TALKING IT OUT

The free verbal expression of feelings and emotions“Talking it out,” in the usual sense of giving vent to what is uppermost on one’s mind, is regarded as a relatively superficial process—yet it may afford temporary relief and open the way to deeper therapy. Individuals who are anxious or emotionally upset frequently report that they feel more relaxed and comfortable after an opportunity to “let off steam” and give voice to their problems and worries in the presence of an understanding listener. Many a therapist has had the experience reported by Maslow and Mittelmann(1941) : A woman who came in for an interview talked volubly about her problems for fifty minutes straight, then got up to leave, remarking, “Thank you, doctor, you have helped me immensely.” The doctor had not uttered a word.Talking is an essential aspect of the psychiatric interview, but in any of the deeper procedures it involves far more than having the patient unburden himself about his conscious difficulties. In non-directive or client-centered therapy, the patient leads the way and says whatever is on his mind—yet talking is only one aspect of the therapy. The patient’s progress and growth are believed to be dependent on rapport with the therapist and on his ability to reflect back the patient’s own thoughts and feelings in such a way that he sees himself in a new light, gradually modifies his aims and attitudes, and begins to realize his own inner potential.In psychoanalysis, too, talking it out is only one part of the process, even though this type of therapy is often characterized as “the talking cure.” Although talking is essential, the object is to get the patient to give voice to what is innermost in his mind, not what is uppermost. Moreover, the process goes far beyond catharsis or simply giving vent to emotions, since its aim is to discover the hidden sources of the patient’s distress and help gain insight into his unconscious motivations—for only in this way can a basic change be brought about. To accomplish this, the psychoanalyst employs the special techniques of free association and dream interpretation, which are designed to probe beneath the surface and relate present difficulties to earlier experiences. In so doing, the analyst recognizes that what the patient cannot “talk out” is likely to be more crucial than what he can talk about. He must therefore use his ingenuity in overcoming the patient’s resistances to revealing significant material.In general, then, it may be said that although talking out frequently makes a patient feel better, it does not in itself effect a cure. Its major value lies in the fact that it often helps to pave the way to genuine treatment