On being a client
I’ve been struck recently that although there is an immense volume of information about how to be a therapist: masters programs, CEU trainings, supervision, books, videos, articles. There is not very much information about how to be a client. What is the expectation when you sit down for a session? Do you need to come with ready prepared topics to discuss, do you expect the therapist to set the agenda and feed you information, do you wing it and hope for the best? The truth is that every therapist has their own brand of therapy. Some err towards education and behavior change. Others focus solely on exploring and changing faulty thinking patterns through scripted protocols. Still others may be wanting to dig up and reprocess past traumas or early memories. I have many of my clients ask in their first sessions “am I doing this right?” Because of the frequency that I encounter this question I wanted to take some time to reflect on ways that you as a client might make the best use of your time in the chair.
1) Start with as clear a picture as you can about what you are wanting to get out of therapy. Do you want to have better relationships? Are you struggling with your anxiety? Have you been depressed? Imagine where you would like to be in 5 years, what will be different in our life? What are ways that your problem impacts your life in the course of your day to day life? Someone once told me that “a problem well stated is half solved.” If you can identify your main objectives for sessions, you’re off to a good start.
2) Be as honest as possible with your therapist. To the extent that you have built a sense of trust in your therapist over the course of your sessions, see how it feels to share things that you feel vulnerable about. Especially if it’s a concern or sense of shame that follows you into the counseling room: perhaps a worry about how you are being experienced in session, a sense of frustration with the process of counseling, if you feel cared for in the counseling relationship. There’s an old axiom for therapy: Suppression in one area usually leads to suppression in others. If there is something you’re avoiding in your sessions, you likely aren’t going to get very far talking about other things. Again it’s OK to build your trust, don’t rush it, especially if you have trauma or pronounced difficulties with trust in other relationships. If that’s you, maybe try actively discussing your difficulty with trust. I had a client recently who I was sensing some disconnection with. When I brought it up, she was able to identify that a secret she had been keeping out of our therapy that was inhibiting her ability to connect. After reflecting on whether or not our relationship felt safe enough for her, she broke some new ground and brought the secret out into the light and it revitalized her work moving forward.
3) Be attentive for the re-creation of unsatisfying relationship dynamics in your relationship with your therapist. For instance if you have a sense of always having to censor yourself in relationships so as not to burden others, if you find that you push away people that care for you, or if you habitually fall into victim roles to elicit concern, pay attention to whether or not those default templates start to intrude into your connection with your therapist. Use therapy as a lab to experiment with new strategies or new relationship templates. This is especially important for group work as groups are going to be more likely to engage your automatic interpersonal templates: both the parts that you like about yourself and the parts that you want to move on from. There is no perfect counselor out there - every counselor is going to rupture the connection at some point in an episode of care. The good news though, is that the healthiest attachments are built through cycles of relationship rupture followed with repair. It takes some vulnerability to speak up but sharing these things can help deepen the connection and help you practice authenticity in a safe place. The stronger your bond with your therapist, the more likely it is that you are going to be helped by therapy.
4) Discuss dreams that you have. Before you say that you don’t remember dreams, or don’t have dreams, maybe try to keep a dream journal on your nightstand for a week and practice writing down what you can remember first thing on waking up. There are many different types of dreams out there but sometimes they can be so much more than just jumbled fragments of your past - they might symbolically represent many of your unsaid thoughts, fears and hopes for the future. They can provide insight into your relationships and they are usually brutally honest - bypassing the censorship of your conscious mind. Pay especially close attention to dreams that stir strong feelings or dreams that are repeated.
5) Become curious about your inner processes. Rather than feel embarrassed or shameful about yourself or ways that you act, see if you can cultivate an attitude of self compassion and curiosity so that you can explore where those big feelings are coming from. Increased levels of shame paradoxically keep us trapped in the same behavioral or emotional patterns that elicit the shame in the first place. Curiosity and self-compassion can help you to cool those intense emotions down enough so that you can work with them.
6) So much about successful therapy is growing your self awareness. Socrates is often quoted as saying “the unexamined life is not worth living.” These blindspots and hidden areas in our lives can keep us from the quality of relationships we want or from achieving the level of meaning in our lives that we’re meant to enjoy. There are three types of material that are especially important to examine in therapy:
Material that we don’t share with other people (secrets or memories that you feel shame about, habits that you have that maybe others don’t know about). Shame tends to grow when it’s kept in the dark and shinning some light on it can be a very liberating experience. It’s not a good idea to spill all your secrets in the first session though. Take some time to build a sense of trust with your therapist.
Material that other people know about us but we don’t know about ourselves. Feedback from friends and family about how you come across in relationships can be one source of this self knowledge. A skilled therapist who has taken the time to get to know you will also be able to provide feedback on how you are experienced in the counseling relationship and/or can help you explore your current relationships for repeating themes that can give you some clues.
Things that other people don’t know about us and that we are not yet aware of ourselves (interests, passions, skills or feelings that we’re unconscious of). This type of knowledge takes some time to surface but can be some of the most rewarding to uncover in therapy. Dreams, art and poetry can help with the unconscious material, bringing the hidden parts of yourself into the light where they can be explored and integrated into your life.
Hopefully some of these tips will be helpful to you to as you get started in therapy. This is not an exhaustive list and the details in this list might not be ubiquitous across different therapists or different types of therapy, but hopefully some of this will be helpful to you as you try to decide if therapy would be right for you.
