How does psychotherapy make you feel?
The first time someone comes in for therapy, there is often a sense of “dumping” or “venting”. There is so much to say and explain about who you are, what your struggles are, what your history is. Clients often describe feeling “lighter” after this and after sessions in general. Why? Because much of what goes on in someone’s head or emotional world is left unsaid. Sometimes he or she doesn’t have enough supportive people to talk to. Sometimes the person is very private or shut down or ashamed.
For most people the idea of having an objective person that doesn’t have a stake in their lives gives them the ease to share things they wouldn’t otherwise. They can be free from judgment or feeling concern for bringing someone else down. Things often considered unspeakable get spoken. I often hear, “I’ve never told anyone that before.” One can suddenly have a voice that they’ve never had before and be validated by another person listening and showing empathy towards them. While it’s easy to be flip about how therapists just listen to people’s problems, there is something incredibly powerful about what takes place.
Of course, therapy isn’t just about dumping your stuff on someone else.
Giving voice to what is happening is just the first step. Through discussion one can often attain great insight about their situations as well as work on concrete steps to address them. This can take a myriad of forms from adjusting the way one thinks about things to making lifestyle changes like diet, exercise, and sleep to learning skills to better regulate one’s emotions to learning new communication skills. The effectiveness is not based on what approach is taken. Rather it is dependent largely on your relationship with your therapist.
Can psychotherapy make you feel worse?
Simply put, yes, it can.
It is inevitable that you will sometimes talk about something in therapy that is really uncomfortable or brings out old hurts. Remembering something painful can lead to an increase in symptoms in the short-term as you bring something to the surface.
When it comes to trauma, I often refer to “opening up Pandora’s box.” One traumatic memory might bring another and another out with it like the scarves a magician uses. Similarly, when someone has grief, abuse, or other painful experiences happening in the present it often triggers memories of similar things in the past.
So, unfortunately, it is impossible to protect against sometimes leaving a session feeling worse than when you came in. However, in my 17 years in the field, my clients have told me over and over again that although this happens occasionally, the vast majority of the time they leave feeling better than when they came in. It is important to find a therapist with whom you feel comfortable and trust to guide you through the difficult parts.
What Can I expect in a therapy session?
In an initial appointment, expect to fill out paperwork and to give a lot of background about yourself, your current situation, your history, and your family history.
A therapist is looking to get as much information about you as possible . He or she is looking to accurately diagnose you as well, so be completely honest . It doesn’t matter that you’re embarrassed or ashamed about your difficulty getting out of bed or about how much you drink. Your therapist needs to know in order to effectively help you and is not there to judge you.
Don’t be afraid to ask your therapist questions as well (How long have you been a therapist?, What approaches do you take primarily?). You are interviewing him or her as well to see if it is a good fit. Follow up sessions tend to be much more focused on addressing the problems at hand in contrast to the information gathering that happens in the first session.
However, this can take many forms.
Each therapist has/his or her own style and it can also be highly dependent on what is being presented. Expect to be processing current situations at the very least in order to gain insight and identify how to effectively address them. Depending on what is presented there might be a lot of work around patterns or working through past issues as well. One therapist might be very directive and another might allow you to come to answers on your own.
Again, it is all about finding the right fit for you. Don’t be afraid to speak up if it’s not working for you. Sometimes the therapist can adjust their approach and other times you might decide together that it’s appropriate for you to see someone else.
The most important thing to take away from all of this is that you are at the center of your treatment. The benefits can be enormous, so take an active role and ensure you are getting everything you can out of the process.