What even IS therapy??

Just a bunch of psychotherapy books …Photo by Ryan Gagnon on Unsplash

Today I’m thinking about what makes therapy …therapy…

Once you’ve decided to start your therapy journey, and you’ve gone about looking for the right therapist, it’s also the right time to start getting familiar with what therapy IS, and what it isn’t. Best to know what exactly it is that you are signing up for, right?

1. How does therapy differ from other relationships where I can share what I think and feel (aka, why am I paying you to listen to me)? 

• First off, therapists are professional listeners. Yeah we often have some fun techniques to try out and we are masters at (over)analyzing, but at the core of what we do is listening. This sort of listening is different from being on the hearing end of a conversation - it’s attending to everything, the said and the not said. It’s listening to the tone of your voice, intensity of how you say what you say, it’s watching your body language, your facial expressions, your mannerisms. It’s paying attention to our own nervous systems for cues as to what sort of energy you are bringing each session. And it’s listening without letting ourselves get in the way. Who else listens to you like that? 
  

• Second, therapy - at least a lot of therapy - is more than venting to an impartial witness who will simply nod and ask “And how did that make you feel?” Therapy should stir up feelings and help you make connections that you didn’t notice before and seems like something that impacts your life. Therapists help by sharing insights, pointing out ways you might get in your own way, and helping you feel less alone. Therapy should feel hard sometimes. There’s crying involved. There’s all those uncomfortable feelings and thoughts you usually try to avoid. It’s all that, and it’s also discovery - of who you can be, of what holds you back, of all the ways you might find joy in your life.
  

• Finally, as an added bonus, you get to talk about yourself and all the squirrely things that go through your mind without having to reciprocate, and no one will call you a narcissist. In fact, if you talk about other people too much, your therapist might jump in with “Ah, what’s happening here? How does this story relate to you?” How often do you get to do that?? And this feels way better than it sounds. Sometimes just saying things out loud without worrying about how the listener is going to take it can be liberating, it can help you feel seen in real ways - because you are being real - and can help you figure shit out just by talking it through. Magic.

2. What is the most important aspect of therapy? 

For most therapy, and most research concurs, the most important part of the entire situation is the relationship between you and your therapist. Why would you share your soul with someone who doesn’t get you, and why the hell would you listen to what they have to say? So the first aspect of therapy is finding a therapist who you click with. I wrote about the process and steps of finding a therapist here (blog 2); and after you find a therapist, you need to make sure you have a connection with them. I think this is exponentially more important when you are looking for trauma therapy specifically, because experiencing trauma often makes it harder to trust. And therapy is about developing a trusting relationship. 

3. What does a good working therapeutic relationship look like?

It means you feel comfortable talking to (obviously), who you feel accepts you, validates you, who asks some questions that get you to look at yourself, and who you truly feel gets you. You feel cared about and supported. Often that interaction alone starts to help you see yourself in a new way. At the same time, this isn’t a person who feels like a friend, and while you can ask questions of your therapist, the conversation should always be focused on you. It’s a dynamic that sort of feels like “this person knows all-the-everything about me..…and I know she likes dogs and hates capitalism.” Our codes of ethics dictate we maintain this distance, but it also helps us see you clearer so we can help you most effectively. 

4. All these therapists are listing all these different kinds of therapy!?!  How do I know what I am looking for? 

Great question. For starters, you want someone who specializes in the problems you are struggling with.. Therapy is not one-size-fits-all. I get the sense that many people looking for therapy assume that we can just treat all the things. I promise you - the brain is far too wily a place for all of us to be able to effectively treat all the things. All therapists don’t love working in the same ways, most of us have our favorite ways of working, and those ways are typically where we do our best work. You want us when we are doing our best work! Therapists have lots of options in the methods and treatment models we can be trained in, and those models impact how we define problems and how we work with those problems. Sometimes when therapists and clients don’t click, it’s a disconnect in the way the therapist works, and what the therapist specializes in, and what the client actually needs. This isn’t a bad thing, but it does mean not every therapist is for every person.

You can start by googling the different methods the therapist might list in their profile, and see if the description sounds like something you might like to try, or even makes sense to you. Maybe you want to work on how you think, or maybe you want someone to help you with solutions. Maybe you’ve tried something like that and are looking for something a little different, maybe a “bottoms up” approach. For example, I primarily use EMDR, which means we are looking for old origins to current problems, and connecting our bodies and brains to find new solutions. There is some talking, but also a lot of internal processing - letting your brain do the work it needs to do. You can also research “best treatment for….” whatever you are struggling with, and look for someone who offers that method.

5. How often do I need to do this, and for how long? 

I think good therapy - at least in the beginning, happens once a week. I know finances and schedules can make this weekly commitment difficult; but I would argue an investment of time and money early on will save you in the long run. I would argue that infrequent therapy is far more difficult for both clients and therapists. It’s harder to focus beyond the crisis of the week, which means it’s more difficult to get to the root of issues. I think it’s also harder to form a good working relationship when you see someone less frequently. That listening I talked about before - part of good listening is knowing you, and that takes time. Also, are you going to listen to someone you barely know and who doesn’t know the real you yet? No, of course not. All these obstacles could mean therapy takes longer, and in the long run costs more time and money. If you feel like it’s time for therapy, do it like it's the first hot day and the pool is still a little cold: just jump all the way in.