It’s very normal for people to have a mixture of feelings about starting therapy.
People who have never been in therapy before often ask me questions about the basics and what it means to see a psychologist. I hope to address some of the most common questions and concerns here.
How often will we meet?
I see clients at a minimum of once a week. In some cases I’ll recommend meeting more often.
Meeting more than once a week dramatically enhances a therapy.
You will feel more support.
Trust will develop more quickly and more deeply.
You will experience the benefits of a therapeutic relationship in a more sustained way.
How long will I be in therapy?
Some people come to therapy for only a few months, while others make use of therapy for years.
Some people just come to do a piece of work, while others are looking for a place where they can be free to talk about whatever comes up in life.
Sometimes people need to know there’s an end date to feel comfortable starting, but then decide to continue when that time comes.
When working with kids and adolsecents I have found a long-term approach allows for the greatest results. It takes time for children to really open up and trust a new person, and that person needs to be a consistent, reliable presence.
Financial, time, and emotional resources certainly can influence the length of therapy. Without ignoring the reality of those aspects, I encourage you to take the time you need in therapy and to find what is right for you.
Does coming to therapy mean I’m “sick” or that there’s something wrong with me?
Needing therapy and coming to therapy does not mean you are sick, or that something is wrong with you.
I believe choosing to start therapy means you want more out relationships and more out of life.
If I start therapy, will I have to end some of my relationships?
Therapy opens up possibilities, it doesn’t take them away.
You may find that through our work together you feel freer in how you think about your relationships, both those that you have with others and those within yourself.
You may find new ways of hearing what others are saying.
You might find new ways of expressing yourself, your needs, and your desires.
You may even find that your needs and desires themselves become clearer or change.
While sometimes people ultimately choose to end a conflicted relationship, therapy can help you clarify your reasons, find more peace in the process, and feel more comfortable with the elements that are out of your control.
Is what I talk about confidential?
With only a few exceptions, therapy is confidential.
Your confidentiality is protected by both law and a professional codes of ethics.
Just as importantly, confidentiality is something I value very highly.
I strive to create an environment where you can speak as freely to me as you would to yourself. Without confidentiality that is simply not possible.
The exceptions to confidentiality revolve around ensuring the safety of children, the elderly and dependent adults, and preventing violence against you and others.
My initial paperwork outlines the specifics of when I’d be required to make a report. On the rare occasion that I learn about something that I’m mandated to report, I’ll be clear about this with the client and we may work together in the reporting process.
Is therapy just listening or giving advice?
While I certainly listen more than I talk, therapy happens through a conversation and relationship.
Even when I’m quiet, I’m actively involved and focused on our time together. It’s a quality of the interaction that you will experience quickly.
While I will express values or opinions in our work together, I haven't found giving advice to be helpful.
As an example, in my parent work we might talk about different options on how to handle challenging situations, but I don't imagine it would be useful to say, “I think you should…”
If somebody does ask for advice I find we often learn more by exploring the request. This isn’t an attempt to deflect your question or avoid giving an opinion.
On the contrary, I find that having some curiosity leads to a deeper, more fruitful conversation than simply giving the advice.
The desire to give or receive advice isn’t good or bad, it just tells us there’s another layer of something going on that would be beneficial to explore.
Is therapy going to be hard?
Therapy is most effective when you risk opening up, say the things you’re afraid to say, and be as honest as you can with yourself and your therapist.
This can mean moving into the places that we most want to protect and looking into the places we most want to hide from.
This can feel vulnerable.
Acknowledging and truly experiencing difficult feelings can be tiring, scary, and painful.
Because of this, it’s common for people to feel like therapy is emotionally difficult.
However, that difficulty is a natural part of moving on from the past and coming to terms with the present.
What keeps people coming back is the recognition that the pain and difficulty is associated with growth.
What keeps people coming back is the experience of no longer being alone with these feelings.
What keeps people coming back is the sense of freedom and flexibility that comes as a result of their investment in themselves and the therapy.
what is psychodynamic therapy?
Garrick Duckler and the APSA made a short video that eloquently highlights the kind of questions and thinking that arise in a contemporary psychodynamic therapy. I encourage you to watch it (here) if you’d like to learn more about this type of therapy.
do you prescribe medications?
As a a psychologist I cannot prescribe medication.
However, I have worked with many people who are on medications or who are considering taking them. For those who aren't sure whether they want medication or not, therapy can be a great place to explore the issue.
While the majority of psychotropic medications are prescribed by primary care physicians, I typically recommend speaking with a psychiatrist if you are looking to begin medication or experiencing unwelcome side effects from a current prescription.