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Transference

How to Get the Most Out of Therapy

Optimize your therapeutic gains with these simple strategies.

I've noticed that many of my new clients—whether they've been in therapy in the past or not—don't know exactly what they want to get out of therapy or how to get it. We therapists don't do a great job of explaining how to be an effective therapy patient, so here is some of my advice.

1. Shop around.

The therapist match is essential to the success of treatment. Interview several therapists, try sessions with the ones you like, and pick your favorite.

Some questions you may want to ask are:

  • What populations do you work well with?
  • What treatment models do you use?
  • Do you have a set way of doing therapy or does it change based on the client?

As a therapist, I can tell you that I don't take it personally if someone wants to interview me before starting treatment. Even the best therapists will not match with everyone. Bad matches lead to patients who think "therapy doesn't work for me," which is tragic.

2. Be intentional.

This is your therapy. You're outsourcing the skillset to an expert, but it is up to you to decide what you want from this process. You are with yourself for the rest of your life, your therapist isn't. The emotional labor is yours, as are the results. You will carry it with you across therapists and across your lifetime.

3. Be honest.

Therapists aren't here to judge you. Don't rob yourself of getting what you need because you're worried your therapist will judge you. It is literally our job to empathize. We have heard more stories and perspectives than you can imagine.

4. Be aware of transference.

Transference is the effect of all of our outside experiences on our perception of another person. Both the client and therapist will make assumptions about the other based on previous life experiences.

For example, say your therapist looks like your brother, or talks like your friend, or reminds you of someone or something that you can't quite put your finger on. This is transference. It can happen overtly like this, but it also happens on various levels with everyone you meet.

The feeling can have a very strong effect, evidenced by an example Pat Ogden gave in her book Trauma and the Body, when a client suddenly felt unsafe with her therapist in a session after months of successful work and had no idea why. By the end of the session, they had discovered that the therapist was wearing the same sweater as someone who sexually assaulted her in the past. This sweater shaped the client's experience of her therapist though they were nothing like the abuser from the client's past.

Therapists are trained to be aware of transference so as to avoid impact on the work (the therapist and client were able to unravel the trigger of the sweater once they had identified it). If you feel something getting in the way or feeling stuck, talk to your therapist about it. The cure for problematic transference is awareness.

5. Take notes in a therapeutic journal.

Actively write down the insights, questions, and themes of your therapy in a journal. You can use this journal to write when you're feeling strong or confusing emotions between sessions. Most people get the greatest benefit from a paper journal. Though a digital journal may be easier to organize and access, typing typically doesn't have the same therapeutic effect as writing.

Journaling will help you organize your thoughts, vent excess emotion, and increase calm. It will also reduce the need for therapy sessions, saving you money. The healthiest, happiest, and most insightful people are self-aware and actively growing. Keep a record of your growth and make sure it's going the way you want.

6. Don't keep therapy in the session.

There's a lot of time between sessions. If you're saving all of your emotional growth for 45 minutes per week, it is going to take a long time. Take time before your sessions to prepare your agenda for the session, and take time after to process the results of the session.

I like to assign between-session "homework" for my clients, but even if you don't get homework from your therapist, you should be using the time between sessions to consider what was discovered in-session, jotting down questions or insights, and journaling about your feelings. Bring this to session and it will supercharge your progress.

7. Print and staple this article into your new therapy journal.

Your journey starts (or continues) here. This article may be a good reminder of how to get the most out of therapy, so take it! Make sure you're maximizing your time, money, and emotional labor by implementing these tips.

To find a therapist, visit the Psychology Today Therapy Directory.

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