Why therapy?
People come along to therapy for many reasons – and I use the term to cover both counselling (generally understood to be focussed on various issues) and psychotherapy (exploring the mind and tends to be longer term). Many therapists would use these terms interchangeably, however. Usually people seek therapy because life isn’t working for them as well as it might. A succession of failed or abusive relationships, perhaps. An addiction or habit that’s hard to kick. Or overwhelming anxiety that won’t go away despite all rational thought telling them that there’s nothing to worry about. And many other presenting issues besides.
There are people who have therapy sessions because they are curious to find out more about themselves. This might seem like an odd thing to do for many. The stereotypical British culture doesn’t have a place for the therapist. People are expected to get over themselves, keep quiet about problems and not to be seen to be lazy. To go against that might feel shameful. To disclose about one’s family or one’s intimate relationships to a therapist would be embarrassing.
However, if you have read this far, you will have taken the first step of your journey to therapy!
The journey
Let’s now assume that you are at least a bit interested in how you might use therapy. Chances are, there is a debate going on in your mind. One set of voices telling you it’s what you want, that it would be a relief to be listened to, that it’s a chance to be honest about some things that you have never spoken about, that you don’t have to feel alone any more. Another set of voices tells you that your struggles are nothing, that you will be wasting the therapist’s time, that you could do better things with your money, that the therapist might turn out to create more harm than good and that finding the time will be hard anyway. These are your defence mechanisms coming in. They are there to protect you. Recognising this work of the “inner critic” is therapeutic in itself.
Therapy takes many forms. From the focused, outcome-oriented CBT, that’s favoured by the NHS and is shown to give good results for people with depression and anxiety disorders. To psychoanalysis, various spiritual-informed therapies and therapies involving specific modalities, like working with horses or art. What many therapeutic approaches agree on is that it’s the relationship between the client and the therapist that brings about transformation, possibly more so than the therapeutic approach being used, which is why it’s important that you find a therapist that’s a good fit for you.
The next stage, these days at least, tends to involve a lot of looking through bios on the internet, using search engines or directory sites such as Psychology Today and Counselling Directory. In my opinion this is probably the best way to find a therapist. It might be tempting to ask a friend, but the wonderful therapist who helped them through their darkest days is not necessarily going to be right for you. In fact, you may find the experience rather underwhelming. Take your time and consider how you feel when looking through the many options available. Who are you skipping over, and why? Who are you drawn to, and why? The ideal therapist might not be the person that looks like your kindly aunt.
The first session
Am I jumping ahead too quickly? Yes, and I confess that was deliberate. Because booking a first session can feel like committing to something you might wish you hadn’t done. But let’s assume you found someone who feels like a good fit, and it’s time to go along. It’s easy to feel anxious or tearful. Even though you know there is no need. The therapist normally expects you to be on time as they work to strict time boundaries (if they don’t then this can feel unsettling). If you are late, that’s not a problem, except that your session will be commensurately shorter. The therapist will likely go over the “contract”, which generally covers confidentiality and safety. This is a chance to say what you need too. After that, you can say whatever you want! There are no rights and wrongs. In fact therapists are often on alert for any “shoulds and oughts” in the narrative.
Therapy is not like medicine, with its diagnosis/treatment model. It’s an exploration where one human helps another through a genuine relationship. There is no predicting what might happen and how it will be dealt with. In many ways it mirrors the infant/parent relationship. Attentive, nurturing and vulnerable. Which is why a confidentiality contract is so important, as are firm boundaries.
The therapeutic relationship is a unique experience.
Adrian Tupper
adriantupper.co.uk