Updating the Image of Psychotherapist: From Orthodontist to Helicopter Pilot When people think about PsychotherapyWhen people think about psychotherapy, there is a common image that comes to mind that is off putting and misleading.  For a long time, psychiatry has used the orthodontic metaphor of straightening to convey what it does.

For example, there is a leading professional journal named Ortho-Psychiatry.  The Greek term which means to straighten conveys the notion that emotional problems are like crooked teeth i.e. something in a person’s mind has become misshapen and needs to “straightened out”.
While this image conveys some truth, in other ways it is false. Certainly, the traumatic events of childhood warp and distort our perceptions and responses to life and cause us to have exaggerated and irrational thoughts, feelings and reactions.  Those distortions need to be identified and removed (straightened)  so that one may once again accurately perceive and rationally respond to the challenges one encounters in life.
That said, the actual process of “straightening” associated with the dentistry and the forcing teeth back into alignment is very misleading. Specifically, the metaphor of therapist as a dentist and therapy exaggerates the role of the therapist on one hand, and grossly minimizes the role that self-discovery by the client on the other.  Healing and change are the results of a client’s own discovery and effort made as s/he works with the therapist and not because of the action of the therapist alone.
Perhaps better metaphors for conveying what psychotherapy is and what a psychotherapist actually does are a helicopter and a pilot — where the client is the co-pilot.  Therapy is the vehicle that lifts the client up to be able to get a different, “aerial” view of his life and see her problems from a larger perspective. The therapist is the pilot who points out the relative relationships and historical connections of various aspects and events of the client’s life and how they relate to the particular issue with which the person is struggling.
The chief function of psychotherapy is to help a folk to change their perspective which in turn allows them to change their experience and behavior. Increased awareness of life patterns and unrecognized resources allows clients to experience life more positively and cope with challenges more effectively.
The healing self-discovery is not imposed on the person by the therapist nor is it forcibly resisted.  The “ah hah” moment is accomplished by the person’s willingness to explore and look and see how different things appear from a different and elevated perspective.  More later …