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What to Expect in Psychotherapy

November 9, 2017 at 2:29 am · · Comments Off on What to Expect in Psychotherapy

What to Expect in Psychotherapy

Dr. K. P. Lanthier, C.Psych.

People attend psychotherapy to learn how to understand the thoughts, feelings and behaviors that repeatedly cause them problems. Psychotherapy is about learning to cope rather than an emphasis on a cure. Understanding your own feelings, conflicts and the way you react will increase self-esteem, self-confidence and control. How well you achieve these goals will be one measure of satisfaction with your psychotherapy.

There can be a degree of trial and error in psychotherapy when choosing the best clinical modality relevant to your psychological distress. Certain models of therapy are designed for certain problems. There is no guarantee that treatment will work. Psychotherapy can be discussed in terms of short-term (12-20 sessions), crisis management (2-3 sessions) or long-term (12-24) months or open-ended. If you are considering ending therapy, it is important to discuss this with your therapist. It is common courtesy, and a predetermined last session can be arranged, to facilitate a proper closure.

Sometimes, after attending three or four sessions, individuals question whether they should continue receiving help. You may consider dropping out during this period. It is imperative to discuss these concerns with your therapist.

Psychotherapy is designed to have you look at things you tend to avoid on a day to day basis. You may see yourself in many uncomfortable or surprising ways. Treatment can evoke anxiety, sadness and depression at times. This is not a sign that treatment is not working.   Therapy can be hard. Typically, you will set the theme for the session. However, in the initial couple of visits, your therapist will be more active in the treatment gathering historical data about your life and presenting issues. This is termed the assessment phase. Then there will be more listening than talking. You may interpret this as a lack of interest or understanding. To the contrary, your therapist will be with you the whole way. To some degree, the usual ‘give and take’ format of conversation is dispensed with in therapy sessions. It is more one sided than your other relationships. This is an important strategy that facilitates the therapeutic process. The relationship is protected by important modes of conduct and boundaries. This can stir up positive and negative feelings within an individual. Often the feelings are linked to past life experiences.

Typically, advice giving and personal opinions are not shared with the patient/client to promote understanding and self-determination of one’s own actions. Attention is drawn to possible patterns of behavior that contribute to one’s difficulty. Openness and honesty about one’s thoughts, feelings and beliefs are essential to assist your therapist in understanding possible recurring themes. Homework assignments might be apart of the treatment plan or processing session material is expected to continue beyond the therapy hour.

Expect to have a variety of reactions toward your therapist. You may have doubt, distrust, anger or even feel attracted to your therapist. These emotions are common, yet can be difficult and embarrassing. It is important to have an open discussion that will likely lead to greater self-understanding. Professional practitioners are trained to tolerate envy, dissatisfaction, aggression or admiration from their clients. It is usually viewed in the context of the past influencing the present dynamics of the current situation. Physical violence and property destruction are not tolerated during the therapy hour.

Sometimes people drop out of treatment for fear of dependency upon the therapist. It is natural to miss your therapist when they are not available. Therapy is a great opportunity to learn how to depend on someone while maintaining one’s own autonomy and independence. As treatment draws to a closure, discuss any underlying fears about ending the therapeutic relationship. You and your therapist can work out a plan to minimize the impact of the loss.

What to expect in psychotherapy? Time is required to build trust with your therapist. Time is needed to share one’s deepest thoughts and emotions. Time is needed to learn any new skill. Time is needed to practice that new skill in areas of sports, school, work, or interpersonal engagement. Psychotherapy can be time consuming, while emotional problems, mental illness or stress can be debilitating. Take that first step today. Get professional assistance for your emotional needs and wellness.  You may also find helpful reading