Common impediments to good psychotherapy ? or hell is other people

Abstract

This paper discusses the thesis that the practice of psychotherapy, like other intense human relationships, involves a number of inherent difficulties that must be endured. These common impediments include 1) the identity and status of psychotherapy as a profession, 2) the requirement of a delicate balance in therapy between thought and emotion, 3) the necessity of a resolution to the patient's transferential rage while minimizing the therapist's tendency to avoid that rage, and 4) the therapist's desire and temptation to control and manipulate the patient. These four impediments are built-in barriers with which all therapists must live. Our task is to attack the more approachable, controllable problems in our impediments, such as limitations in our training models, frequent sell-out by psychotherapists to entrepreneurial profit-centered models of practice, and unclear guidelines about which patients should receive which psychotherapy and when.