"Happiness is like Self-Esteem: You have to work for both."

I've had several conversations recently about how therapy works and how it works differently for each client. Some seem to make leaps and bounds in their quality of life in pursuing insight into their histories and behaviors. Some report being flummoxed with an untangling and a difficult inertia leaving them clouded, stuck.

In my practice, I prefer to first provide clients with tools and skills to improve their functioning. I've found that new skills, improved functioning provide direction away from acute distress. With more mental energy we can come back to build insight next.

I find that clients who are pushed to dig deep and pursue insight about their present based on distant, painful memories often become resistant and sometimes disillusioned with counseling. When we can work the fine balance, not denying the potential benefits of exploring past roads, and focus first on regaining functionality with new skills, clients tend to make positives strides faster and become more invested in our work together.

When clients are more well-suited to resolving conflicts and are getting through their day to day successfully, we often ramp up the exploration. That's when the anxiety, the crush, the dark inertia is lifted enough for insight to be more beneficial than detrimental. It becomes about asking, how did I get there, and how can I avoid that again? What contributed to that painful phase, and how can I prevent it again? Insight into what shapes us, what has us thinking the way we do, speaking the way we do, will help us understand the motivations behind our current behaviors. With that new awareness, it becomes easier to re-habituate and choose new, more functional behaviors today.

The New York Times recently had an interesting piece on the values of insight in therapy. Well worth a read. It fits nicely with the way I practice and the value I share with Dr. Susan Heitler. We help clients learn new conflict resolution and communication skills - we lean more towards 'how-to' work before the 'how-come.'

I agree with the article's author Dr. Friedman and his assertion that insight is one ingredient in fulfilling therapy. He adds, "happiness is a bit like self-esteem: You have to work for both. So far as I know, you can’t get an infusion of either one from a therapist."