If I say the word 'psychotherapy' do you know what that means? People have called it 'the talking cure', but does that tell you what it is? It's a compound word coming from two Greek words: psyche and therapeuo.

Psyche means 'soul' and therapeuo refers to 'healing', so if you put those words together the compound must mean something that heals the soul. Now do you know what psychotherapy is?

If you were a bug on the wall in a therapy session, what might you see? You'd see two people sitting in a room talking. You might see one of the people crying, fidgeting, talking rapidly, or you might see two people sitting in relative quiet, but the tension in the room would be stifling. You might see three people in the room, or you might see a whole group of about eight or nine. You might see a family in the room talking with the therapist, and you could tell which one was the therapist because he or she would be acting like a policeman directing traffic.

Psychotherapy is not a legal matter, even though it often has legal implications or is focused on someone's legal process. Psychotherapy is not just a conversation; it's a dialogue. Psychotherapy is not a medical procedure, so there is no linear process of cause-and-effect involved in the cure. Psychotherapy is not social work, so the emphasis is not on the procurement of community resources, even though it may result in the client becoming more proactive and researching for him or herself these same resources. Psychotherapy is not a game in which two people waste one another's time and energy; it is not a farce or a futile process, and that brings us to some observations made and refined over the years about assessing research outcomes on psychotherapy.

All major approaches to psychotherapy have some things in common things that contribute to the effectiveness of psychotherapy in one way or another. These things also help define psychotherapy. Thus, whether a psychotherapist follows a cognitive behavioural approach, a psychodynamic perspective, an interpersonal approach, transactional analysis, rational emotive behavioural therapy, reality therapy, a Jungian approach, or gestalt therapy the therapist will engage the client and some common factors will influence the outcome.

Writing for the 'Handbook for Theory, Research, and Practice in Gestalt Therapy', I once described these common factors inherent to all approaches to doing psychotherapy, relating them to gestalt therapy as follows:

An experienced gestalt therapist would immediately recognise these features as belonging to gestalt therapy theory and practice.

• Client and extra-therapeutic factors: This is the field all things affect and so this is the view of the field most associated with the client's life space. This is what the client brings to therapy that bears on the process of therapy and the issues to be visited during that process. This includes the client's cognitive-intellectual capacities. It includes those elements of culture, history, financial resources, and legal impact that affect the course of therapy.

• Therapist qualities: This relates to the presence of the therapist as an authentic person, the capacity of the therapist for contact, and his or her training and experience. It includes the life space of the therapist.

• Relationship: This concerns the relational qualities of the working alliance, and it relates directly to the gestalt therapy concepts inherent to dialogue-presence, inclusion, commitment to dialogue, and the creating of conditions permissive and conducive to dialogue.

• Specific Method: Certainly, this encompasses the aspects of theory referred to above, but more specifically this also relates to gestalt therapy's reliance on a phenomenological method and experiment, for gestalt therapy is decidedly phenomenological and experiential.

• Expectancy: This relates to faith in the paradoxical theory of change; it is a faith position more generally as well in that gestalt therapists trust that what is necessary will be supplied by the field.

The most salient feature of psychotherapy is those extra-therapeutic events and facts that the client brings to therapy. It accounts for about 40 percent of positive outcomes, so what is it more specifically?

Here in Bermuda, the extra-therapeutic factors affecting psychotherapy are the economy resulting in a slowdown of construction, the dwindling workforce as major companies let some of their workers go, and the trickle-down effect of fewer people requiring accommodations. It is the tension between guest workers and Bermudians. It is race. It is the systemic dysfunction that grows within some organisations like that stubborn mould that keeps coming back no matter what you do.

This is not an exhaustive list, but it will suffice. It illustrates strongly that psychotherapy is a matter of what is relevant in the current moment. At times it might be necessary to revisit one's childhood, but the current context is a more salient ingredient in psychotherapy; so, psychotherapy is some kind of process, verbal and/or experiential, that in some way addresses the current experience of the client, the person who comes for help.

And, last for this look at what psychotherapy is, psychotherapy is an agreement between two people that one is seeking help and will pay for it, and the other has wisdom, training, and experience to offer in facilitating the other person's quest for answers, solutions, skill building, insight, and/or awareness. Thus, there is a contract that forms in which the provider gives informed consent about what he or she has to offer, the limits of that, and the conditions under which the process of psychotherapy will be conducted.

All these things are involved in 'the talking cure', no matter how much or how little actual talking actually takes place.