In psychotherapy, the patient and therapist give their attention to the life of the mind, imagination, feelings and experiences. Patients are asked to say everything that occurs to them. No thought, feeling, or fantasy is to be censored or judged.
It is gradually discovered that unconscious forces, which by definition operate outside of awareness, influence patients’ perceptions of reality. As a result, distortions and disguises, which are called defenses, occur in feelings, thoughts, understandings of the world, interpersonal relationships, choices, and behaviors.
Patients are often surprised, even astonished, by how unaware they had been of limits they imposed on themselves under the domination of these irrational forces. Maladaptive patterns and costly coping mechanisms, the defenses mentioned above, are discovered to be the source of illness and distress, and these are observed and explored.
As free association proceeds, as dreams are told and interpreted, as everyday life and personal history become familiar by repetition and review, as understanding of defenses advances, and feelings intensify, as language is found, and the relationship between therapist and patient deepens, the unconscious forces are brought into conscious awareness. The past is discovered in the present. New ways of being in the world unfold and rigid defenses soften or are supplanted by less costly mechanisms. The patient becomes more fully known to self and others.
Awareness leads to insight, and insight leads to change.
© 2011 Jessica B. Londa, Ph.D.