The Other Side Of The Couch: A Therapist Shares What REALLY Happens in Therapy

As a psychologist specializing in women’s health and wellness, the new year and the months that follow are some of my busiest months. Relationship worries. Body-image concerns. Parenting woes. Depression. Anxiety. Potential clients reach out, hoping to change or better understand pieces and aspects of themselves. Each conversation offers the opportunity for them to ask a range of normal questions that arise when one considers seeing a therapist.

There are many myths that surround therapy. Sadly, still somewhat stigmatized, it’s not often that those seeing a therapist openly talk about their experiences. To further complicate matters, sensationalized media images often portray therapy in a less-than-illuminating light making it seem as if boundaries are loose, advice is given and that therapy is a unidirectional relationship with the therapist asking unlimited questions about “how one feels.”

While therapists certainly do help clients explore their feelings, this is just one piece of the therapy puzzle. Far different from other medical services that offer and even promise relief relatively soon after having an appointment, therapy is a process. And by noticing and exploring this process, insight emerges, paving the way for “new” ways of perceiving things, an internal shift that happens over time.

Below, you’ll find answers to some common questions that emerge when one considers seeing a therapist. By sharing these, I hope to provide an honest, thoughtful and meaningful perspective about some of the most common questions that arise in the burgeoning client/therapist relationship:

1) How is therapy different from talking to a friend? This question is a common one, as well as an important one. Certainly, if one has never seen a therapist, it may be hard to envision how talking to a stranger will feel safer and more intimate than talking with a friend. The difference: a friendship is subjective and reciprocal. In a friendship, you share intimately with your friend, and in return, they also share. You learn personal information about each other and it is through this mutual sharing that intimacy is built. Therapy, while very intimate, is not reciprocal in this way. Except when clinically relevant, therapists rarely share intimate details about their own lives, but rather listen intently as a way to help clients understand what is taking place in theirs.

2) Who goes to therapy? There are some things I want to explore, but I am not clinically depressed, is therapy right for me? People see therapists for a wide variety of reasons. Certainly some are struggling with concerns, such as depression or anxiety while others may find themselves in stressful or difficult life situations. It’s not uncommon for people to seek out therapy during “normal” and what many may even label “happy” transitions of life. For example, I often see clients who are recently engaged, or expecting their first baby. Life transitions, even when positive, can be stressful. Therapy offers a supportive space to understand and explore these changes, as well as gain insight into any coping patterns that may be triggered during stressful times.

3) How do I choose a therapist? There are many different ways to choose a therapist. Online directories, such as Psychology Today and Good Therapy provide a database of therapists searchable by location, clinical orientation, degree/education, fee, and areas of specialization. Trusted friends and colleagues may also provide recommendations, as can medical doctors and nurse practitioners. Regardless of the many avenues used to find a therapist, the most important factor is finding the right match. There are many different kinds of therapists, as well as many different kinds of therapy. Typically speaking, behavioral therapists help clients focus on changing certain behaviors and may assign workbooks or homework to foster this process. Psychodynamic/analytic therapists tend to focus on the client/therapist relationship, viewing this as the vehicle, which helps facilitate insight and change.

4) How long does therapy last? The answer to this question varies as each person’s needs differ. For some, longer-term support/therapy may be warranted if a long-standing mental health concern is present. For others, a shorter or briefer course of treatment may be fine, especially if the concern is related to a situational stressor. Discussing your treatment plan during the initial session often helps clarify what may be right for you. And, it’s okay not to know how long therapy will last, but to let the process evolve, and over time, in the therapeutic relationship address and ask questions as they emerge.

Recently, I read Brene Brown’s new book, ‘Daring Greatly’. I think her book beautifully summarizes the main reason people seek out therapy. In over ten years of seeing clients, I can honestly say that regardless of the concerns that bring one to therapy, most people want the same thing. They want to learn how to live authentically. They want to embody better awareness, and through this, spark new inspiration and insight into how they are leading and living their lives. And I can wholeheartedly say that day in and day out, witnessing this courageous and loving act towards the self is why I do what I do.

As a dear colleague shared with me, “Our stories are our living relatives.” We all have our stories and we carry them with us. Therapy offers a safe place and space to share our stories, to embrace our historical narratives, creating and making new meaning as we go.

You can read more from Juli Fraga here.

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