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What to Expect in Psychotherapy

6 Must-Knows Before Starting Talk-Therapy

There are many forms of talk therapy, each with the same goal of reducing symptoms and develop well-being. Before you start your journey of self-awareness, there are some fundamentals you need to know.

1. Psychotherapy cannot be successful unless you want to be there. Though I believe everyone can benefit from psychotherapy, you can’t heal if you don’t come on your own accord. First and foremost, it’s essential that you not feel trapped into making an appointment. Out of concern and love, parents sometimes force children and teens into therapy before they are ready. The same goes for adults when partners, friends, or relatives pressure them to get into treatment. If you feel coerced into going to therapy, express your discomfort to the therapist. Often, I detect when this has happened and rework the session to give the decision-making power back to the patient. There are other times that I’m not so attuned and miss the clues. Therapists are nurturers and helpers but not mind readers, so don’t hold in your reluctance.

2. Psychotherapy will not fix you. YOU will fix you. The job of a psychotherapist is to help you help yourself. Think of the Chinese proverb, “Give a man a fish; you feed him for a day. Teach a man to fish; you feed him for a lifetime.” Advice-giving creates dependency, whereas helping you discover your patterns that keep you stuck or undermine your well-being creates self-awareness. The goal of psychotherapy is to empower you with ways to deal with life issues, learn the triggers for your depression, and build resiliency, so you can find well-being.

3. Psychotherapy does not always make you feel better. Making a breakthrough in therapy is always exciting and meaningful. However, achieving awareness sometimes requires you to be brave and fearless. Recalling memories and experiences, or changing a behavioral style, can be trying, upsetting—even overwhelming. Being in therapy will reduce your symptoms and help you feel better, but it’s beneficial to know that the journey can sometimes be bumpy. So, for psychotherapy to be a successful, you have to crave change, possess a curiosity of your inner world and an interest in understanding what motivates you, and tolerate a moderate degree of frustration. This is where the myth that only crazy people—or weak-minded individuals—go to therapy gets the boot. Talk therapy is a valiant undertaking. And anyone who says otherwise is foolishly misinformed.

4. Psychotherapy will not work if you have unrealistic expectations. Setting realistic goals can make psychotherapy a winning experience. Change does not happen overnight. Nor does the development of insight. Hardest of all is replacing old behaviors with new ones. It takes time. I remember feeling frustrated that I couldn’t resume my college studies faster when I first entered treatment. My suicidal thinking was reduced and my despair lifted in just a few sessions. Why did I have to wait until next semester to get back to classes? I didn’t want to graduate a semester late, and I seemed more concerned about the passage of time than the healing that needed to be done. Talking with my therapist helped me realized that I was being unrealistic—and that I needed time to recover from my depressive episode. Once I realized that I had other hurdles to cross, talk therapy took on a deeper meaning to me. When it comes to your depression, make sure you and your therapist center therapy with sensible and realistic objectives, specific to your needs. As time progresses, you can review these targeted goals and redefine them if necessary. Remember, yard by yard is hard, inch by inch a cinch.

5. Psychotherapy is not like talking to a friend. Therapy is the forming of an alliance to bring about change in your life. This is done with a therapist who is caring, empathic, and skilled in the symptoms and/or illness you experience. Psychotherapists train many years in the art of listening and, unlike a friend or family member, listen not only with the intent to just understand but also with the goal to identify and analyze. Being an active listener enables a therapist to use theory and techniques to stir your observations as treatment proceeds. I often hear people say, “Therapy is a big rip off,” or, “You’re paying for someone to listen to you.” Well, it is true that you’re paying for someone to listen, but a psychotherapist’s skills go beyond that of ordinary listening. When you’re in therapy, you’re working with an Olympic medal listener. That, combined with your therapist’s clinical objectivity, enables you to get a balanced, unbiased frame of reference in treatment. Something friendship often blurs.

6. Psychotherapy requires you to be comfortable with your therapist. There’s a lot of chemistry in talk therapy. The kind in which you and your therapist click, and you find a sense of ease. Without this connection, it may be difficult to feel comfortable talking about difficult issues and to feel safe letting go of fears or trying out new behaviors. The importance of your therapist’s training should be equally matched with the level of comfort you feel in sessions. Once you’ve done your research on finding a therapist, let your phone call be the first litmus test for this chemistry connection. Many times, you can get a sense of how a therapist conducts him- or herself with this initial phone contact. Thereafter, let your gut instincts take over at the consultation. If you don’t feel comfortable, it’s perfectly fine to seek out another professional. I’ve done this when I sought out treatment as a patient—and as a therapist, I encourage second opinions if the match isn’t there. Finding a “good fit” in therapy is more important than in any other kind of professional relationship you’ll have in your life.

More from Deborah Serani Psy.D.
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