Making the most of therapy

This section is for questions relating to therapy, assessment, formulation and other aspects of working with people in mental health services.

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lingua_franca
Posts: 902
Joined: Tue Sep 14, 2010 11:29 pm

Making the most of therapy

Post by lingua_franca » Thu Jan 31, 2019 12:41 pm

I'm doing a course on psychoanalytic/dynamic approaches to child mental health at the moment and I decided to have a weekly session of psychodynamic therapy myself, as the course tutors recommend it. (They also recommend psychoanalysis if you have the means, but that's expensive, not to mention far too full-on for me even if I had the money!) This is a new experience for me, as in the past I have only sought out therapy to address a specific problem. This is the first time I've gone in with nothing particular in mind other than better appreciating the material on the course and enriching my work with children. I'm thinking about how to get the most benefit from my therapy time.

I can identify some patterns of transference (there have been several points where I have felt that the therapist is judging me, but reflecting on it I can see that this is my own self-critical inner voice) and it's already been helpful to me in making me realise just how deep my self-criticism goes. I wasn't aware of its extent before. However, I have also started to feel as though the therapist is trying to identify problems where there are none, perhaps because she is also more comfortable in treating named difficulties than in this more open-ended exploratory work. For example, in one session I ended up talking about a time I'd been swimming at the beach as a child, and I'd skinned my knee on the rock and plunged straight into the water - the cut had stung badly at first, but then the salt had cleansed and soothed it. I commented on how I felt that discoveries made in therapy could sometimes be like this, first stinging and then leading to some peace of mind. To which she responded, "Do you cut yourself, Lingua?" :shock: I can, err, see where that question might have come from, given the emphasis on free association in this type of therapy, but I did feel that it was clear from my wording that I was using an allegory, so it seemed like a bit of stretch.

It's a struggle for me not to rack my brains for difficulties I want to target as I approach each session, rather than just keeping it open, and last time I caught myself hopefully offering her a time I'd lost my temper with a student (adult), thinking that this might constitute 'a real problem'. :P (Now I'm wondering if I feel that I need real concrete problems in order to be listened to - this therapy certainly makes me think, which I suppose is the point.) I'd be really interested to hear how other people make use of therapy professionally, what it looks like, and how it benefits your day-to-day work.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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ChrisCross
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Joined: Thu Jan 26, 2017 8:37 pm

Re: Making the most of therapy

Post by ChrisCross » Fri Feb 01, 2019 7:43 pm

Hi Lingua,

Thanks for sharing your experience - it raised some interesting questions in my own mind about the purpose of therapy (which I guess is totally different for each of us and that's the beauty of it, I think).

When I started my DClin training I met with a CAT therapist for a handful of sessions, which were supplemented by the course. Since that ended I decided to self-fund some weekly sessions with a Jungian psychotherapist and have been finding them really useful for both professional development and personal well-being. In fact, I was going in for a session just this morning when I read your post and it made me smile because I think I can relate somewhat to the struggle you described about racking your brain for a target problem/difficulty. I wonder if the way therapy services are structured in this country can sometimes imply that therapy = fixing problems. Even when I suggested that I wanted to see a therapist to a course tutor I was told "but that implies you have a problem that you want to fix?" A shame really, because I think being on the receiving end of therapy can offer so much - least of all because we get to experience what it means to be "on the other side of the chair." I do think it should be a compulsory part of training to be honest.

I remember it feeling really alien when my therapist simply sat with me in silence at the beginning of the session and I had thoughts like "ok, so we're doing this now are we?" and "so you just expect me to sit with whatever is going on inside of me and see what happens?!" But I've since realised that it was the most compassionate thing my therapist could have done for me. It meant that whatever came up was totally my agenda and she was demonstrating that she was really listening intently to what I had to say. At the beginning, I'd do anything I could to avoid eye contact; I'd look at the floor or the paintings on the wall and desperately scramble for something to say. I still feel a lot of pressure to "bring something" to sessions (and sometimes I do - I find dreams can be especially helpful to explore). But I think, over time, I'm getting better at just noticing what is going on in my mind and body and allowing the session to unfold in an organic way.

I personally like to approach my therapy with a bit of playful curiosity too. It can be an opportunity to challenge social conventions and say or do things that you wouldn't ordinarily say or do in the presence of other people. For example, I've always seen myself as a logical and methodical sort of person and until recently hadn't really given much time to the creative and sensitive aspects of my personality. Therapy has helped me to become more 'in touch' with this part of me whilst simultaneously exploring the reasons why I had closed it off for so long. The other week, I decided to bring along a poem I wrote and share it with my therapist (even now I cringe just admitting that I wrote a poem, but hey, I'm sharing that on a public form so I guess that has to count for something!)

Also, if you ever feel like your therapist is making assumptions in the interpretations that they offer then I would totally encourage you to call them out on this. Whilst another person's interpretations can be helpful in accessing the unconscious, we're ultimately the experts in our own experiences and a good therapist will respect this and allow you to take more of a lead.

Lancelot
Posts: 253
Joined: Sun Dec 27, 2009 8:07 pm

Re: Making the most of therapy

Post by Lancelot » Sun Feb 03, 2019 3:18 pm

Everything is grist for the mill in psychodynamic therapy, including feeling the need to have a target, to rack for difficulties i.e. what is that about. To think about the wider themes for example 'to be control of the process' which is understandable but likely to come from somewhere. I always considered free association one of the best features of PDT. You can be free to explore what is in the upmost in your mind, however trivial on the surface it appears. Freud apparently said as analogy to patients to "Act as though, for instance, you were a traveler sitting next to the window of a railway carriage and describing to someone inside the carriage the changing views which you see outside."

It is up to you but would it be worth keeping open to see what you discover...

Opentoideas
Posts: 10
Joined: Mon Feb 15, 2016 8:48 pm

Re: Making the most of therapy

Post by Opentoideas » Thu Feb 07, 2019 5:16 pm

I trained as a psychologist overseas and coming to working in England I really noticed a big difference in how therapy is viewed in society. In the country where I trained, going to therapy for personal growth or self-exploration is an accepted idea, whereas here it seemed to me that therapy was considered to be something only for people who had a problem.

In my training, it was a requirement to undergo therapy. Over the years I have repeatedly drawn on my experience of being on the other side of the fence (or couch) in my work. I recall times when I felt misunderstood by my therapist as well as times when I felt heard and accepted. Both of these experiences guide me in understanding what my clients might be experiencing and how I can attune myself to their needs. I do find it a bit strange that one can train and qualify here without ever having experienced what it is like to be on the other side. It's like being a mechanic who's never driven a car. No amount of theory can substitute for first-hand experience.

lingua_franca
Posts: 902
Joined: Tue Sep 14, 2010 11:29 pm

Re: Making the most of therapy

Post by lingua_franca » Thu Feb 07, 2019 5:52 pm

Thanks, all. I'm trying to rise to the challenge of being more spontaneous and just blurting out thoughts as they appear. As a writer, I've always been very interested in story and narrative, and how they are structured. Thinking about it, I suspect that it is this that gets in the way here, and not just my perception of therapy as a remedy for difficulties - the fact that when I sit talking in a room for an hour part of my brain is focused on having that coherent narrative thread and purpose. I need to learn to switch off writing and editing mode and just learn to speak freely. Chris, I really like your idea about approaching it in a more playful and curious spirit - I also see myself as quite a methodical person, and the idea of trying to find some freedom in it appeals to me.

It isn't the case that I've never had therapy before (I have - I just went in response to particular problems that I needed help with, rather than simply to explore), so I'd prefer to keep this discussion on specific ways to make the most of therapy time, and not on the pros and cons of having therapy in general.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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