Do I Need to Talk About My Past in Psychotherapy?

I’ve heard this question from several of my clients. Some of them had just started psychotherapy for the first time, and their understanding of what it is and how it works had been shaped primarily by TV shows and movies. One client even made a humorous reference to the TV series The Sopranos, wondering out loud if his psychotherapy would resemble that of the mafia boss Tony Soprano.

My short answer to the headline question is, “It depends.” First and foremost, the need to explore the past in psychotherapy depends on the client’s presenting concerns. Sometimes it’s obvious. For example, if you’ve developed fear of driving following a recent car accident, there is no need to discuss your childhood and your parents. However, if the root cause of your current difficulties is not so obvious, if may be useful to consider several factors. First, if you are having a strong emotional or behavioural reaction every time you think about or something reminds of some event in the past, this is a clear indicator that you could benefit from discussing this event in psychotherapy. Another factor to consider is your level of preoccupation with the past. If you are focusing too much on the past events, or avoid thinking and talking about them altogether, it may be worth exploring these events in psychotherapy. Yet another factor to consider is whether or not you’ve already taken steps to heal from the past event. If, for example, you’ve received support from others after the event occurred or you’ve already spent time in psychotherapy processing it, you may not need to dwell on it going forward.

The extent to which you’ll be invited to discuss your past in psychotherapy may also depend on your psychotherapist’s theoretical orientation. If your psychotherapist is practising traditional psychoanalysis (the type of psychotherapy originated by Sigmund Freud), he or she is likely to believe that it’s important to understand the past as a way of shedding light on the dynamics of the present. If, however, your psychotherapist is practising a more contemporary solution-focused brief therapy (SFBT), he or she will be guided by the belief that it is not necessary to know the cause of a problem in order to solve it. Thus, even if your issues originated in the past, your SFBT-oriented therapist will focus on the present.

I don’t adhere strongly to either belief. I am quite flexible in my approach, which I try to adjust to each specific client in each specific situation. I believe that what is right for one client may not be right for another. With some clients, I spend more time gathering information about potential causes of their problems. With others, I focus on the solutions. In each case, my client and I together figure out what is important to discuss and what is not. I believe that it should be completely up to you to give the go-ahead to discuss your past in psychotherapy.