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Writer's picturelilyllewellyn

How does therapy work?

Updated: Jul 24, 2023

You may have doubts about the legitimacy and efficiency of psychotherapy since there isn't an agenda or time scale. These are such valid and important concerns since you don't want to feel as though you're wasting time or money, not achieving anything or are sharing with a person who isn't qualified. Here's what to expect from therapy and how it works...


In the beginning...


you ought to be invited to ask plenty of questions about the therapist's approach. NOT THE OTHER WAY ROUND. The counsellor absolutely shouldn't be rushing in or asking you many direct or personal questions. Instead, they should be listening closely and trying to figure out what is the best way of doing therapy with you!


I shudder when I recall one of my past therapists say to me as soon as I walked through the door, "This is a safe space. So go ahead and tell me why you're here". While this is well intended, it reads, "You ought to know that I'm trustworthy. There's no need to feel vulnerable. Don't waste time. Now, tell me your deepest fears and secrets".


Horrible.


In the first session, I (as a counsellor) better know my clients have just met me. I'm a brand new person and a stranger. Of course, they can't be expected to trust me.


I should constantly be working hard to demonstrate to you that I can be trusted and will go at your pace. If you feel uncomfortable about a pressure from your therapist to share too soon, this may be a red flag that needs to be addressed with the therapist (as scary as this can seem).


Throughout your time in therapy, though particularly at the start, you can make clear what has motivated you to reach out for therapy and what you'd like to achieve. This helps to create a metric for whether therapy is going well. Having said that, don't feel pressured to have super clear goals - you may not have chosen to be in therapy and are simply along because you've been referred or were given an ultimatum. You may not be clear how you're feeling and just want to feel better - all valid and useful starting points.


In my experience of first sessions, some people choose to share and off load heaps about themselves and others say very little. Again, there is no right or wrong so don't feel a pressure to jump right off the deep end. That seems pretty scary considering the therapist is a stranger. Just expect to say a little about yourself and how you've been so that both you and your therapist have a greater understanding of yourself and circumstance. Slow and gentle.


As therapy progresses...


you and your therapist will work hard to find meaning in your experience. This involves tentatively exploring your life and relationships to learn how they are simultaneously independent and connected all at once. The aim is to get a better understanding of what is underlying and at the heart of whatever is it that has brought you to therapy and to remove obstacles that are affecting yourself and quality of life.


There is a lovely quote by Irvin Yalom, who talks about the psychoanalyst Karen Horney, in his book The Gift of Therapy. He writes, "If obstacles are removed, Horney believed, the individual will develop into a mature, fully realised adult, just as an oak tree will develop into an oak tree". This is the goal at the heart of therapy.


Together you and your therapist are checking to see if you feel a part of your life is an obstacle or not. If it is, you may explore how to lift it out of your way.


As therapy continues, you and your therapist will frequently"check-in" with each other to step back and oversee how therapy and the therapeutic relationship are progressing. This is an opportunity to evaluate how you are working together, the goals set and any expectations which may or may not be met. It's important that you speak out if you are not satisfied with the work being done.


You should be free to end sessions...


whenever you like without questions asked, and therapists generally allow you to come back for one-off sessions too. The last session may be prepared and discussed at length or it might come suddenly due to unexpected circumstances. However, the therapeutic process ends when you feel secure and accepting of yourself, more able to face challenges and fulfil your potential.


Ultimately...


Therapy is a joint effort on the part of you and your therapist. The strength of that joint effort (the bond and how you can communicate) is what determines a good therapy experience. A good therapy experience is whatever you, as the client, want it to be! It's an active process that looks and behaves differently for everyone!



(Take a look at page 1 of Irvin Yalom's book "The Gift of Therapy," which was first written in 2002, for more information about the journey our little acorn above took to becoming an oak).


Written by Lily Llewellyn

June 16th 2023



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