The Therapeutic Process
This page aims to give a sense of how therapy with me works. I have written about some of areas that clients sometimes have questions about, including; The client - therapist relationship. How does therapy begin and end? How does each session start? What happens between sessions? Is it all about the past?
If you have a query which you can't see the answer to here, please feel free to contact me and ask.
What Is It Like To Be In Therapy?
I aim to hold a welcoming space for you, and encourage us to emphasise the therapeutic values of curiosity and compassion. I appreciate that people don't come to therapy for fun, but for a serious purpose. However, as this kind of work is about finding fullness of expression—working towards a greater sense of 'wholeness'—if we don't allow room for the light and only attend to the shade, we will be welcoming certain aspects of who you are, and denying others.
I firmly believe that psychotherapy needs to be enjoyable and enriching, even though it may sometimes be challenging. Experience has also shown me that it's helpful for both patient and therapist to keep a sense of humour within reach.
At Each Session
You are invited to express whatever comes to your mind as honestly as possible, without thinking too hard about whether it seems important or makes sense. Rather than being random and aimless, the purpose is to encourage an openness and honesty about your experience, through which we can better understand your inner world. I will be listening carefully and attentively, and you might notice that you are able to hear yourself in new ways too.
You might start a session by describing a feeling, a memory, something that has happened recently, a desire, a dream, etc. Sometimes there will be a definite theme that you want to bring to the session, and on other occasions you may not be sure where to start. This is quite normal, and can be an important part of the process.
You will be encouraged to begin where you are, perhaps even with how you feel in the here-and-now of the session. We follow what emerges, staying open to shifts in energy, silence, surprise, or insight.
We don't have to start exactly where we reached at the end of the previous meeting. We attend to what feels most relevant to you. This is to acknowledge that each time we meet some time has passed, that we are both constantly changing and subject to the ebb and flow of life. As we go along there will be themes that emerge very clearly and pronounced, others more subtle. Working together, we aim to notice and give attention to them, which is what brings everything together in a coherent way.
In Short-term Therapy it may sometimes be more appropriate to keep closely to a particular area, and to begin each session by focussing on it. Together we will decide how best to approach this according to what you need.
A Reflective Space in a Culture of Distraction
Sometimes the interaction between us will have a conversational flow to it. At other times you will be mostly speaking, and me listening. Or, if you are using art materials I will remain present, witnessing and 'holding space' for you to do so.
There will also be moments where there is a spontaneous pause. These 'silences' can be really important, because they allow each of us to think, and notice what is really going on at a deeper level. This might seem strange at first, partly because modern cultures don't tend to value space and peace, leading us to believe something is going wrong unless there is constant talk.
Pauses and silences in a session need not be prolonged and uncomfortable, they could be quite brief, and can become interesting and profound aspects of the therapy. Sometimes this can be where genuinely 'new' thoughts, feelings, and insights make their presence known.
Between Therapy Sessions
In some respects psychotherapy is not limited to the session itself. Particularly in 'open-ended' work the therapy finds its place in the rhythm of your life to some degree, and will likely hold some sense of significance. There is no homework or set exercises. You might choose to reflect upon the sessions in an intentional way, or as thoughts about them arise. Perhaps you would find benefit in something more routine like keeping a journal, or recording your dreams each morning.
Part of how the therapeutic process works is the very sense of it being a process. The 'therapy' doesn't happen all at once, it is more like an unfolding, and over longer periods of time it can come to feel that there is something quite natural about it. I think this relates very much to how the human psyche works; change can't be forced. Knowing that you will be returning offers a form of psychological 'holding' between sessions.
Beginning Therapy
At the start we aim to establish a safe and trusting connection between us, and part of this involves talking about the various details which can help the therapy to be reliable, consistent, and ultimately effective. These include the therapeutic boundaries and our roles, how we will arrange sessions, how the fee is to be paid, the cancellation policy, confidentiality, how holidays and breaks work, etc. Elements such as these all have an obvious practical aspect, and as part of the therapy we will also work with them on a psychological level.
I understand there may be a sense of urgency around getting to know the cause of problems, or even of finding relief from symptoms and situations. Whilst we want therapy to feel beneficial from the start, part of the work is often about slowing down, so we can really notice what's going on.
It is okay to climb down the steps into the shallow end of the pool, and gradually swim out to deeper waters, as you feel comfortable to do so. This will of course mean taking the risk of venturing into new territory at times, but first we form a trusting therapeutic alliance/relationship. Part of how we begin is about being careful not to leap straight from the top diving board.
Ending Therapy
It might seem unusual to do so at the start, but we will also acknowledge that at some point our work together will come to a conclusion. The purpose is to recognise whatever feelings there may be around this, and to encourage openness about it from the start. We might consider any significant experiences of 'endings' in your life, how previous therapies have finished, what might lead you to feel unsafe or that therapy is not helping and leave prematurely. You may be aware of patterns around endings that you would like to work on, or that we keep an eye out for.
You are always free to end therapy at any time, but it is usually considered best to arrange for this with your therapist, so the ending phase can be a beneficial part of the work, through being consciously thought about within the therapy. At the start we will consider how we might recognise when we reach a good point to finish therapy. We will then review how things are going along the way. Sometimes this is at fixed intervals, or could be done more spontaneously.
The Alliance At The Heart Of Therapy
Our working alliance is intentionally different from other relationships in your life. It is important that the only relationship we have is that of client and therapist. This allows you to relate to me in a very different way than if we were friends, relatives, colleagues, teacher/student, etc. The neutrality of the therapist allows something different to happen, because if there was any other kind of relationship happening then you would have certain responsibilities towards me.
Within the therapy relationship nothing is expected of you other than payment of the fee, and that we both adhere to the boundaries around safety and personal respect (which we will cover prior to beginning therapy).
At times it will feel like there are elements of other kinds of relationship present between us, and you will inevitably experience a variety of feelings towards me. That is quite normal, and we will utilise the relationship between us as something beneficial to explore. Working with responses and patterns of relating that we observe within therapy offers a valuable window to help us understand your inner world.
Your patterns of relating and attachment that exist for you in other relationships will also appear within the therapy, in one form or another. Sometimes we will can observe this between us very directly during the session, and on other occasions it might be less central but we notice something specific around the edge of therapy. For example, how you feel about breaks, paying the fee, or arriving late to a session, could all help lead us to a deeper understanding, if we choose to think about it carefully.
Although the therapy situation is a kind of construction it doesn't mean that the feelings arising within it are not real. This might sound like a paradox, but in many ways it is what allows the experiences in therapy to be deeply authentic.
The Importance of Boundaries
The boundaries of the therapeutic alliance make it a safe space in which to explore a whole range of themes regarding relationships in general, in a way that wouldn't be possible if we were forming any other kind of relationship. This is because no matter what thoughts and feelings appear, we are both fully aware that our contact is limited to the therapy session itself, and any necessary admin emails.
Your expectations of me may vary at times, and that is something for us to explore. Fundamentally though I remain only your therapist, there to support you in a particular way, only during the session itself. What you tell me in the session, and in any written communication is strictly confidential (although there are limits to the principal of confidentiality in certain situations).
I keep my personal life mostly private, not to be distant, but to give full attention to your experience.
Your Role In The Process
You don’t need to arrive with answers. The spirit of enquiry is enough. This means a willingness to stay with what emerges, and to explore it together. Some sessions may feel insightful and illuminating; others more raw or uncertain. All are part of the process.
Psychotherapy can sometimes feel challenging, as well as rewarding. There will be 'lightbulb' moments of insight, followed by the work of turning new understanding into genuine acceptance and change. We enter into this process together, and I accompany you on the journey.
Psychotherapy (as I practice it) is not something done to a passive patient by an active 'expert' therapist, neither does it mean the client does everything by themselves. Instead, it is a process in which we both willingly participate, and the healing factor is something which develops out of the relational space between the client and the therapist.
Past, Present, and Future
Psychotherapy is rooted in the present. We will often consider aspects of your past, because this helps us to understand your development, and see how previous experience influences the present.
The purpose of noticing these details is about recognising responses and patterns (of emotion, thought, and behaviour), some of which you may not be aware of as 'patterns' because they are unconscious, and 'just happen'. Quite often these develop in order to meet a need for protection of some kind. Responses and patterns that served you well at some point in life, might continue in situations when they are not necessary, and begin to limit the full expression of your being.
Noticing how the past appears within the present helps us to think about what you might want to be different in the future. One of the key aims of psychotherapy is to open up space to notice the details of what is happening in your life, and reach a new understanding of why. You may then discover that there are possibilities and options for something to be different, where it previously seemed like there was no choice at all.
This may feel like venturing off of the map, and might bring with it fear about what happens if you do things differently. Working through this together and venturing into what was previously unknown can bring true transformation.
Attending to Suffering, and the Work of Transformation - Without aiming for 'perfection'.
What usually brings a person into Psychotherapy is some form of problem, difficulty, or challenge. It may be something very recent, or be known to have its origin in the past. A key aspect of the way I work is in how I approach the difficult stuff of life.
In line with the thinking of depth psychology, I encourage you to seek the meaning within the 'symptom.' This is about listening and watching carefully. The suggestion is that what might feel like something to be 'got rid of', is a communication from the psyche alerting us to the fact that something needs to change in some way. Very often the 'change' that's called for is acceptance of an aspect of ourselves. This is a move towards depth. From noticing the ripples on the surface, to realising that the ripples have not caused themselves.
We might ask a question something like this: What does it mean about the life I have, that it is necessary to experience this particular suffering, at this particular time?
The idea of uncomfortable experiences being necessary is not about some kind of deserved punishment, but to see them as having a certain purpose and function. It implies trusting our inner world, that there is not some kind of programming error, but that what is happening is quite natural, given the combination of our own unique personality and life experience. This has the benefit of respecting even our uncomfortable experiences as not being without purpose.
We hold the wisdom of what we need, what will really heal, deep within us, and our task is to access that. In this way our suffering turns from meaningless, into something that can be a guide, if we can come to understand it carefully. This isn't to glamourise suffering, but to suggest that we must be careful in seeking to simply try and remove it, because in some way it is part of us and asks for our compassion.
I appreciate that when someone is in distress or feeling an urgent need for change, the main feeling is usually something like, "I just want this pain to stop." Or if the 'symptoms' have come about due to mistreatment by another, then it might seem like blaming oneself to look within. But this is where compassion is so important.
For a time maybe all we can do is bear witness to our own suffering with honesty, and we begin tending to the wound simply by acknowledging - "yes, this hurts." The task is then to make sure we don't remain in that place, remembering that this is not all of who we are, and begin making steps to regain our sense of 'wholeness' that includes the wounded aspect.
Working Through
One of the main reasons that therapy can often continue for an extended period of time, is because it can be difficult to change. We often find that in our efforts we may encounter the same problem over and over. This is known as 'working through', and it means continuing to work towards deeper understanding of ourselves when faced with the challenge of doing things differently.
We might feel that we are back in exactly the same place. Staying in therapy can help us to realise that whilst there may be elements that are the same, some things have changed. The process of transformation might be thought of as like a spiral; you're moving round an issue and inevitably meet with a similar view every now and then, but it's not exactly the same because you have also travelled vertically and are really in a different place with a changed perspective.
Taking the Next Steps
If you're curious about whether we might work well together, you're welcome to get in touch to arrange an initial consultation.
To contact me please use the email address or contact form below (also at the foot of any page on this website).
It is useful to mention some general background about what brings you to therapy, but there is no need to include personal information.
I always respond to enquiries within 48 hours (unless on leave). If you do not see a reply please check your 'spam' folder, and contact me again if necessary.
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