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Inherent in the topic of this round table, “Goals in Therapy,” are the essence and reason for our being. For our being human and for our human being. Our goals in therapy determine the what and how of our being healers and helpers. In asserting what and how we are helping healing and helping growing, we are also asking and answering healing what, helping for what, with what and toward what end.
My opening words, poetic in form, allusive in feeling and maybe mystifying in effect, nonetheless state the big questions which I feel all of us are attempting to answer, whatever our particular interest, private persuasion or theoretical preferences.
To restate what I have just said in more formalistic and literal language: goals in therapy may be limited or extensive, changing in either direction according to the needs, possibilities, and wishes of patient and physician. Relief from a depression through electro-shock therapy or lessening of tension by thorazine or reserpine may be the immediate, limited goals, with or without the goal of concomitant and/or subsequent psychotherapy.
Psychotherapeutic goals also vary in kind and degree. Efforts may be directed toward symptom removal—e.g., a phobia—or toward amelioration of a syndrome, such as a schizophrenic panic. The goal might be to help with a specific problem, such as a decision to marry, whether or not to break up an important business relationship, or to aid in resolving a work inhibition. Such goals, as well as others, might be relief, amelioration, social rehabilitation, adjustment or problem resolution.
The fulfillment of more extensive goals in therapy generally require longer and more intensive periods of therapy to effect a significant degree of basic personality change. Such goals in therapy imply the bringing about of a major shift in the individual's psychic economy. Where previously most of his energies were manifested in sick ways of existing, they now would be invested predominantly in healthier ways of living.