In the age of the fifteen-minute doctor’s appointment, it is difficult to conceive of medical treatment that lasts months, or even years. And yet, not all ills respond to quick cures. This is particularly true in the mental health field, says psychotherapist Drew Permut. In his new book, Inside Your Therapist’s Mind: How a Psychotherapist Thinks, and Why It Works, Permut considers the interpersonal nature of psychotherapy and the time and effort it takes to develop an effective therapeutic relationship.
Drawing on his thirty years of experience as a psychotherapist, Permut offers case studies that go beyond the usual parade of medical diagnoses. Rather than label his patients as alcoholic, paranoid, or depressed, Permut introduces them as people with complex thoughts, emotions, and circumstances. “The focus is on the patient’s very particular and unique personality and how his or her problems and symptoms are related to underlying, usually unconscious processes,” he states.
Writing in a clear, logical voice, Permut goes on to suggest that this complexity is compounded by the unconscious processes of the therapist as well as the patient. Thus, he strongly recommends extensive therapy for the therapist before he or she even begins to treat patients. Permut rationally explains why it is important that therapists get to know their own blind spots and defenses: So that they won’t overlook or misinterpret important aspects of the patient’s story.
Permut’s somewhat detached, professional observations give way to a more intimate perspective when he writes about treatment sessions. Here, Permut is in his element and ably demonstrates the give-and-take process he uses in therapy. Readers will feel like they are in the office with Permut as he observes a patient’s demeanor, listens to the patient’s story, and comprehends his own response before making any suggestions. Permut largely presents cases where his personal brand of insight helped his patients make progress, but he can be forgiven any implied self-importance, for he also includes an instructive chapter on mistakes and errors (including some of his own missteps).
Open-minded with his patients, Permut is perhaps less so when considering treatment modalities outside of psychotherapy. He briefly addresses options like medication but spends little time comparing psychotherapy to other popular methods, such as cognitive behavioral therapy. Instead, he is comfortable addressing most questions through the filter of Freudian psychoanalytic theory and concentrating on how early childhood experiences might remain unresolved and show up in a patient’s adult behavior.
Permut’s main point—that successful therapy requires an investment of time, money, and attention—is sure to clash with the “quick fix” mentality. Indeed, we want a cure and we want it now. Inside Your Therapist’s Mind, however, espouses a slower, more nuanced approach that may lead to more enduring mental health.