What to expect from therapy

There are many different types of therapies, and of course many different types of therapists. There are plenty of ‘fly on the wall’ therapy shows now, but who knows if that TV therapist is anything like the ‘real thing’? All I can do is tell you what to expect in therapy with me.

First and foremost, therapy involves a relationship. The relationship between client and therapist is the core process that helps change along. You must feel good with your therapist. You need to feel heard, respected and understood. It can take time to build the relationship – some say the first 4 sessions are mostly about building basic trust and understanding. You are likely to know quickly if you don’t feel right with someone. It helps to call a few therapists and get a sense of who feels right for you.

My type of therapy is constructivist and integrative. Constructivists believe that, in a sense, we create our own worlds. Our life experiences are like mini-experiments from which we draw lessons about ourselves, other people and our world. We create a mental model and we update it as we discover new things. Or sometimes we don’t update it – sometimes we get stuck. Sometimes we can’t let go of something in the past, sometimes we feel the present or the future is too uncertain or worrying. We can get trapped in our own thoughts, feelings and habitual behaviours, and it can be hard to see the way forward – and that’s when it’s a good idea to see a therapist.

At the first session, we’ll spend time exploring what it is that’s brought you to therapy, what it is you’d like to be different, what particular ideas you have about how therapy should go. It’s important to get a bit of background, some history and health information. Everything you say in therapy is strictly confidential. Of course, it takes time to develop trust and you’re not expected to open up and pour everything out at the first session – unless you want to!

It’s important that you know that you can bring whatever you want to therapy. I don’t have an agenda, a programme to work through, a set of exercises to shape you up. Most problems cannot be solved in such a simple way – if they could, people would figure it out for themselves. You talk about whatever is on your mind – however big or small the issue it. It’s surprising how something that seems trivial often holds the seeds of an issue that cuts deeper. But don’t worry, you don’t have to expose your deepest thoughts and worries – or at least not until and unless you feel enough trust in the relationship to do that.

Part of the essence of therapy is that opening yourself up to another person, feeling enough trust to really examine things that perhaps you try not to think about or look at straight on, that process helps you to grow. You feel accepted, secure, stronger for bringing everything out into the light. You learn new ways of being in a relationship with another person, and that gives you a different idea of yourself.

It’s not a magic fix. Sometimes you’ll make a connection, even a profound insight, and it can be quite disorientating, but it’s not as if it changes you overnight. Change is incremental. Change also involves taking away those new insights, working to strengthen that new sense of self, and applying it outside the therapy room. The real change happens in the real world. And therapy can be quite hard work. You have to be willing to challenge yourself, upend some assumptions, see things anew. And that can be quite unsettling. But if you’re committed, you’ll develop those inner and outer resources that will allow you to achieve real change.

Good therapy is forward focused, because it’s going out into a better future that you care about. But it’s likely that there will be some focus on the past. It took years to create the person you are, and those years mattered. There might be patterns that repeat, and the chances are those patterns mean something to you – you might not quite know how you end up with this same issue or dilemma repeatedly, but there will be something underlying it that you haven’t seen yet. Deeper issues generally need a longer period of therapy, but it’s also possible to set shorter term goals and focus on a specific issue you want to tackle.

It’s very important to set goals so everyone is on the same page. I won’t tell you what to do, so if you want a more directive therapist, that is probably a different type of therapy that you are seeking. That doesn’t mean that I won’t share some of my thoughts, feelings and reactions – it’s a relationship, so I will do that. And I will have ideas that I’ll put to you, and suggestions for things that you can try or that we can try together to explore and process thoughts and feelings.

In the end, it’s all about you. The therapy is shaped for you. Every person is unique and each therapeutic relationship is a brand new journey. Are you ready to begin the journey?