Vietnam 2015-16 197 (2)

The Aim of Psychotherapy

“It is not just that the patient sees that he has been active in bringing on his own misery, whereas he thought he had been merely passive, but he sees, too, that he can also be active in another way that alters his past, present, and future all at once (Schafer, 1973).”

It’s a ludicrous idea that there could be one sentence that summarizes the aims of psychotherapy and psychoanalysis. Those aims are always specific to the individual patient; they are always found anew and are never taken from a textbook. That being said, I’m going to venture into the ludicrous by saying that at the moment the above quotation comes the closest to encapsulating in just a few words the aims of the psychotherapeutic endeavor.

The writer, a psychoanalyst, describes a powerful outcome of a successful psychotherapy experience: the profound realization, emotionally as well as intellectually, of one’s own contribution to one’s own suffering. Not infrequently, a patient begins psychotherapy with a sense of having being harmed by others who are to blame. And, of course, there is often blame to be leveled and anger to be expressed. People do hurt other people, sometimes intentionally, sometimes not. Anger in such situations is a justifiable and healthy emotion. Other times, people begin therapy with massive amounts of anger aimed at themselves. The trajectory of therapy then involves redirecting that anger to where it more appropriately belongs.

Schafer writes about a further step in the healing process. The goal here is not to let someone off the hook or create more self-blame. Rather, it is to see how a person contributes to his own misery so he can not only create less misery, but contribute to his flourishing as well. In a successful treatment, a person learns that he is not passive, that he has agency over his life to create a life, although never free from suffering, more alive and meaningful. Often a person sees that it is through his efforts to protect himself, the defenses and walls he erects to be safe, that he has contributed most profoundly to his own suffering. At that point, determining what other, better, ways there are of creating safety becomes a central focus of the work.

Schafer points out that this realization can then alter a person’s “past, present, and future all at once.” That is such a mysterious part of the quotation. While we can never literally go back and change what has happened, we can, especially through psychotherapy, change our understanding of what happened and our perception of the present and the future.  When a person reaches this point, and I’m very pleased to have had many clients experience this, then it is as if the past is altered by the realization of who the person is now. And what is possible in the future becomes much more promising.

Perhaps tomorrow I’ll read a passage that will better summarize what this fascinating, complicated, and mysterious process we call psychotherapy is all about. For now, the words quoted above describe that powerful transformation that can happen in a person’s life through a dedicated effort on the parts of both people, patient and therapist.


Schafer, R. (1973). The Termination of Brief Psychoanalytic Psychotherapy. Intl. J. of Psychoanalytic Psychotherapy, 2:135-148.

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