therefore need the latter to experience the former (thus far).

Developing awareness of Self includes reducing the chatter of the cognitive apparatus and/or the limbic system. It involves developing an awareness of the phenomena we experience: emotions, images, sensations, thoughts, behaviors. It also rests on understanding our human internal systems, how they generate our phenomena, a sense of why these systems were probably built, and the beliefs and emotions we implicitly form as the result of how our specific interactions are, and have been processed by our internal systems. There are several systems that are touched upon in my practice, but I will mention two: our thought-generation module and our attachment module. (I do not know the extent to which these modules have been documented, particularly the former, but positing their existence seems to provide explanatory power and indirectly yield positive results in therapy.)

Understanding that our thought-generation module is designed, in part, toward anticipating worst-case dangers, assigning them a high probability, and problem-solving them, helps us understand why our thought-generation module gravitates towards the worst. It can also help us understand how, in situations in which there is no readily available solution, our thought-generator tends to get stuck in problem-solving loops. This helps inject some distance between the underlying felt anxiety that accompanies such loops and ourselves. It also helps us steer our risk assessments toward less catastrophic levels. And perhaps, it can help inject a little bit of gentleness toward ourselves in the process.

I am particularly touched by our attachment module. This is a module that seems to be designed to ensure our survival by programming us into not being alone, especially in infancy, by bonding with others. This also applies in adulthood. So, I will add that in addition to love and resonance, Self, at the core, includes wanting to be loved. I noticed this in all my clients (and in myself as well), and it has been the central aspect of therapy in my practice thus far. Incidentally, being loving and wanting to be loved allow for recursive relational links to be built with each other. (The research on attachment theory appears quite robust – the Attachment Theory entry on Wikipedia, anecdotally, features 249 citations at the date of this writing. Loneliness, in addition to its emotional cost and its theorized decrease in life expectancy in nature, also appears to have biological consequences. The U.S. Surgeon General, in its 2023 advisory “Our Epidemic of Loneliness and Isolation,” states that lack of social connection can “increase the risk for premature death as much as smoking up to 15 cigarettes a day”.)

Love

Understanding our human systems helps reframe how we experience our emotional vulnerabilities. Instead of shame, we can gain an appreciation for what our vulnerabilities embed: the caring that our systems have for our being alive, an appreciation for the preciousness and importance of wanting to be loved, and our ability to resonate. For yes, wanting to be loved (and the ability to resonate), means that we can be hurt. But it also means that we can resonate with someone else’s hurt and welcome them in awareness. And I believe, in this context, that this is love. It is an intrinsic part of Self. And when safe, we can, in turn, feel genuinely loved: we can open ourselves to being resonated with and welcomed with our vulnerabilities. This means that we can participate in and nurture our community. We can bring the next generation into the world and become the warm peace of the felt experiences of genuinely welcoming others and having our Self be welcome.

In therapy

I find that in therapy, recalling that the purpose of therapy is to help clients welcome their Self can bring me clarity and help me steer my next therapeutic move.

When my anxious attachment style features become activated, it helps me to remember that therapy is not about my client experiencing my liking them (and, usually as a consequence, their liking my liking - though I believe that we are designed to feel good when our love is accepted), but my client welcoming of their own Self. It reminds me that helping my clients develop awareness is a component of welcoming Self, that being heard, simply because it is judgment-less, is a form of welcoming, and that interventions that lessen the noise of the nervous system are supportive - and sometimes vital.

When my avoidant style features become activated, it helps me to remember that therapy is more than my observing my clients, sharing those observations, or imparting cognitive technique for their own sake. For if done without consideration of their potential effect on welcoming Self, they may reinforce shame (directly if they are perceived as intrusive, or if their content triggers unaddressed negative beliefs about Self, or indirectly when neutral detachment is experienced as ‘unwelcomability’). Therapy is also about the quality of relationship with Self, with an underlying appreciation for our and our client’s humanity and tenderness toward not having received growth-constitutive love.

And viewing the purpose of therapy as welcoming Self also accounts for the results of the research that identifies as primary factor of efficacy of therapy the quality of the relationship between client and therapist. I believe that what this research may be saying is that the client-therapist relationship is a proxy for the resonance that occurs between the relationship of the therapist with their core Self on one end, and the relationship of the client with their core Self on the other end.

When the client-therapist relationship is welcoming, our clients are experiencing a Self that, because it is resonating with another welcomed Self, is lovable. And when ego knows that this lovability is done not on the surface but in deep awareness of who the Self is, that lovability becomes anchored. When Self is truly welcomed, access to the love that is embedded in core Self goes live. For this to occur, it means that we, therapists, need to welcome our own Self, that is, our humanity and the vulnerabilities it embeds. So, I am hoping that in due time, when there is awareness that the purpose of therapy is to help welcome Self, when we are at parties, people will know that no, we are not judging them, rather, they will know that therapy is about our welcoming their humanity, which is also ours.

References

Kinreich, S., Djalovski, A., Kraus, L., Louzoun, Y., & Feldman, R. (2017). Brain-to-Brain Synchrony during Naturalistic Social Interactions. Scientific Reports, 7(1). https://www.nature.com/articles/s41598-017-17339-5