In Therapy

Ryan, First I want to say thanks for the great blog, I've been reading all your entries and I'm really enjoying hearing things from the other side. I've found alot of it to be very affirming both for how I behave as a patient and for what a great job my therapist does. I really liked this post because I realized that aside from a "how are you?" on my way to sit down, we usually don't chitchat at all. But at the end of the appointment when we both get up, my therapist heads to his desk and calendar to schedule our next appointment and that's when we chat. Provides a good transition back to the "real" world. And I really agree with your advice to get there early. My therapist schedules on the 1/2 hour but usually gets me from the waiting room at 20 of the hour. I try to get there on time so I have ten minutes to chill out and get ready for the session. I find its very effective. Thanks again, I look forward to reading more.

Ryan: Personally, I find small talk is a powerful tool for creating a context for conversation and information gathering. My style of therapy is conversational, rather than interogative or benign, so I suspect this is, ultimately, a stylistic idiosyncracy. I'm often amused when my patients ask me, "Is this therapy?", then come back later with, "I don't know what you're doing, but it's working!" I think it also depends on the quality and direction of the small talk. Being curious about the dog with the bad leg, or the progress on the repair of the car's transmission, when school lets out, or suggesting a homeopathic solution for those chronic sinus infections I find, again personally, sets people at ease and provides them with a sense of deeper connection. It also often gives me a broader picture of who they are. That said, the "How about this heat?" and "Did you see the game last night." never enters into it. So, I guess that's not really small talk, is it? :) Blessings, Michael

Well not really, but I believe I probably
have done every single chit-chat theory.

Usually, the chit-chat is a reminder for me,
I am seen as a person and not a little problem
walking into their office for an hour.
My dr and therapist are getting too smart for
their own britches though, ha ha
they see the purpose. Thats all that matters to
me, they see.

I've been with my current therapist for five years, and with the one before than for eleven. (We moved out of state so I had to change doctors.) After all that time together you get to know each other a little bit outside of the problem arenia. My doctor provides "clues" for the chit-chat. He has some beautiful, bountiful plants hanging in front of the window and he always buys flowers each week. He also wears some very colorful ties. I find it much easier to come in and say "What a nice tie you have on today," rather than "I don't understand why I can't just walk away from that so-and-so!" I think the chit-chat is social correctness and it is how I pay respect to my doctor and treat him like he is a social being - not "just" my psychiatrist!

That's what my therapist does and I do It's like we are having coffee together. I've been seeing her for six years and I don't know if it's what therapy is supose to be like. We never go into any deep discussions about anything. Like I said it's like a coffee date. Just chit chat about stuff since last time I say her nothing deep. How my kids are doing, how my mom is doing,stuff like that. Is that therapy?

Thanks for writing, Nicki. If you're concerned your therapy isn't going as deep as you'd like, I'd suggest raising the issue with your therapist. Perhaps the two of you can find a way to make the time more meaningful for you both. Take a look at a later post of mine titled "Say Anything" for pointers. Thanks again.

i sit down, smile, say a little line about the weather sometimes. but, come in with usually three key things i want to address. i gather this within the drive to therapy (no radio) and sitting in the waiting room...i get there early.

usually a revelation from the last session (tomorrow, it will be 'i think only my naughty id came to session last time, and i am embarrassed by what she had to say')...and then (i did have the conversation with my husband, and this is how it played out) and then (i guess i am learning it is ok to HAVE fantasies, no matter how illicit, and not feel shame or guilt, but it is the acting out of the fantasies that is the dividing line into what i should feel guilty about...no one can stop their mind from a fantasy.)

so, i guess i've lined my session out right here.

but, i try to carry the ball from session to session. fyi i am in pd pt.

psychodynamic psychotherapy with a psychoanalyst/psychiatrist