I have been asked several times, what I do as a psychotherapist. It oftentimes seems that people are not sure what to expect when seeking help from a mental health practitioner. Most people can recall a movie in which a group of zombie-like patients sit in a sterile, dimly lit room decorated with large pictures akin to Rorschach ink blots lining the walls. Meanwhile, in this same Hollywood version, an emotionally detached clinician sits quietly scribbling notes onto a pad while giving accusatory glances and inquisitions, as if to shame someone for their internal struggles or, worse yet, as if fighting to convince the patient that he or she is mentally incompetent and unable to differentiate reality from non-reality. On the other hand, we may see a more comedic approach to therapy, albeit, again from a movie or television program, in which the therapist comes across as goofy and out of touch; pretending to live in harmony with all life forces while we in the audience are wondering how much grasp he or she has on reality. Seeing images like these over and over, it's no wonder people are uncertain of therapists. We are portrayed as either out to get you, or as living precariously on the fringe of society's accepted boundaries of normal behavior.
What are therapists really like? We're generally like anybody else. We shop for groceries, we mail in the car payment every month, we might have pets, we like Italian food, we watch movies, we play sports, we laugh at jokes, we check our email. So, if we are regular people, then what is therapy really like? Therapists have varying styles of therapy; after all, we're individuals with our own personalities. However, when describing therapy to someone, I generally explain that the therapist and patient take some time to get to know one another and develop a therapist/patient relationship. In the very beginning some therapists may ask about a person's daily routine, whether anyone in the patient's family was addicted to drugs/alcohol, if the patient ever witnessed or personally experienced abuse, or bring up other questions that may seem somewhat uncomfortable. Once again, each therapist will have his or her own style, but the reason for such initial questions may be to determine how to shape that style to match whatever issues or struggles the patient is bringing in. Furthermore, keep in mind that not every therapist is capable of handling every type of psychological problem. Therapists may be trained in different specialties, as are physicians, and this will limit the scope of treatment a therapist can or will provide. Therefore, it's perfectly acceptable for the patient to ask the therapist questions too, especially if this is the individual's first time in therapy and he or she doesn't really know what to expect. However, it can save the patient a lot of time and running around if he or she will ask questions prior to setting up the first session, therefore, one can eliminate therapists who may not be able to help. Remember that you the patient are also looking for a good match, so it's alright to see a couple of therapists and then decide where you feel most comfortable. Therapy, regardless of the issues discussed, is likely something that will take awhile. I've never met a person who said one session was all that was needed; (this, however, does not mean that you must remain in therapy for decades). It's not uncommon for someone to spend several months in weekly therapy, but you can arrange with your therapist how often you would like to meet. During the course of therapy, there will be sessions that seem very productive and sessions that seem kind of bland. A patient and his or her therapist will develop a relationship of trust and consistency. Therapy is sometimes the very first place that some patients ever feel truly safe. A patient should never feel afraid of his or her therapist. Initial nervousness is normal, but if you've been meeting with your therapist for months and you feel afraid being harmed by the therapist, then something is definitely wrong. In such a scenario, it is important that the patient let someone know, maybe another therapist or even the police. Beyond such extremes though, therapy is not magic, it is work and sometimes that work is difficult and uncomfortable. It can be of great value for a patient to step back and take a look at how he or she has been thinking or behaving and whether those things have served the patient well. Patients can use their therapists as non-judgmental sounding boards when a quandary arises, or patients can share with their therapists things they've never told anyone. We're not allowed to go blabbing it to everyone in town, it's actually illegal given that whole patient/therapist confidentiality thing. However, even that has limitations, so be sure to ask about the limits of confidentiality during that initial session. Furthermore, at the risk of sounding like a cliche, therapy is certainly a journey and not a destination. It's my sincerest hope that you'll enjoy those travels.
Well, I hope this has offered a little more insight into what psychotherapists do and what psychotherapy is like. Generally, one's world should feel comfortable, safe, and reasonably consistent. If it does not, you may consider speaking with a therapist. Here's to wishing you Good Mental Health.
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