Evaluating the increasing need for therapy today, Psychiatrist Prof. Dr. Tarhan said, “Modern people are now lonely, unable to manage their expectations, and relationships have become superficial. This has increased the inclination towards therapists. Having a psychological counselor, just like a financial advisor or a legal consultant, has now become a necessity of modern life.”
Stating that the majority of clients attribute their problems to external factors, Prof. Dr. Tarhan said, “70-80% of those who come to therapy attribute the problem to external causes; to their spouse, society, economy… However, if a person cannot change the flow, they should change their perspective. Gaining mental flexibility is an important goal of the therapy process.”
Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, evaluated everything about the therapy process on the program Nevzat Tarhan ile Akla Ziyan, broadcast on EKOTÜRK screens.
Is the need for a therapist real or artificial?
Prof. Dr. Tarhan stated that therapy has become not just a treatment but a life necessity in the modern age, saying, “Recently, a mother was telling a story; her child was going to a therapist. The child asked, ‘Mom, did you go to therapy when you were a child?’ The mother replied, ‘No, I never went, nor did I feel the need.’ This dialogue shows today’s reality. Now even adolescents feel the need for therapy. So, is this need real or artificial? It’s a controversial topic. Modernism has weakened human stress management. People are now struggling to solve their problems and feel under emotional pressure. In such situations, therapy becomes a necessity.”
Prof. Dr. Nevzat Tarhan, evaluating the increasing need for therapy today, stated, “Modern people are now lonely, unable to manage their expectations, and relationships have become superficial. This has increased the inclination towards therapists. Having a ‘psychological counselor,’ just like a financial advisor or a legal consultant, has now become a necessity of modern life.”
Stating that modern life pushes people's stress threshold, Prof. Dr. Tarhan continued:
“In ancient times, when a person encountered a lion or a tiger, their pulse would rise to 140 a few times a year. Today, however, there are people whose pulse rises to 140 every day in city traffic and business life. Stressors have increased, and expectations have multiplied. People now mistake everything they want for a need. Yet, human needs are not limitless, but desires are. The modern age has made people forget this difference.”
Loneliness has now become a global threat
Emphasizing that loneliness has now become a global threat, Prof. Dr. Tarhan stated that modern people have lost their capacity to form “deep connections”:
Prof. Dr. Tarhan said, “The United Nations identifies three major global problems: income inequality, climate change, and loneliness. Loneliness has become the epidemic of our age. People now have many friends but cannot form secure, deep relationships. Even young people who cannot form secure bonds within their families try to establish this relationship with a therapist.”
Classical therapy approaches have given way to “positive psychotherapy”
Stating that classical therapy approaches have now given way to “positive psychotherapy,” Prof. Dr. Tarhan said, “If a person feels the need for change but doesn’t know how to do it, positive psychotherapy comes into play. In this approach, we focus on potential, not pathology. We bring out the person’s strong character traits and teach them to manage their weaknesses with these resources. This is a healing approach without causing further wounds.”
Emphasizing that developments in neuroscience have transformed psychotherapy, Prof. Dr. Tarhan said, “Areas related to happiness in the brain were found to be more active in positive-focused therapies. While negative-focused therapies trap a person in the past, positive-focused ones strengthen psychological immunity. This also provides more lasting results in coping with traumas.”
No therapy without trust
Noting that one of the most fundamental elements of therapy is the “therapeutic alliance,” Prof. Dr. Tarhan said, “The client will tell their therapist something they couldn’t tell anyone else. If the therapist reveals the names of past clients, trust will not be established. This is an issue of professional ethics. Trust, transparency, sincerity, and active listening are essential for a therapeutic alliance. A sincere therapist activates the mirror neurons in the brain of the person across from them. Therefore, emotional healing occurs much faster in every therapy where trust is formed.”
Prof. Dr. Tarhan also stated that “nonverbal communication,” meaning facial expressions, gestures, and body language, is as important as words in the therapy process, saying, “People communicate not only with words but also with emotions. Sometimes a glance, a facial expression, is more effective than a thousand words. That feeling of warmth solves half of the therapy.”
Every therapy is personalized
Prof. Dr. Tarhan stated that the therapy process should be personalized, saying, “We generally start with a goal of 10 sessions. First, we conduct personality tests and relationship assessment scales. We try to understand the person’s inner and outer world, and their unspoken thoughts, with projective tests. Then we decide which therapy method is appropriate. Just as a good mechanic has every tool in their bag, a therapist also has different tools. Sometimes cognitive behavioral therapy, sometimes neurofeedback, sometimes psychoanalysis is needed.”
Emphasizing the importance of teamwork between psychiatrists and psychologists, Prof. Dr. Tarhan said, “It is necessary to approach humans as a biopsychosocial and spiritual whole. If the biological infrastructure is impaired, psychological interventions alone will not be sufficient. Therefore, a therapy plan combined with medication provides the most ideal results. The goal of therapy is not just to see the wound, but to help the person rebuild themselves.”
“Therapists should hang their biases at the coat check”
Prof. Dr. Tarhan stated that therapists should shed their identity roles and appear only in the role of a “clinician” before the client, saying, “In therapy, there are things that can be shared and things that cannot. The therapist must respect the person’s privacy, disability, and sacred values. For example, someone might have a stutter; this is their disability. Or they might belong to a different subculture. The therapist should not make them feel this. They should hang their prejudices at the coat check. Outside, they might have the identity of a mother, father, spouse, business person, or even a political figure, but in therapy, they should only be present as a clinician. Someone who cannot adopt that role, who does not have a non-categorical way of thinking, cannot conduct therapy. Each case must be evaluated separately. You can see ten different cases in a day. You cannot focus on a new case without setting aside the previous one. That’s why taking written notes is very valuable. The client feels, ‘What I’m saying is important, my therapist is taking notes.’ When those notes are used in subsequent sessions, the trust relationship strengthens.”
Advice and therapy are not the same
Prof. Dr. Tarhan stated that the fundamental difference distinguishing therapy from advice is that it should be a “structured process,” saying, “Some people seek advice. However, therapy is not advice. Therapy is a structured process tailored to the individual’s needs. Goals are set, and a roadmap is drawn. The therapist measures the person’s condition with assessment scales at the beginning and observes the change with the same scales at the end of therapy. Subjective and objective data are compared. Thus, the concrete effect of therapy is monitored.”
If one cannot change the flow, one should change their perspective
Stating that the majority of clients attribute their problems to external factors, Prof. Dr. Tarhan continued:
“70-80% of those who come to therapy attribute the problem to external causes; to their spouse, society, economy… However, if a person cannot change the flow, they should change their perspective. Even if a person's psychological resources are strong, if they have cognitive distortions, they cannot utilize them. Gaining mental flexibility is an important goal of the therapy process. We call this ‘cognitive flexibility.’ That is, one should be able to see not only plan A but also plans B and C.”
Ego wars harm relationships
Emphasizing that a frequently observed situation in family and couple therapies is “waiting for the other party to change,” Prof. Dr. Tarhan said, “In close relationships, parties usually try to change each other. However, one should ask, ‘What is right for the future of our relationship?’ Most people say, ‘If my spouse improves, I will improve too.’ When both sides think this way, ego wars begin. Change must start with oneself. Therapy also begins by fostering this awareness.”
Stating that the desire for change is the most important condition for starting therapy, Prof. Dr. Tarhan said, “If a person constantly talks about their spouse, boss, or environment but never about themselves, it means they do not want change. Therefore, the first goal in therapy is to create motivation for change. Even agreeing to go to a therapist means 50% improvement. Because this is an indicator of maturity.”
Therapy aims for change, not relief
Prof. Dr. Tarhan underlined the goal of “change” instead of “relief” in the therapy process, saying, “Some people say, ‘I came out of therapy, I felt so relieved.’ However, the purpose of therapy is not relief, but change. Therapy is like a ladder; a person should take one step up in each session. Goals should be set, a connection should be established, and assignments should be given to the person. This is one of the building blocks of the therapeutic process.”
Prof. Dr. Tarhan also touched upon the emotional dimension of the therapeutic relationship, saying, “Some people see the therapist as an attachment object; they place them in the role of their mother, spouse, or a missing role in their life. We call this ‘transference.’ In such a situation, the therapist must protect their professional boundaries and, if necessary, refer the client to another specialist. Otherwise, the therapy will be disrupted.”
Prof. Dr. Tarhan also touched upon power struggles in family relationships, saying, “Some people are truly ‘sick-making’ individuals. But if a person doesn't allow it, no one can make them sick. Individuals with a high sense of control and lack of empathy try to enslave the other party. This is not sustainable. In the early stages of marriage, acquiring the skill to say ‘no’ is very important. Being able to say, ‘I’m doing this for you, but it’s not right,’ keeps relationships balanced.”
Emphasizing that the ultimate goal of therapy is for a person to be able to look at themselves impartially, Prof. Dr. Tarhan said, “If a person cannot be impartial about the problem they are experiencing, they cannot produce a solution. A person who always sees themselves as right cannot see their own blind spot. In therapy, both the client and the therapist must be independent of their own prejudices. Real change is only possible with this awareness.”
Taking 10 sessions of therapy is an investment in oneself
Stating that going to therapy should not be seen as a “luxury” but as a medium-to long-term investment in one’s mental health, Prof. Dr. Tarhan said, “Of course, it seems like a luxury, but when a person considers what they might lose in such situations, taking ten sessions of therapy is actually a medium-to long-term investment. This prevents them from making many mistakes, being alone, or falling into depression in the future. It is possible to see every event not as a trauma, but as a developing experience. We should be able to see both the positive and negative aspects of life, but we must set our focus towards the positive.”
Emphasizing that it is “extremely human and beneficial to seek help from an expert” when a person cannot achieve this on their own, Prof. Dr. Tarhan said, “If you encounter an obstacle on your life path and you cannot overcome it, you seek advice. An expert who has seen hundreds of patients on this subject can say, ‘Look at it from this perspective, if you do this, it will get better.’ In the past, people received this guidance from wise individuals; now, professionally trained therapists do this.”
Prof. Dr. Tarhan also touched upon the importance of cultural adaptation in the therapy process, saying, “Even within therapy training, this is emphasized: one needs to know the person’s culture, identity, and values. A client cannot benefit from a therapist who does not understand their values. A person working with a therapist appropriate for their culture makes faster progress.”
Artificial intelligence will shorten the duration of therapy but cannot replace it
Evaluating the role of artificial intelligence in the therapy process, Prof. Dr. Tarhan concluded by saying, “Artificial intelligence can be utilized. Before going to a therapist, a person can ask questions to AI, weigh their thoughts. This can reduce the number of sessions. Perhaps therapy that would take ten sessions can be completed in six sessions. But artificial intelligence is not a conscious being. If you put it in place of a therapist, it will manage you, guide you like a child. Therefore, the information obtained should be evaluated together with a therapist.”