"Pay attention" and "You're doing great"

These are two sentiments I find myself conveying to patients way more than I ever thought I would as a practicing Psychologist. When I got into the field, my own arrogance and the medical system in which the field of Psychology is housed led me to believe I would be fixing people...or at least teaching them new things. During the course of my own development I realized that most patients don't need to be fixed - they need to be understood, validated, and (at most) guided toward a valued life. The first two were of a paramount importance that it took me a while to appreciate. I first noticed it when I heard the redundancy in my message across patient appointments. It felt like I would often leave sessions and reflect that over the past hour, I basically told them all some form of "pay attention to your thoughts, feelings, and behaviors throughout the week" and "I think you're doing better and behaving more adaptively than you think you are". This is a staple of positive psychology, which assumes a certain amount of adaptability, resilience, and health that all humans will posses as a default. My belief is that concrete intervention is less common in productive psychotherapy than many of us think. In fact, this is not too unlike traditional physical medicine, which often endeavors to support the natural healing capabilities of the human body, rather than introduce an entirely new function. My approach to psychotherapy relies heavily on the following premises:

1. People are strong, resilient, and adaptable.

2. Figuring out what is important to people will make the "right" course of action emerge on its own.

3. People often know what they need to heal, but either don't ask themselves what that is or don't trust this instinct.

4. We can't know what is working or not working in our lives until we pay attention and take inventory.

5. Reviewing what we're doing well and building on those strengths may reduce existential angst, increase positive self regard, and help us to continue along productive paths.

6. People may need a little extra help to see that their lives could be different and plan their route to a valued life.