What Really Happens in Therapy?

Everyone has an image of what therapy involves, constructed from a mixture of sources that may differ in terms of their reliability. 

It’s so common to be anxious and intimidated about the idea of therapy, and for many, this can be a barrier that proves too big to overcome. The anxiety felt before the first appointment is natural and expected, and typically resolves once the process is demystified and becomes more familiar. 

Here are some of the basics to help explain what goes on behind the closed doors of a therapy room!

• Yes there is a couch. No you don’t have to lie down (unless you want to of course!)
• No you will not be hypnotized.
• You do not have to talk about anything you’re not comfortable talking about. It’s helpful, and even encouraged, to let your therapist know your limits.
• You’re in charge of the process. Your therapist can recommend what they think might be helpful, but it is completely up to you to steer the ship. 
• The first session is the assessment session. This is where the therapist will ask lots of questions to get a clear picture of what’s going on for you at the moment. This may involve your current difficulties, your hopes, dreams, fears, disappointments, joys and stressors. Your history will be also reviewed, in so far as it is relevant to your presenting concerns. Then, your goals will be elucidated to provide the direction for therapy. 
• Please don’t apologise for crying. I personally feel so privileged when people feel comfortable enough in the therapy space to connect with their emotions. The tissues are not there for decoration. It’s also completely OK if you don’t cry!
• Yes you will be asked about your childhood. This is a very informative way of understanding the predisposing factors that may be contributing to your current difficulties. 
• Your therapist is trained in evidence-based techniques to help. This means that they will create a formulation – making sense of your current difficulties, how you arrived there, and why you may be stuck there, and how best to shift things to get you feeling better and moving towards your goals. 
• Going to sessions alone is unlikely to achieve significant change. Skills will be introduced in sessions, which with regular practice, will help you achieve change. 
• Therapy is a pretty special space. It’s one where you are held and met with compassion, empathy, no judgment and unconditional regard. 
• Everyone is different. That means that the therapist you connect with, how many sessions you need and what skills will be most helpful is different for everyone. 

It’s a special job, and I am filled with gratitude towards all my clients for letting me in and allowing me to walk beside them in their lives for a while. If therapy has been something you’ve wanted to look into but fear has held you back, I hope this information has been helpful!