I am a retired Clinical Psychologist and psychotherapist who has spent the last thirty-five years in clinical practice, talking to people, both old and young, about the things that trouble them.
Their problems have ranged from difficulties in family relationships, or at work, to recovering from recent sad, frightening, or traumatic experiences, or those unforgotten from earlier in their lives.
Like all of us, they want to feel loved and safe, which can be a challenge when life has delivered curved balls.
Since this applies to everyone to some degree, I see psychotherapy as offering a particular kind of listening, whereby people are helped to gradually make sense of what they are experiencing, and to get on with their lives, less tripped up by feelings and behaviours that made it hard to love or feel lovable, to work, and to play.
I thought it might be helpful for readers who have not experienced psychotherapy before, and who wonder what happens when you visit a psychotherapist, to demystify this process a little. Having said that, it is important to acknowledge that when it comes to psychotherapy practice it is difficult to generalise.
Just as in parenting, where it has been said that each child in a family has a different parent (Winnicott), due to factors such as the personality of each parent and child, birth order, life experiences etc, so each person beginning therapy will have a different experience, depending on the unique relationship that develops between them and their therapist. Research has demonstrated that the quality of this relationship is one of the most important factors in a good therapy outcome, much more important, it turns out, than the specific therapeutic approach of the therapist.
This is not to say that all therapy models are equal, or that any approach will do. It is important that the person to whom you entrust your mental health is qualified and registered with an appropriate body. In Australia all psychologists must be registered with the Australian Health Practitioner Regulation Agency (AHPRA). It is important to verify this when you make an appointment.
Evidence shows that improvements in therapy are also related to a therapist’s willingness to check in with you about how things are going. So, while you can expect it might take a little time for the two of you to get to know each other, if you are not feeling like the relationship is a good fit, or you are not finding the process helpful, it is important to discuss this with your therapist, and if necessary, seek help elsewhere.
Most therapists will begin their work with you by asking about the reason for your visit. While they may already have some information from a doctor’s referral, I think it is important to hear from the person themselves how they see their problem. Sometimes people find it difficult to put a finger on that, just knowing that things don’t feel right. This is perfectly normal – it is the therapist’s job to help you sort that out.
Generally, psychotherapists are interested in your history because it helps to understand what might have contributed to your current problems. Some people can be reluctant to talk about painful things in their past. Responsible therapists understand this reticence and will reassure you that you can take your time, and never be pressured into talking unless it feels safe for you.
Psychotherapy takes time. Just as growing a plant takes many hours of sunshine and water, so developing a more robust sense of oneself will be the work of months, not days. In Western Australia at the moment, Medicare will partially rebate the cost of ten session of psychotherapy per calendar year with a registered provider. The frequency of these sessions will be decided between you and your therapist. It is not at all unusual for people to see their therapist for a number of months or years.
Psychotherapists differ in the degree of structure they provide in their sessions. Some are quite structured in their work, with set exercises and homework. Others, such as me, generally find it more helpful to encourage people to talk about whatever is on their mind, and for us to explore this together. I rarely offer advice, as such, but rather find that people are quite good at knowing what they need to do, if only they could get out of their own way.
This reflects my training in a particular kind of “psychoanalytic” psychotherapy. Once again, different models suit different people.
Talking therapies are not for everyone, but at their best they offer a means of feeling more accepting of the person you are, more at peace with the events of your life, and more “real”.
Mindful Margaret River is an alliance of mental wellbeing professionals, government agencies, community members and the Augusta Margaret River Shire to promote health and wellbeing.
First published in the Augusta Margaret River Mail, 20 November 2020