If you’ve never participated in therapy picking up the phone the first time takes guts!
Fortunately, there are lots of therapists in Doylestown who are caring and capable of helping you. They might not be able to help you though if you don’t get the inner gumption to call. Because of this, I have written this list of FAQs to give you the courage to pick up that phone and get scheduled so you can feel better quicker.
Besides the notion of baring your inner soul to a stranger, which of course is anxiety-producing, most of us haven’t had first account discussions with family or friends who have shared what therapy feels like and what really goes on in the therapy space. This has kept therapy kind of secret squirrel and a bit mysterious. It seems there is still some shame in admitting that you are going to therapy nowadays despite the fact that it’s so life-altering when it works. I mean, where else on this planet are you going to find someone who listens to you without judging who you are or the decisions you may make? In “the olden days” life was simpler. With that more basic existence, our roles were pre-set and our expectations for life weren’t quite so grand. Additionally, people tended to live in a multi-generational household that could offer more support. Although the expectations were often driven by our roles that society created, they were easier in some ways because there was less to wrestle with. Nowadays many of us live far away from where we began. Our family and friends can be thousands of miles away. Today’s culture involves social media where we feel pressure to appear happy, successful and to be “living the dream”. Most of us compare our lives to others via glossy postings on Facebook or Instagram and can leave us feeling like we are not entitled to support from friends and family. Needless to say, this has created more isolation than ever before because we aren’t getting accurate feedback relating to normal human challenges that all of us are facing.
It most certainly takes courage when struggling with life to seek help from a stranger, however; I can promise you the most fascinating thing happens! Upon finally scheduling and showing up to therapy - you almost immediately become lighter and feel better! This is not because the therapist has said something brilliant and life-altering or because you come to a sudden awareness but instead because you are now no longer stuck in not knowing what to do. You have figured out partially what to do - you’ve taken care of yourself by getting help and support. After most of the first sessions with clients, I end our therapy session time together by asking, “How was this for you?” Most people say, “I feel better!” By putting your foot down making a line in the sand with your suffering, you start the change process. You have now decided that you are worth the fight. You are taking care of yourself.
So that you don’t waste one more minute suffering alone, I thought it might be helpful to tell you what therapy is really like and answer some frequently asked questions so that you might muster the courage to pick up the phone and schedule with a therapist.
Do I have to lie down on a couch during therapy?
Nope, you probably will be sitting upright and looking at the therapist.
I believe the idea of therapy is somewhat scary because of how the media has portrayed it. It usually involves a stone-faced man or woman with a tight bun, who looks a little uptight, with glasses (natch!) nodding their head and listening with a blank face on while they scribble something down each time the client speaks. It doesn’t help that often therapy is portrayed in the media with the client on the couch…literally, that is -laying down on the couch staring at the ceiling without the benefit of eye contact while talking to themselves. Although there are some psychoanalytic therapists (think Freudian) who still may employ that kind of seating for their clients, most of us clinicians use a regular couch, loveseat or an upholstered chair, value eye contact, and offer a compassionate response face-to-face. Often there is no coffee table in the office to prevent the feeling of a barrier between the client and the clinician - and this does leave both feeling more seen. That being said, I do have a coffee table as do many therapists because it holds drinks, feelings charts, pens, and pads.
The therapist said they’ll do an assessment, what’s that?
An assessment is a comprehensive evaluation that summarizes life events.
Although you may think that you scheduled therapy to work on your immediate problem you may be in for a surprise. You are actually there to learn what your patterns of interaction with yourself and others look like. Learning your patterns holds the key in aiding you to make the changes necessary so you can live your best life. To get to the patterns, the clinician doing an assessment will most often ask questions about the problem, your childhood history, your work life, friends, your family of origin, your immediate family, your relationship with drugs and alcohol, your health history and what your interests are. Asking about mental health symptoms is also part of the assessment where you are identifying troubles related to functioning like sleeping, eating, focus, worry, pleasure, past trauma, energy, and mood. Seeing the whole picture of your life allows the therapist to come up with a hypothesis related to why you are experiencing the troubles you are having and allows the counselor to start tracking patterns of disconnect as it relates to your thinking, feeling and doing. These patterns ideally are shared with the client such that it interrupts the unconscious behavior and allows you to course-correct areas of life that you have not been mindful of.
Almost always, therapy focuses on how you got your needs met as a child by your caregivers. How you had to function in your family of origin in order to get your needs met creates what’s called your “attachment pattern.” This information is gold in understanding why you are or aren’t getting your needs met today. This info is usually part of the therapist’s hypothesis that ideally will be shared with you so that you can change up your childhood dance steps in relationships and better get your needs met by your loved ones.
Will my therapist really keep my secrets safe?
Absolutely. Our lips are locked.
HIPAA also is known as the Health Insurance Portability and Accountability Act and is a 1996 Federal law that restricts access to an individual’s private medical information. What this means is that if your therapist shares any information about you, or receives information about you, without your expressed permission in writing the clinician is breaking the law and there are stiff penalties when getting caught. HIPAA aside, most therapists are not shocked by much. Clinicians have sat with many people in desperate situations. Because therapists treat a variety of people and problems it’s hard to surprise a clinician. Because of that, it’s just another day at the office. Your secret probably won’t raise the therapist’s eyebrows and thus won’t even be tempting to talk about to others.
Will my therapist tell me how to fix my problems?
You don’t need my solutions you’ve got all the answers inside of you.
You might be shocked at this but therapists aren’t meant to give advice. What we are supposed to do is to help you find your answers to your problems because EVERYONE has the answers to their problems inside. At times people can’t access their answers because of faulty thinking, anxiety, depression or lack of confidence but therapy is meant to hold the space where you can sit and get in touch with your answers. Your therapist is going to remind you of the great person that you are, how your history skewed your vision, and offer you hope that you can make any change that you want. The process involves the therapist challenging your thinking, pointing out when a relationship boundary has been crossed and at times they reinforce your already present gut feeling. The idea is that things have happened in your life which have cut you off from your internal GPS. Therapy is going to get you back on the road to listening to yourself so that your thoughts, feelings, and behavior all match up.
Will my therapist start talking first?
Maybe. We all do it slightly differently.
The miracle of therapy is that it works if the client develops a trusting relationship with the therapist. Once that occurs, the actual interventions and model of therapy the therapist is trained in becomes less important. It’s about your therapist almost reparenting you such, that you establish a closer relationship with yourself. The treatment reinstalls your ability to trust yourself and others as nature intended it to be.
Once the assessment is completed it’s the client’s job to bring in to session what they want to work on. At times I have had clients who arrive in therapy, with pen and paper in hand waiting for me to wax eloquent on things they are supposed to change. I’ve had clients who insisted I spend the session giving them strategies to fix their problems almost like I was offering a seminar. I had to explain to them that this is not education - this is psychotherapy. In therapy, the client brings in the topic each week. This may seem disconnected if the topic changes week to week, but guess what? There is a red thread that weaves each story together which equates to the patterns of behavior the client engages in. Despite the storyline and characters changing, the pattern remains intact! A good therapist will start to punctuate the pattern whenever they see it, transparently so that the client starts to make sense of the chaos they find themselves in. Soon what used to be distressing now becomes predictable and before you know it optional choices which were unseen prior, start to become obvious. You now have a choice. Knowing your patterns sets you free!
I’m really emotional will my therapist think I am crazy?
No, what we know is that you are triggered and probably alone.
Triggers - we all have them! In case you don’t know what they are- they are historical events that are kept in our subconscious mind as dangerous. Because we never put words to them or processed them ( usually because we were too powerless or young) they hold tremendous power over us. It’s the protective mechanism our brain has developed to protect us from something bad, usually from an event that occurred in the past. So when anything looks remotely like that frustrating/upsetting/scary/sad historical event our brain goes into protective overdrive. We have a knee-jerk reaction to a stimulus that our brain recognizes but our conscious doesn’t, and before you know it we are either yelling, crying, freaking out, shutting down, or leaving the room. It’s that fight, flight or freeze reaction. What I have seen countless times is a client putting words and memories finally to the stimulus, and once it’s sorted out it tends to lose its power over us.
Again I can’t stress enough how powerful the relationship between the client and the clinician is. Feeling seen, heard and felt leaves us no longer alone because someone understands us and it makes sense to them too.
Clinicians are used to tears, upset and pain and we all know it’s the triggers and sense of being alone that are controlling the show. We know if we keep the focus on what you are feeling, you will be feeling better in no time.
How long will I be in therapy for?
Not sure, you tell me.
The length of stay in therapy is truly directed by the client. Just how much change a person wants to make is very individualized. For example, I can say that there are typical lengths of stays within my couples therapy practice. The couples who make the changes they identified wanting to make are with me generally a year at least. This is because change is hard and as humans, we are wired to create equilibrium. This translates to avoiding difficult things. Additionally, having a history of trauma can make the therapeutic work more complex in that there is a weaving of the trauma with the current state of affairs. This involves at times working on the traumatic earlier event so as to see the current problem more clearly. Behavioral work in therapy, like learning how to maintain an erection for example, in sex therapy, can be resolved in a couple of months should the interpersonal relationship be healthy. Should the person have a history of trauma related to their sexual self, it could require working on the trauma first which would take more time.
At times people want to quit therapy because it can be hard, painful work. Having a therapist better attune to the difficulty of the work might require a discussion of why it’s so hard to continue. Perhaps the therapist can pace the work or offer further support in the way of group, or couples therapy to allow the work to be shared. At times a client may have had enough growth despite not completing their work.
How do I end therapy when it’s time?
You discuss it with your therapist and both share your thoughts then you make a decision.
Sometimes it’s an internal feeling of being done. At other times it’s the sense that you need a break and needs to rest and at other times the therapist might underline in a session that you appear to have been making consistent progress and perhaps it’s time to discuss discharge. It can look many different ways. I think the best way to know is to go back to the beginning and ask yourself did you meet the goals you established at the beginning of treatment with the therapist? On the first phone call with a potential client, I ask them, “How would your life look different if the therapy worked and you’ve reached your goals?” I ask them this so that there is a clear picture of what goals we are working towards so that when they are met, it’s noticed. People often call me stating that they want a better marriage. A better marriage can mean lots of things to people so parsing out what that means to you is very important. Does it mean better communication? Less fighting? Spending more time together and enjoying each other? Hotter sex? It can mean many things. Getting clear about your goals for treatment and discussing them with the therapist will ensure you have a marker for progress that is solidly understood between the two of you. The client is always in charge of deciding when to end treatment and this decision ideally is discussed with the therapist so that the therapist can share their impressions of the client’s progress. It’s a gift as a therapist to have a client tell me when they are done working with me. It allows me to close the relationship with the client in a therapeutic way. I support a client’s choice every time but will share my concerns if I don’t feel they are ready. - it is still the client’s right to terminate therapy when it feels right.
I hope these FAQs were helpful in getting you more comfortable with the idea of trying out counseling in Doylestown to help you sort out your problems. If you are looking for help with couples therapy, have sexual health issues, find yourself alone and unhappy as a man, need assistance with affair recovery, struggle with out of control sexual behavior please call me at (215) 272-1161 or click here for a free 15- minute phone consultation. I’d love to help. I can also help point you to a therapist if your problem isn’t my specialty.