Psychotherapy

Unknowingly, I had started my psychotherapy career as a specialist. I gradually developed into a generalist with some more specific areas of expertise-a decades-long career path that posed never-ending challenges to becoming reasonably trustworthy. When I use the term psychotherapy throughout this book, I have the generalist version in mind: therapists who work with patients presenting with a wide range of psychiatric disorders and personal problems. As I make plain in this chapter, however, the specialist-generalist distinction applies in varying degrees to a nearly unlimited variety of blends. For me, learning to blend was not easy, and, unlike systematic desensitization, generalist psychotherapy never came easy. I needed to figure out how to talk with people plagued by psychiatric illness about their extremely challenging problems in living-mostly, problems in close relationships. More specifically, how could I do this work with confidence and competence?