What is Therapy?

If you’ve never been to therapy before, you may have a lot of questions about it. What you have seen on television or in the movies isn’t really what therapy looks like. It usually is a misrepresented idea of what therapy is, and has made many people a little uneasy about participating in therapy. There is nothing mysterious or magical about therapy. People come to therapy because something in their lives isn’t working; they are unhappy about what is going on and are looking for help from someone who may be able to offer them support. Therapists don’t have magic cures to life problems. Therapists are taught skills that have been helpful in dealing with some issues that arise in life. This is their area of expertise.

The types of problems people come to therapy for can include:

  • relationship difficulties
  • depression or anxiety
  • specific fears or phobias
  • problems with drugs, alcohol and addictions
  • problems with work and school
  • coping with significant losses & changes in one’s life
  • adult survivors of childhood abuse issues
  • help dealing with traumatic issues
  • grieving
  • parenting issues
  • sexual problems
  • any reason a person feels dissatisfied with life

What the Heck is Psychotherapy?

You’ve seen the movies…. You go see a therapist, you lay on a couch, you ramble on and on about your life’s difficulties. The therapist sits there listening to you, taking notes, asking you questions, and mysteriously encourages you to “look deeper.” Many times the therapist comes up with some advice that you never would have thought of on your own, or so it seems, and miracle of all miracles, you are cured! Thanks Doc! The therapy pill – where life difficulties and problems are solved in a few short sessions (or just one) because a good therapist is someone who can give you great advice and send you on your way…. Then later they show you the picture of your therapist’s life and if you ever really knew the truth about your therapist’s life, you wouldn’t ever go see another therapist as long as you lived!

Sorry folks, this isn’t therapy… its Hollywood. You are not going to go see a therapist and get the miracle answers to your major life issues. You may walk away with a different view of things after an initial session, but you won’t be miraculously cured. Therapy isn’t a cure. Therapy isn’t like going to the doctor for a quick fix. You are not going to get some great advice or be prescribed a magic pill that makes you feel all better. It just doesn’t work like that. It is a place where you can examine things in your life more fully, and through this process, gain more control over problems that exist currently in your life, or that will come up in the future. Ultimately the hope is that therapy will impact your life in such a way that is meaningful to you – which is the “cure” of psychotherapy.

Therapy is called the “Talking Cure;” a name I find a bit misleading. It is a process of self-discovery, self-exploration, self-challenge and personal growth. And I would have to say that a lot of therapy isn’t about talking, its about feeling, thinking, and doing — trying new things out, learning new ways of living and making different choices. You work with a therapist to learn new skills and ways of being, then apply them to your life. You may come to a therapist because you are having trouble in your life, maybe something just doesn’t seem right, or maybe things are really out of control. Either way, it is a therapist’s job to work with you to explore and learn more about what is happening that makes you uncomfortable today, help you to solve your own problems, and learn to grow as an individual, couple or family. What you can expect from therapy is personal growth and improvement in areas of life that are unsatisfying to you.

Now Wait Just One Minute… You Might be Saying to Yourself… Personal Growth? I am SUFFERING and you are talking TO ME about Personal Growth – GET REAL!

Now I know if you are really suffering right now, the idea of “personal growth” sounds trite to some of you, especially if you are in a major life crisis right now. It may sound downright insensitive and turn you right off to the idea of therapy. So for you folks, know that personal growth is the end result. The growing process is what is so painful. During therapy you will grow. You will learn new ways of looking at things. You will learn new ways of thinking about things. You will learn how you typically look at the world, why that is and alternative ways of viewing things. You will learn how to cope with life difficulties more effectively. You will learn ways of responding and acting that work better for you, or how not to allow other people’s viewpoints undermine your views. These are all things that will happen after being in therapy for awhile, but that isn’t what will happen when you first walk into see the therapist. When you first walk into the session, we expect that you want relief from what is most troubling you. A good therapist is going to address this first. You want to feel some sense of relief after you walk out of the first meeting, even though the problems are not gone or resolved, you want to have some sense of hope. This is what your first session will hopefully leave you feeling – a renewed sense of hope. You may even feel a sense of hope after you made the first call to the therapist. It may be just that first step of making the call that provides you with that sense of hope. But know this…

We all enter therapy through the door on the left…

It looks a little scary doesn’t it?

That is normal. When you first consider going to see a therapist, even if you have been in therapy many times before, it is always scary to go back into the “Gold Mine.” Even though you know there are good things in the mine, it is a scary place to walk into. You will be exploring you, and that isn’t an easy thing to do. Anxiety and reluctance to enter into therapy is normal. It doesn’t mean you shouldn’t go. Just know that the first step of asking for help is one of the hardest things to do. You will be talking with a person you may not know well about very personal things. People often confide things to their therapists that they may not confide in any other people, or at least a very select few. Being a little anxious about doing this is a good thing. It is healthy. But it doesn’t mean you shouldn’t do it. It means you should be cautious with a new, or even with a previous therapist, to be sure he/she is the right person for you to be seeing at this time in your life before you dive in. Get to know your therapist a little, be sure you are comfortable with him or her. But most importantly, trust yourself. If something feels wrong, maybe it is. Refer to the discussion below for red flags to watch out for so that if you feel like something isn’t right, you can check it out.

On the other hand, therapy is a tough thing to do. A therapist asks you to explore very personal aspects of yourself, that are often painful. We are known for encouraging our clients to “sit with their feelings” – this is a basic therapeutic strategy used to help clients learn more about themselves by learning to listen to themselves more. Sitting in sadness, anger, anxiety, fear, or despair isn’t a fun thing to do. After doing this in therapy, it is common for a client to feel vulnerable and want some distance from the therapist. This is natural and self-protective. It is a healthy and natural response to experiencing pain. This doesn’t mean it is time to leave therapy; in fact, just the opposite. It means you are doing some of the major work of therapy and are in the middle stage of your treatment.

Therapy is a business relationship. This is something that is very important to keep in mind. When you see a therapist, you are paying the therapist to play a certain role in your life. Your therapist is not your friend, your lover, your partner, your mother, your child, etc. Your therapist is a professional who is trained to listen to you, help you to examine your circumstances, your beliefs, your personal style, empathize with you and support you while you grow and change. The relationship is focused in one direction, from the therapist to you. It is not a mutual relationship like a friendship would be, although if a therapist doesn’t have caring feelings towards you he/she won’t be very effective in working with you. A therapeutic relationship is one where the therapist is there to support you. You are not the therapist’s therapist. If you find that therapy becomes more about the therapist than about you – that isn’t a good therapist for you, or for the therapist. A therapist may choose to share personal information with you, but all therapists are trained to be cautious about sharing personal information with clients, because of the nature of the therapeutic relationship. The focus of the relationship is one where the therapist is a support system for you. Therapists are not paid to be supported by you, they are there to offer support to you. If your therapist needs a therapist, he/she can pay for one too!

Even more importantly, sex isn’t a part of therapy, ever, not in any form. A therapist will typically have physical and emotional boundaries with you, and will be very careful about crossing over these boundaries because they are trying to maintain the professional role that they play in your life. Because therapy is such a private and personal relationship, in order to maintain the safety of the relationship, it is important to have professional boundaries between a client and a therapist. Typically a therapist won’t touch you in ways other than shaking your hand. This may vary between therapists and the type of therapy that one practices. For example, if a therapist specializes in doing holding therapy, there will be a lot of physical contact between you and your therapist. Some people find this very difficult, but it is a type of therapy that uses physical contact for emotional healing. Usually if a person is seeking out therapy from a therapist who uses this technique, hopefully the client is seeking out this specific type of therapy.

Personally, I find that if want to use touch with a client, it is best that I set the stage for it before doing it. I will ask his/her permission first, and I make sure that there is a relationship that is clearly established that is felt as safe and professional by my client before ever using any form of touch in therapy. For example, sometimes I will touch a teenager on the back, on his/her shoulder, as a gesture of comfort or encouragement. I am unique as a therapist this way as many therapists see this as a highly risky thing to do. I have found that for many teens, this gesture is welcomed and taken well if the relationship I have built with a particular client warrants this. But I always ask before I touch them, to ensure that it is comfortable. For many people, even this amount of touching is not comfortable, and with clients who are not comfortable with physical contact with a therapist, it is vital that this boundary be respected. Hugging is another example of a gray area with therapists. Most therapists don’t hug their clients. They see it as too personal and crossing over that professional line. Many therapists see value in hugging clients, as so many people have been “touch starved” or not experienced appropriate touch, so they see hugging as a form of good therapy. Again, hugging is an area where you as the client need to decide what you are comfortable with and what you are not. Many therapists won’t even use hugging anymore out of fear of being sued of falsely accused of inappropriate touching. Flirting, seduction, sexual behaviors and touching that could be interpreted as possibly seductive or innocent, are not appropriate. If there is any kind of physical contact between you and your therapist, it is best if it is initiated by you because it is something you want, and it is something that is discussed first so that there are not misunderstandings between you and your therapist. If your therapist initiates the touch, make sure that it is something that you are comfortable with and is warranted in your relationship. Know that touch is considered risky for therapists and is discouraged overall for client safety. Also, if something felt okay before but it no longer feels okay, tell this to your therapist. Whenever something doesn’t feel okay, for what ever reason, it isn’t, and a good therapist will talk about this with you and respect it. That is a part of learning in therapy.