The reason why people come to the psychologist, regardless of their personal needs or day-to-day problems, can be summarized in one term: change for the better through a therapeutic process.

In all cases it is an aspect of life where there is something to learn, usually by adopting new habits and other ways of thinking and feeling.

But… How is this gradual change towards a better way of living different from any other vital change that can take place without going to psychotherapy? To address this issue we spoke with psychologist José Miguel Martín Vázquez, from Todo es Mente .

José Miguel Martín Vázquez: the therapeutic process and change

José Miguel Martín Vázquez is a psychologist specializing in online therapy through his Todo es Mente psychological assistance center. In this interview he talks about the way in which the therapeutic alliance between professional and patient can promote change in those who come to the psychologist’s help.

What are the main ingredients for the therapeutic change the patient wants to make?

Within a general context of a positive therapeutic climate, certain facilitating features must be given, to a sufficient degree, both by the client and by the therapist. Common to both would be 10: self-criticism, communication, concentration, confidence, flexibility, humility, intelligence, motivation, patience and sincerity.

A therapist should also have high self-esteem, good self-knowledge (ideally he should have done psychotherapy himself) and an eclectic mentality (regardless of his basic therapeutic orientation).

It will be necessary for the client to achieve a knowledge of himself and his problems, which will lay the foundations for projecting and maintaining behavioural changes. The unconscious has to unlearn and learn little by little, because we are always our past.

Putting words to the problem that is causing the patient’s discomfort is surely a complicated matter. How do you set the goals of psychotherapy in the first sessions with the psychologist?

Focusing on the client’s personality is much more fundamental than focusing on a diagnosis. In the same way that focusing therapy on increasing the client’s field of awareness is more important than the specific techniques we use.

In a deep and resolving psychotherapy there is no “pill for a symptom”; we go beyond the “external” manifestations of the problem, to focus on the mental context that produces it.

Client and therapist decide what the goals of the psychotherapy will be (usually we do this in the framing session). I work for therapeutic processes. At a certain point in the therapy, we both know that we have reached the agreed goals. At that point we evaluate the process and the change of the personality, and we analyze it. Then we either end the psychotherapy or open a new process with new goals.

To what extent is it important to modify our habits to benefit from the effects of psychotherapy, between sessions?

Psychotherapy begins at the first contact, and ends when the client decides it is over. It’s all psychotherapy. A therapy focused only on weekly sessions will not be the most productive. I advise clients to establish written exchanges between sessions, in order to empower and make the process more effective.

It is often very helpful to do a biographical review, with continuous exchanges of ideas and perspectives between sessions; likewise, exchanges can be made on any relevant and current topic in the client’s life. Behavioral change is important but, in order to be sustained and help in the resolution of the problem, it must be sufficiently “conscious”, have an intimate sense that is achieved with knowledge of oneself and the problem.

There is often talk of the need to get out of the comfort zone in order to progress and enjoy a good quality of life. Do you agree with this?

Yes, in a gradual way, as the client becomes more aware, as well as psychologically stronger. It is common sense that if we continue to think and do the same things, with the usual level of emotional comfort, we do not progress (we are doing the same thing).

Suffering, like daring, is an ingredient of life as well as psychotherapy. But there is “suffering without meaning” and “suffering with meaning”. Personality change is equivalent to increased coping skills, and to achieve greater physical endurance, it is normal to be stiff.

In your professional experience, have you come across many people who come to therapy with the idea that it is the psychologist who has to take care of their improvement throughout the treatment, without them having to invest any effort? What to do in these cases?

There are cases of this kind. They are usually people with the mental scheme “Doctor/patient”, who are not aware of the complexity of the mental and the responsibility we have in our psychological balance. A psychotherapy is a psychic work, and it will be necessary to have the disposition to “work”. In this group of clients it is frequent the ignorance, or even the greater or smaller denial, of the psychosomatic fact (the connection mind/body).

In the most favorable cases, we are achieving a greater awareness and the person becomes more conscious of what psychic change is; there are “blind” clients to psychosomatics, who discover a new world. In other cases, we both know that progress will not be possible.

Do you think that people are coming to psychotherapy more and more informed, and that this facilitates the process of change for the better for those people with problems?

It’s one thing to be informed, it’s another to know. Intellectual knowledge is useful but insufficient, because experiential knowledge will tend to prevail. There are people who, because of their life experiences, are more prepared to benefit from therapy. They know, from experience, that “Everything is Mind”; they just need someone to accompany them in their process of inner growth.

Someone may have the good intention of doing psychotherapy, because their doctor recommended it, but not understand that psychotherapy is neither “going to the psychologist” nor “doing sessions with a psychologist”. Everyone has their own time, depending on what aspect of life they are in.

What can psychologists do to increase the positive impact their work has on society?

Do your job well. Serve others in the best way they know how and can. I call this attitude “Perfection in activity”, and I consider it one of the 7 sources of secondary self-esteem (along with the sincere affection of others, self-knowledge, secondary ethics, achievement of internal goals, overcoming obstacles, and transcendence). Others will love us and we do not love ourselves.