Why bother with therapy?
One reason will be to get support from another person to obtain some helpful change in your life – as you’ve struggled to manage this on your own to date. In my experience, most folk enter therapy to seek some change in their lives. It’s not essential to do so, but likely.
So, how much do we know about what goes on in therapy that is helpful? Is there a difference between what is helpful in therapy and the things humans do to make a change?
The language is tricky here and can involve complex definitions. More troublesome, those definitions may vary according to who is speaking: a therapist, a client, a close friend or family member or a researcher, and so on.
In the US, a helpful therapeutic action is termed a ‘corrective experience’; that is experiences in which the client comes to understand or experience an event or relationship in a different or unexpected way. I’m surprised that it is used in the US where the term ‘Correctional Facility’ has very particular meaning, associated with seeking enforced change. ‘Correction’ implies something needs to be remedied, i.e., that there is already something that is “incorrect” and should/must be “corrected”.
Given this implicit judgement, I will avoid this term. Such judgement begs the question: who wants the ’correction’? It could be a ‘client’, a therapist, a spouse, a parent etc.
It may be possible to minimise judgement by talking of the experience of moving from one place to another, psychologically. This works as long as we avoid another implicit judgement – that the ‘move’ arises from what happened during a therapy session or soon after a session (when, for example, there is a eureka moment at home).
It is just as possible that there is sheer happenstance in the ‘move’, when it comes. It can arise from:
- The passage of time; the necessary delay involved to help ‘the penny to drop’.
- From other peoples’ intended actions happening to fall when a ‘client’ is susceptible to making a change. A therapist is only just one such person.
- From unintended actions taken by the ‘client’ or another between sessions, high emotions lead to a row and that row has its own consequences.
- From intended or unintended actions taken after therapy has finished when the therapy may have primed the ‘client’ to act differently. This can happen when post-hypnotic suggestions or affirmations slot into place.
- Moves that happen and no-one notices, even though there is benefit or suffering from the change (see the Johari Window).
Such complications make it important to assess the mechanisms that promote change. How does change happen? I have devoted a few pages to this topic and I trust these are helpful. Look for:
For me, it is more about how you come to know a change has been made and how aware you are of the impact of that change on you and others around you. This means evaluating whether the change is helpful and, if so, to whom. There are two different issues here:
- there is the process of change that can be described, and
- there is coming to a judgement about that change and what it has done. This is an ‘evaluation’: was the change, good, bad, indifferent or confusing etc?
When I taught on a vocational programme in university on a vocational programme, many students made large changes in their lives. Simple exposurer to the programme, meant that their views on the world would change. Their attitudes towards important relationships very often changed. If the student had a changing view of those events; then their loved ones often had very different views.
Therapy can have the same impact on us and our families and our friends.
I think it is important to be aware of one important change: the change in perspective of ourselves and those close to us. In short, before starting therapy, consider:
- how potential change experiences might come about?
- what you may be exploring in therapy.
- how you and others may feel about likely changes.
- how you and others might perceive those changes (differently) and be impacted by them.
- where perceptions of your key relationships might go.
- how such change experiences might come about.
- where the unintended outcome of change might take you and your important relationships.
These are not easy matters to consider: how can you know what you do not know, you may tell me. Even so, make these questions part of pre-therapy ‘safe experiments’ so you can make some preparation. Only you can decide on how much preparation. There is a price to be paid for too much preparation, and for too little prepartion.
In time, and with the support of therapy, you will just notice – even record – helpful events. You will identify changes that appear to transform you and your life.
For my part, although nothing can be guaranteed, I’d hope therapy will enhance your curiosity. How can you create novel experiences – some unexpected – without curiosity?
I’d want therapy to promote a more positive outlook in your life and the opportunities facing you, as well as an acceptance of what is acheivable and not acheivable. What other changes can arise from therapy:
- Change in the sense of self, a stronger, positive sense of self (who we are).
- New awareness of experiences; in the body, relating to the emotions or behaviour of ourselves and others.
- Recognition of hope, or finding reason to hope.
- Acquisition of specific new skills through practice, e.g. affect regulation or thought stopping.
- Changes in specific behaviour, whether in work, within the family or friendship network.
- Recognition of an action or a feeling that appears to be getting worse and growing confidence in our ability to ‘look it in the eyes’.
- Changes in the quality of relationship between ‘client’ and therapist over time.
and what do we know about therapists and clients that get these ‘better’ results?
The following helpful experiences have been reported in research as helping get results:
- engaging in mutual collaboration with the therapist.
- begin ’emotionally present’; that is, saying what I feel, now.
- a feeling of autonomy and open reflection on who we are, and
- the ability to explore significant relationships in a problem-oriented manner.
- taking personal responsibility and knowing what is mine, and what is yours.
- letting go of the past, and still knowing the past.
- feeling ‘understood’ by another person.
If your relationship with a therapist can:
- generate a positive relationship; that is, be a person, without being intrusive;
- foster awareness and understanding of ourselves and our environment;
- demonstrate a nurturing or empathic response;
- self disclose without hogging the floor;
- be facilitative – that is, make things happen;
- be helpfully re-assuring – a ‘safe pair of hands’;
- be empowering of themselves and others;
- give consistent feedback, one to another; and
- help to identify problems that are around and changes that are occuring.
….. then this is evidence of progress and effective work. Please bear in mind that all this includes loving confrontation – that is, the ability to speak plainly without giving or taking offence. As folk who know me, I have self-disclosed the ability to be ‘gobby’ and I ask to be told when that quality gets in the way of our work.
Research has emphasised that therapist friendliness, positivity and light humour can make an important difference. A key quality, know for years, is the ability of therapists to remain non-judgmental. Without that quality, it is difficult to disclose or open up to another person.
Frfom my point of view, a good client and a good therapist know how to step outside the Window of Tolerance and to keep on the scenic route most of the time.
A Safe Experiment
Turn to this page, and print of a picture of the face I provide some way down the page:
Fill the page with your own preferences for the ideal therapist. Do not edit your thoughts in the first place.
CONSIDER: when you consult a potential therapist, to what extent do they fulfill your requirements?
CONSIDER: To what extent do you need to revisit your requirements in order to negotiate a working relationship; a good alliance with some-one who can help you change.