How does therapy work?
I thought that it would be helpful if I shared an introduction to therapy blog post. Above is a picture of me in the therapy room that I work from in Surbiton, Greater London. This might be helpful to see the environment that sessions take place in. Therapy rooms are calming places, they are designed and decorated to be as calm as possible, this is so that you feel comfortable and so that you can talk freely. The chairs are comfortable, and you sit opposite your counsellor. And you talk through what is on your mind. There’s often tissues available, in case you cry. Crying is okay in therapy, I think it is okay in most situations but I like my clients to know that they are welcome to cry in therapy. I have cried a lot in my own personal therapy sessions! And it has been very helpful. Did you know that when we cry we release stress hormones in our tears?!
Your therapy should take place somewhere quiet and confidential. There won’t be anyone else in the room, it will be just you and your therapist unless you need a translator for example, but this is rare and often there are counsellors available who speak your preferred language.
What is the difference between therapy and counselling?
Well, this is debated in the field. Personally I don’t think there is much difference. I think the word counselling is used more in the UK and in the USA the word therapy is used more. Just to confuse things more the word psychotherapy is also used, amongst many others. None of these terms are protected by law, meaning anybody can use them, even if they aren’t trained. So it is important to only use a counsellor or therapist that is appropriately trained, so they should be on a Professional Standards Authority accredited voluntary register such as the British Association for Counselling and Psychotherapy, like me, or there are other registers like the British Psychological Society or the National Counselling & Psychotherapy Society. This ensures that the counsellor or therapist works to certain ethical standards. They will often have a certain amount of supervision with a more experienced therapist per month and a certain amount of training to undertake each year.
Counselling is perhaps more listening based. Therapy suggests that there is more intention and planning behind the therapist’s interventions. Counselling is a type of therapy. The terms counsellor and therapist can be used interchangeably. When it comes to a psychotherapist they may have had more training than someone who calls themselves a counsellor, but not necessarily. Experience is also important to check.
What will happen in a therapy session, what’s it like?
They are around 50 minutes long, that is how long my sessions are. Some therapists work longer and others for less. I have had therapy that’s 50 minutes long, but I have also had therapy that was 1 hour. It depends on how the therapist chooses to work. But it will be for the same length of time each session, unless you agree to have a longer one. Sometimes you may need a 90 minute session for example, but not all therapists offer this. Sessions are usually at the same time each week, so you will meet each Wednesday at 9am for example.
In the session your counsellor will listen carefully to you. A big part of counselling is active listening. Sometimes people haven’t experienced this much, so it can be strange at first. But the idea is that you can understand yourself better when there is someone else there who is curious about your feelings and actively trying to understand what you’re talking about. 2 minds are better than 1!
They will ask you questions which are often open ended to help you to reflect further on your current predicament. This can be really helpful, particularly if you are confused about something, or maybe you have been avoiding a feeling and you needed to sit with someone else who isn’t going to judge you, in order to explore something painful or upsetting. Someone else offering you acceptance can help you to accept yourself, and you can learn more about yourself. Sometimes we don’t acknowledge our emotions much, and therapy encourages us to do this. Embracing emotions is key to emotional literacy. We can manage our emotions better when we understand them. We don’t want to be ruled by our feelings, it’s not pleasant when our emotions feel out of control.
What happens in the begininning?
There will usually be an introductory session in which the therapist will ask you lots of questions, more so than a usual session. Afterwards sessions will be more open and you will be able to talk about what comes up for you in that week, or whatever you would like to talk about. It is interesting what comes up sometimes. In that first session they will be asking things like who do you live with, are you taking any medication, if you work or study, about the people in your life and how you get on with them, about any previous therapy and how it went etc. They are just trying to get an overview of your mental health and you current life situation as this is important context. They will also ask you if you have self harmed before, or if you are experiencing suicidal thoughts. This is so that they can support you and keep you safe. They will also speak about any boundaries or anything that’s part of the agreement, such as what confidentiality is and any limits to it. No ethical therapist will promise complete confidentiality without any limits, this is because sometimes, for your safety, confidentiality has to be broken. For example a therapist might contact your GP if they were concerned about your wellbeing, but this is usually spoken through with you first. They may ask you to sign an agreement about the parameters of the session to show that you agree to what has been offered. You will set a goal or 2 about what you would like to focus on in the sessions. Usually people come to therapy for a reason, there is something they would like to explore or work on.
What is therapy like?
It is very special and intimate. It can also be difficult. You are given time and space to explore aspects of yourself or your past and this can be really healing. It is comforting to know that you are being listened to and you are talking to someone that cares about you, and that they are not a family member or a friend, they are separate from that part of your life. So you can really open up. Your therapist won’t share much about themselves and this is because the focus is on you. When you have worked with a therapist for a while they may share more about themselves, but the focus should always be on you.
I have had some unhelpful experiences with therapy. So I would encourage you to choose a counsellor that you get on with, it should be someone that you feel comfortable talking to, someone that you trust and someone who you feel heard around. I worked with a therapist for a while and they used to yawn during our sessions, after a while it really started to grate on me. I ended up leaving this therapist and found one that I got on a lot better with. The sessions were in the evening time, so I’m sure that they were tired and it probably wasn’t personal, but I found it distracting enough that I couldn’t talk about what was on my mind without getting distracted by the yawning! I share this story to let you know that you can change therapists, and you don’t need to work with the first one that you meet. Try a few out!
Therapy has helped me a lot at different points in my life. I had a period of life where I experienced lots of bereavements in the same year and so having that space to talk about everything I missed about those loved ones was incredibly valuable. It was moving (in a great way) to have someone listen so carefully to me talk about how I felt. With another therapist I talked a lot about my past experiences and she really encouraged me to honour my feelings and to challenge myself, doing things slightly out of your comfort zone allows you to grow. When you form a therapeutic relationship you can analyse your personality, habits and feelings with them. It is very insightful.
I hope this has been a helpful post. There are many different therapists and many different therapies out there. Just make sure that you find someone who is on a recognised ethical register, someone who you get on well with, and make sure that you actually want to take part. Therapy is something that works best when you want to do it yourself. Have fun searching! And most importantly I hope that your therapeutic journey is enlightening. If you would like to know more then please get in touch, I am always happy to answer questions!
