What is long-term therapy? In the age of managed care, some therapies have a pre-established length of treatment no matter what your situation. In long-term therapy, you determine how much support you want and when you are ready to move on. Your therapist will stick with you through ups and downs for as long as it continues to be helpful for you. This is not a one-shot treatment, but a lifetime relationship that you can return to whenever you want. 

Most long-term psychotherapy is depth psychotherapy. Depth means these methods recognize the existence of an unconscious. Non depth psychologies focus on what is directly introspectable, such as thoughts and feelings. Methods such as cognitive behavioral psychotherapy use our capacity for cognition as the central tool in pursuing change, most of which is defined in behavioral, cognitive, or affective terms. We learn ways of coping, we define our thoughts and change or stop them, and so on.

Depth psychotherapies are based in the assumption that we have motives that are outside of our awareness. We cannot directly apprehend these motives, and we cannot directly change them. Instead, we know them by their effects, and we affect them by our choices of relationship experience and our willingness to pursue a deeper understanding of ourselves. We can know we have motives that are outside of our awareness because we do things we do not want to do and we do not do things that we want to do. We choose not to eat sweets, but find ourselves with a half eaten candy bar.

In order to understand our deeper motives, we enter into a relationship with a therapist whose goal is to provide as accurately as possible a mirror into the many complex responses and actions that occur within the therapeutic relationship. This process allows us to recognize inconsistencies: thoughts, feelings, and behaviors that do not match with our deepest ideals or our conscious intentions. The encouraging presence of the empathic therapist promotes our own inner courage and our healthy desire to know ourselves well. The process itself is the therapeutic tool, not some technique or method. Having the luxury of sitting with another human being, stopping the world, noticing with wonder and worry the many complex part of ourselves which we have not allowed into our awareness–the deepest meaning of being valued to that degree and detail by another person–that is what ultimately permeates every thread of our relationship with ourselves.