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What Happens During the Therapy Session?

On this page I aim to provide an idea of what the therapy sessions are like in practice, how I think about working with psyche and the human condition, and the nature of the relationship between client/patient and therapist. Further down the page you will find a longer written piece or two. 

There are many different forms of psychotherapy available, and just like each person who comes to therapy is different, so is each therapist. Even when working with well researched theoretical models, as part of a recognised professional group, there are inevitable differences in how therapy is practiced due to the preferences of the therapist themselves.

 

12 key features of each meeting with me

  • We will aim to develop a shared understanding about the themes we encounter, and what we are working towards.

  • Psychotherapy is something that takes place between the client/patient and the therapist. It is not something that the therapist does to, or does for the patient, or that the patient does by themselves. In this sense it requires the active participation of both people.

  • You are invited to speak as freely as possible, about whatever comes to mind. 

  • You can begin by talking, or go straight to using art materials. You are invited to use the art materials, but it will remain your choice whether or not to do so in each session. 

  • I won't usually introduce a starting point, or assume that what was most important to you in the previous session will have the same priority in the present. We follow the thread of evolving themes, whilst recognising the potential for each session to be something new.

  • ​You are encouraged to describe your dreams during the session. We will work with these in an explorative way to think about their symbolic content, and the meaning they might hold for you.

  • If you find it difficult to talk (or make images) about certain things, rather than focus on the particular theme itself, we might turn our attention to why it is difficult to approach this specific area.

  • The nature of psychotherapy means that all thoughts and emotions are welcomed. The idea is that the therapy can safely hold a wide range of human experience (from joy to despair), but that we work within agreed boundaries

  • Sometimes in the session there may be a pause, or silence. This can feel unusual, as we live in cultures that generally don't value taking time to consider before responding, waiting to see what comes to mind next, or paying careful attention to what is really going on in the present moment. In the psychotherapy setting this is welcomed. 

  • We will give consideration to aspects of your past, for the purpose of better understanding the present, and potential implications for the future.

  • Whilst working with who you are today, we give space for your ideas about the person you would like to become, and the kind of future you desire. 

  • We will observe the relationship between us, and reflect up on it as an important and informative aspect of the therapy. 

What is required from the patient/client?

It is important that we can enter the work in the 'spirit of enquiry' — a kind of non-judgemental curiosity about whatever makes itself known to us in the session — by valuing your experience in all its forms, and adopting a considerate and reflective attitude. A degree of commitment is necessary from both of us to make the therapy as effective as possible. It is also important to be aware that sometimes the work may feel challenging, as well as rewarding.

 

In the session you are encouraged to speak openly about your experience of the therapy itself. This may sometimes feel unusual or tricky because it will include how you experience me. Our aim is for this to be something that can happen with relative ease as the trust between us develops.

The therapeutic alliance / therapeutic relationship

The working relationship we form between us aims to serve you by providing a trustworthy, reliable and consistent experience of relating. It is fairly unique in the sense that whilst it can be a profound and real thing in itself, it is distinct from friendship, family relationship, becoming colleagues or team mates, although it may at times embody some of the qualities found in them.

 

One element of how this works is that as your therapist I will not say much about my personal life. Sometimes people worry this means the therapist will seem cold and distant. However, the intention behind this is to enable the therapist to be authentic and relatable in the sessions, creating a kind of neutrality that enables you to communicate very openly. The details of my life should impinge upon you as little as possible. Your perception of me can then be utilised in the therapy to explore aspects of yourself and patterns of relating.

 

The nature of the therapeutic relationship also means that as you express yourself freely, we can examine and think together about what is occurring between us, in a way that wouldn't be possible if we were forming other kinds of relationship, because you are free of the expectations that could entail. This isn't to say that what happens in therapy is not real, or somehow fake. On the contrary, sometimes it can be more authentic than much of what occurs in daily life, and a chance to nurture a new way of relating to self and others which can then be brought to the rest of your life. 

The work of healing and transformation

People come to psychotherapy for many different reasons. Perhaps the most general, or we could say 'traditional' reason is due to the presence of suffering. This may take the form of uncomfortable or painful emotions, unhelpful patterns of thinking or behaviour, challenging life circumstances and experiences, or feeling 'stuck' and having difficulty finding fulfillment. As part of working towards healing and resolving difficulties, it is important that the therapy sessions also encourage you to find expression for what you love, the things that are 'right' in your life.

 

Sometimes it is a case of our focus having narrowed, so it seems that our difficulties account for the greater proportion of life and identity, and it seems like there is little beyond. Another way of saying this might be that our 'symptoms' are designed to draw our attention to them, in order that we carefully consider what it is that they may be trying to make us aware of. In therapy we zoom in to address key issues and become more aware of the details and textures of life, and we also broaden our focus to see the full picture of who you are, the world you live in, and perhaps move towards a more expansive vision of possibilities for what that life could be.

Although significant, and often the core of ongoing work, the themes that initially 'bring' a person into therapy tend to shift, and the work evolves as we go along. From a deeper perspective we could see encounters with suffering, problems, or feeling 'stuck', as potential openings to Soul. The call to know oneself in a deeper way, pointing towards a need to fully inhabit life and situate yourself within society, culture, the wider world, in your own unique way. 

 

That is not to romanticise pain, or gloss over real difficulty, but to suggest that we must be cautious with an instinct to 'get rid' of what we do not find pleasing, in case we are missing something of potential value. We will aim to come to an understanding about the parts of you which are suffering, in order to find out what might be needed to bring about the changes in life that you seek. This will also involve questioning what you might be holding on to, in the form of attitudes and ways of being, which may have developed for good reason as a necessary protective response to particular events and circumstances in life, but have then become a hindrance later on by becoming patterns of default responses. 

 

This can be one of the more challenging aspects of therapy, and why it can be hard to bring about lasting change: often without realising it (unconsciously) we can actually become quite attached to 'symptoms', problems, and ways of being that contribute to our perceived suffering. This is because in some respects they have served us well at certain times, by protecting vulnerable parts of ourselves from a greater form of suffering. We might find it difficult to really imagine a life without them. Our attempts at 'self cure' (conscious or unconscious) can have the unintended consequence of keeping us beholden to the very things we wish to be rid of, or even give us additional problems. This can be particularly challenging when a person's experience is that their suffering has been originally caused by others. It is important to gain clarity around what one can do to help oneself, whilst at the same time coming to recognise and acknowledge what one is not responsible for. 

This is a way of saying that the psychotherapy sessions are about how we live with ourselves (and others), including the aspects and experiences which it may feel very difficult to be at home with. This is the work of genuine transformation, through integration. Yes, we seek to make changes and minimise suffering, but to do this requires compassion and understanding. The poet Robert Bly puts it this way, "Any part of ourselves which we do not love will eventually become hostile to us." 

 

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