In the time since becoming a therapist, I have yet to have one client ask me where I received my master's degree, or where I did my training, or a word about my licenses. What clients want to know is, "Can you help me? Can you offer me anything at all that will bring me some relief from the pain I'm in?" Some also have other questions they may or may not be as likely to articulate, questions such as "Are you going to judge and reject me if you know the 'real' me? Are you going to understand me? Is this just going to be a supreme waste of my time and money?" I always ask new clients that come to me if they've been in therapy before, and if so, how it went. If therapy is a new experience, I ask what their goals and expectations are going in of themselves, of me as their potential therapist, and of the therapy process. I like to borrow a question two of my favorite author-therapists, Terry Real, and his colleague, Lisa Merlo-Booth, have shared they ask their own clients- "If this therapy is a stunning success, what will that look like?"
Below I'd like to offer some tips that will increase the likelihood that your therapy experience will be worth your time, effort, and money.
1) Do your homework.
Ask yourself direct questions. What qualities are important to you in a therapist? Do you prefer they have a certain working style? background? Is a sense of humor important to you, or do you prefer a more reserved approach? How far are you willing to travel and how far will make it less likely you will attend regularly? Preferred gender or age range?
Equally important, what qualities don't you want in your therapist? I have a close friend who saw a therapist for several years whom she casually mentioned she felt little connection to. "How come?," I inquired. "Because," she replied," she never is willing to disclose anything about her own life. She knows everything about me but refuses to breathe a word about herself." You may be the type of client who doesn't want your therapist to disclose anything about themselves, and thats fine, just be aware of your needs going in, and why.
2) Be clear on your goals, and learn to consistently ask for what you need.
Spend some time answering for yourself what a "stunning success" will look like. How will you know that therapy is working well? What will be different? How will you feel? What will your relationships look like? Your body? Your day to day habits and ways of being and thinking in the world? What will others notice about you that is different? Most importantly, what will be different about you?
Too often I find people are sparklingly clear about what will be different about their spouse, their children, or their boss... "Oh, she won't be such a relentless nag" or "He won't be such a massively royal pain in the ass..." It gets a little...fuzzier....when asked how they, themselves, will be different, but good therapy isn't usually about changing the people around you. Usually, its about deepening and challenging the way you, yourself, have learned to operate and communicate in the world around and inside of you. A good therapist will work with you to raise your own personal standards about how you treat yourself and others, and what you are willing to tolerate in return. What therapy isn't about is getting the people around you to lower their standards and learn to tolerate disrespectful behavior from you.
Articulate your goals to your therapist, and take responsibility for staying on course with these goals. If you don't feel you are being heard, or challenged, share that directly with your therapist. Don't use therapy as another place where you don't take responsibiility for getting your needs met.
Which brings me to the next tip....
3) Your therapist is a) not a mindreader, and b) is responsible for taking care of their own feelings.
Check in with your therapist about what is and what isn't working in your work together. Don't expect him or her to know this. Along those lines, don't withhold important information from your therapist. For example, if you are having an affair or self-medicating with alcohol or food, be brave and share. What you don't share can define your relationship and sabotage your goals. And remember, your therapist is not there to judge you but to help you grow as a fellow human being (and whom has their own challenges along the way too).
If you tend to be a caretaker outside of your therapist's office, you might find yourself wanting to play this role in his or her office as well. Don't. Your therapist is responsible for taking care of their own feelings. I've heard more than once people say things like "Well, I didn't want to hurt his feelings." Even if you say something that the therapist strongly disagrees with or their feelings are wounded, you should always feel you are encouraged to have a dialogue about that without in any way feeling its your job to caretake your therapist. If your therapist becomes defensive or responds in a way that makes you feel unsafe or attacked, share that in the moment. If the dialogue isn't a respectful, productive one, you may need to assess immediately if the boundaries are safe.
However,...
4.) Be open to real feedback.
There is a difference between being criticized by your therapist, and being given feedback by him or her that might make you uncomfortable but will allow you to grow into a more relational, respectful, authentic, and mature human being.
I once worked with a couple for several weeks when one of the partners became quite angry with me for not convincing his spouse to take a sailing trip that he had planned. Her reason for not wanting to go was that he frequently berated her with belittling names. "At least when we're at home, I can get away when I want to," she explained. "But how am I going to get away when we're on a boat in the middle of an ocean?"
Good question. Unfortunately, his response to that was an explosive and abusive one. I would have been doing no one, but especially him, any favors not sharing what I was experiencing there in the room with them."
"May I offer you some feedback?" I asked him. I watched as he shifted in his seat and grabbed the cup of coffee beside him. Then he responded with more of a mutter than anything, "Go ahead."
"You might not like it," I warned. "So I want to be sure you are giving me permission."
I watch him suck a deep breath of air in through his nostrils. "Shoot."
"If how you are in this office today is even an inkling of how you behave outside of this office," I said, " then I wouldn't want to go on this trip either, any more than I'd feel safe driving home with you today."
Its not an easy thing to hear, I know, but what we were able to get to is that the very communication tactics that made him very successful as an attorney were wreaking havoc on his marriage and family life. Because he was willing to be open to this feedback, unpleasant as it might have initially felt, we were quickly able to begin working on turning him into the kind of partner that his wife not only wanted to go on a sailing trip with but whom she actually got excited again about spending the rest of her life beside.
5) Consider asking for homework between sessions and take treatment recommendations seriously.
You see your therapist for a very brief time out of all the hours in your week. Homework that provides a focus and structure for your goals, and expands on the themes you are exploring in therapy can be very beneficial. Homework can come in various forms, from book recommendations, journaling assignments, a planned date with your partner, or a specific commitment to act on something such as exercise or a therapist's recommendation to get a medical or psychiatric evaluation.
Consider that when you don't follow professional recommendations your therapist believes may truly help that you may be undermining your goals, and self-sabotaging the therapy process.
6) Expect that things may feel worse before they feel better.
As the old motto goes, "No pain, no gain." In relationships, ignorance can only be bliss for so long. There is nothing more rewarding than seeing your relationships with yourself and those you love blossom and transform out of old, paralyzing paradigms. Put in the honest, dedicated effort, and the short-term pain will be well worth it.
**Please note that where clients have been mentioned, details have been slightly changed so that their information could not be recognizable to anyone who might be reading this.**
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