Lately I’ve been thinking about this work, and what the therapist owes her/ his clients. Therapists often say that they don’t want to be doing all the work, (meaning that the client must apply him or herself) or nothing useful will really happen. Very true.
However, the therapist must also be working, and working hard, so that when the client leaves every session they take with them something new to ‘chew on’, a new awareness or an insight they didn’t have before. Perhaps they have gone through an emotional experience that has created a self-understanding. This is often more useful than then the intellectual putting together of a new concept. For example, crying teaches how significant something is (or was) in a deeper way than thinking about it.
The therapist needs to connect things that their client said in a previous session to what they are saying today, or show them things about themselves they hadn’t recognized. Good therapists pick up on things that other people wouldn’t notice. Then there is the timing and presenting of things, so that the client can take in what the therapist is saying. Skill, experience and intuition come in here. Therapists have to stay on top of their own reactions to things, so they know when something from their own life is influencing the way they feel and react to their client. Having different therapeutic approaches to the same issue is needed – the therapist needs to adopt to their client, not the other way around!
I guess I’m saying some people are more talented about this work than others — and don’t settle.
Every so often someone comes to me for therapy who has already been through counseling at their HMO. Often they blame themselves for not feeling resolved about what it was that they went to a therapist for in the first place. Blaming your self is reinforced because you’ve been discharged from their HMO as no longer needing therapy. “So what is the matter with me, I’m still feeling lousy?”
It is not uncommon that the person has been put on a psychotropic medication which they may indeed profit from. The problem is medications work better in combination with talk therapy. The therapy actually helps the medication to be more effective, and the medication definitely helps the person get the most out of therapy. In my opinion the person has been short changed. She, or he , could have gotten more help. Often, unfortunately, what they did get was a band aid to “stop the bleeding” but not induce a cure.
Why is this ? HMOs, due to their cost containment strategies, are set up to do short term therapy, which is fine if that is what you need. It can be all you need if you have a present situation which can be cleared up quickly with some help, and has no roots in your past. On the other hand if you are struggling with problems that exist in your life because of your beliefs about yourself and your world, it can be a relief to see how you learned these negative beliefs in your childhood. Making the connection between the present situations and the past is a doorway to changing in a real way. You deserve to have longer therapy.
I offer in-depth therapy that can get to the bottom of what troubles you. I’m not comfortable with skimming the surface, because most human problems do have roots in our childhood. When that is obvious to me as a therapist, I can offer you the option of dealing with these underpinnings of the present problem. My commitment to you holds until you decide you are ready to leave therapy, and my investment in you is still there if or when you want to return.
Going to your HMO therapist is often free or nearly so. I am aware of the expense of paying for insurance and then paying again for therapy out-of-pocket. I have devised a sliding scale that roughly correlates to the income into your household and the number of people that income supports. Almost always, a fee that works for you will work for me.
Question: It seems that when my friends go to therapy, they end up being mad at their parents. I don’t see why this has to happen; I love my folks and think I had a good childhood. Relationships are a struggle for me and I would like to change that, but I don’t want to be turned against my parents.
It is not a necessary for you to “get mad” at your parents to have success in therapy. After all, as adults it is our job to take responsibility for ourselves and not just blame our parents for being inadequate. Although understanding your relationship with your parents is part of the therapeutic process, it is not the end.