When a patient comes to psychotherapy they get the chance to ‘meet’ themselves – often for the first time.
The process of your psychotherapy with me depends a bit on what issues you bring and what you are hoping to achieve. Sometimes people come to ‘dip their toe in the water’ and see what psychotherapy is like and so have one or two sessions. Other patients are quite clear about what they want to work on and this is what we do until such a time that they have achieved what they came for. Other people are less clear about their needs other than wanting to understand why they feel the way they do – these clients will often say to me things like they came to therapy because “I don’t know who I am anymore” or “I feel all at sea with myself” or simply “I’m lost and feel empty”.
For others, short or medium-term psychotherapy turns into a longer therapeutic engagement. Sometimes this happens quite naturally, as more unresolved conflicts come to light that need to be worked through. At other times, the client and I talk through the need for the therapy to become more long term and sometimes this also means meeting more than once a week. A therapist once said to me that the length of time a problem needs for the ‘scar tissue’ to soften and then for change to take place is commensurate with how long the problem has been around for.
The process of psychotherapy and being a client of psychotherapy takes a bit of getting used to. For instance, getting used to speaking when you are not prompted and to come to realise that whatever is on your mind is important even if it seems trivial,
unrelated or strange. Realising also that dreams are important to your therapy and can deepen our understanding of you and the issues you are struggling with.
In order to understand your problem, during the course of therapy I may ask you about your past. This is so that I have some context to your issue and have insight into deeper emotional dynamics that might have influenced your development. Sometimes we can feel resistant to doing this because of the difficult feelings associated with a specific event, relationship or period in our lives. However, this can be an important part of the process of psychotherapy. If this becomes particularly difficult to speak about we will pace these discussions so you don’t feel too overwhelmed.
Finally, a rather disconcerting reality of starting psychotherapy is that sometimes we feel worse before we feel better. Often, there is some initial relief in speaking freely with me – someone who isn’t connected to your world – and initially this can feel good. After an initial period people can sometimes report that they feel worse or their symptoms seem more intense. This is a normal response to psychotherapy. Psychically, we are built to resist change even if the change will benefit us. Our resistance is a way to protect the status quo even if the status quo means enduring the same difficult symptoms. However, after this phase, your mind/psyche will begin to feel less threatened and more accepting of possible change and the benefits of this will soon begin to be seen and felt.