Here are seven A words that provide a lens through which to focus and bring some clarity in thinking about psychotherapy. This is a random selection of seven words beginning with A that do not necessarily belong together, but which give us some handles on what psychotherapy is about. I come across people who are not aware of what psychotherapy can offer, how it can change your life, or the territories of experience that are available to visit.

Psychotherapy offers a method of enquiry into your life, your being, your states of mind, that differs from the mainstream model of “mental health” where symptoms are seen as an expression of dysfunction arising from faulty body systems. From a psychotherapeutic perspective, when you experience psychological and emotional distress, there’s an option to understand and appreciate why and how it arose, and what it might be communicating to you, before you attempt to remove the symptoms.


Anxiety is an example of a common, persistent psychological symptom that can drastically reduce your quality of life – if you cannot find a way to reduce or control it. Alongside anxiety, we could also explore alienation, addiction, and adverse traumatic events. Anxiety is unpleasant and intrusive, and it is often an initial reason why a person seeks therapy. Often people feel that for years they have no choice but to put up with a background noise of constant anxiety. But why tolerate feeling anxious as a “normal” part of life? Being anxious is a symptom, and as such it can be understood, psychologically, as a form of communication, perhaps as a result of childhood experience, or because your brain is constantly on high alert in fight or flight, and you have never learned to deeply relax and still your mind. If you can learn to think differently about your anxiety, you may also be able to experience it differently.


Attachment theory is an incredibly useful focus in psychotherapy. Attachment describes your general style of relating to others, based on an attachment pattern that developed between you and your earliest carer(s), often your mother. Attachment has been extensively researched, and is observable across all mammalian and human relationships. There are different attachment styles, such as anxious, secure, ambivalent or dismissive. These styles can describe a pervasive way in which we “do ourselves” in relationships, and also in activities and projects where we may demonstrate consistent relational tendencies. When you understand your attachment patterning, you will have many useful insights into how you experience relationships, and some of your signature strengths and challenges. Of course, the combination of your attachment style with those of others make unique combinations which each have their unique strengths and flash points. Attachment is a way of getting a handle on some of what happens in your significant relationships.


As we can see from the discussion of anxiety, and attachment, raised self awareness and increasing self insight, is an essential ingredient in the mix that helps us to master stress, difficult feelings and ingrained negative behaviour patterns. When you gain greater self awareness about how you defend yourself against painful feelings, you also gain more understanding about how to respond to them with more free choice, instead being driven by old unconscious patterns. Raising your awareness of how, when and why you become anxious is thus the first stage of therapeutic change. Reflective, contemplative self-awareness is a keystone in psychotherapy. Indeed, awareness can be said to be therapeutic in and of itself. Once you start to observe or witness yourself in a peaceful, neutral, accepting way, change becomes much more possible.


Psychotherapy is a relationship where the focus is on paying careful attention to your state of mind and what is important to you. The psychotherapist focuses their attention on you, and this supports you to give yourself better attention. There is an idea that “attention seeking” is a negative thing and that you should somehow ignore what is tugging at your attention. You can see that children who are not given sufficient attention, often learn to attract attention in negative ways, because even negative attention is better than being ignored. Yet we all need attention, and most of us do not have enough of it. At the very least, psychotherapy is a place where you will experience being attended to and listened to. This process can help you gain a fuller understanding of all that has been happening to you. The experience of receiving respectful, interested empathic attention can be enjoyable and makes the therapeutic hour flow easily.


Acceptance is often a turning point in achieving positive therapeutic outcomes. Acceptance of yourself, of who you are and where you are, and also acceptance of what has happened. When we cease fighting against what is, we can then focus more on changing the things that we can change, as well as living more constructively with what we can’t change. When people reach the stage of acceptance with an issue, there seems to be more grace and flexibility possible, and the beginnings of being able to let things go. We don’t need to condone or agree with the bad things that happened, but holding on to them too tightly or continuing to feel upset by them can keep us stuck in the past. Acceptance is the opposite of judgement, criticism, guilt or feeling you’re not good enough. Acceptance helps you move forwards.


Once you have raised your self awareness, and accepted your feelings, the next therapeutic phase needed is taking direct action. This is where you attempt to live your insights in your everyday life. Putting learning into action, step by step, day by day, is where the new understanding becomes real and starts to bring the happy results you were seeking all along. Awareness, acceptance and attention are not enough on their own, because they can become circular. You need to step out of your familiar comfort zone and try new things.


Finally, authenticity speaks to the idea that therapy is, in part, about supporting you to be aligned with your real, authentic self. There is a difference between your persona, or egoic, functional self, and the authentic self that is an expression of your higher values, your greater potential, your sincerity, your resilience, your love and creativity. Knowing the difference between these two “selves” will help you to see which one you are aligning with in any moment. Choose the authentic self and it will lift you up, and choose your ego self and you will stay fixed on the same spot. It’s always a choice.