Frequently Asked Questions About Therapy
How do I know if I should consider therapy? What would individual therapy be like? How does individual therapy work? How does couples therapy work? Why therapy isn't the same as talking to a friend Differences in therapeutic approach What does the term therapy mean?
How do I know if I should consider therapy?
Emotional Pain
There are many
valid reasons for entering therapy. If you are in emotional pain, if you
feel sad, lonely, anxious, or worried and have been feeling that way for
a period of time, therapy can often help. If you suffer from insecurity,
feelings of low self worth, or have difficulty making decisions, the supportive
relationship therapy offers can usually help you feel better about yourself,
get in touch with and clarify your feelings. Talking to friends may help
you feel better, but does not provide the kind of objectivity and insight
which produces real understanding and allows you to
change. A quite and supportive environment allows you to take
the time to stop, reflect and learn.
Unsatisfying, or Self Destructive Behavior
An equally
important reason to enter therapy is unsatisfying or even self-destructive
patterns of behavior. When you know that the behavior hurts you, yet you
feel stuck and unable to change it, a therapist can work with you to help
you understand and eventually gain control over the behavior. For example,
you are in a difficult or masochistic relationship, yet persist in it, despite
clear evidence that the relationship will not improve. Or you stay in a bad
job. Or you repeat behavior that ruins your chances for professional success,
or consistently and knowingly display attitudes that alienate people.
What these
patterns have in common is that they are driven by motives outside of your
consciousness - they are compulsive. By definition, compulsions are outside
your conscious control; attempts to 'will' yourself to change result in failure
and self-blame. The only way to gain control over compulsions is to unearth
and unravel the unconscious motives that drive them. Once you uncover the
underlying conflicts and motives, you can take actions to resolve these issues.
This awareness - making the unconscious become conscious, is part of the
work of therapy, and sometimes the awareness itself can dissipate the need
for the compulsive behavior and allow you to gain control of this aspect
of your life.
Alcohol and Drug Abuse
A particularly
potent form of compulsive self-destructive behavior is the addictive use
of alcohol or drugs. These substances are often used as sedatives or anesthetics
to escape painful feelings, and their use is a form of slow suicide. Many
believe that alcohol addiction is the number one health problem facing
America. If you do suffer from
substance abuse or addiction, treatment may include referral for temporary
medication in addition to psychotherapy, because we believe substance abuse
is often an attempt to medicate painful feelings, which are better handled
under appropriate medical supervision and in therapy. If you have developed
a full-blown addiction, hospitalization for detoxification may be
appropriate. Alienation and Insecurity
In some instances,
you may not be aware of specific painful feelings, but feel uninvolved, have
difficulty making decisions and a sense that something is missing, that things
aren't going well, but you aren't sure what the problem is. In that case,
our first goal is to identify what is preventing you from feeling better,
growing and making changes. Talking to a trained professional should help
you get in touch with your feelings and uncover what is getting in your
way. Low Self-Esteem
One important
reason to consider counseling or therapy has to do with self-esteem. Feelings
of low self-worth often accompany other issues, and are painful and damaging.
How you feel about yourself - and how you treat yourself - is crucial to
your well being. If low self-esteem is an issue, our goal is to work with
you to increase your feelings of self-worth, and to help you get in touch
with your strengths. While they wouldn't hesitate to call a doctor for a
flu or broken bone, emotional issues - equally real and potentially debilitating,
seem somehow less quantifiable. Relationship Problems
For couples,
you may not feel "heard" by your partner and have difficulty communicating,
or you may have specific differences around how to handle money, children,
or other issues. Your relationship may have turned tense and acrimonious,
or you may feel you are drifting apart. A partial listing of some of the most common problems therapy can help you with are:
Depression
What would individual therapy be like? Individual therapy begins with a discussion of what is troubling you. If we cannot pinpoint exactly what the problem is, we encourage you to discuss whatever is on your mind. We are here to listen in an accepting, nonjudgmental and attentive way. We encourage you to express any and all feelings and thoughts you are comfortable divulging. There is nothing you can say that is "wrong" - we are here to listen, learn and accept you and your predicament, and to gain an understanding of what brought you here. Because we are all very complex beings, gaining an understanding of your feelings, thoughts and motivations is a process that may take more or less time, depending on you and your situation. Therapy is a collaborative experience in which we work together to uncover the cause of your distress. Equally important, successful therapy helps you recognize and utilize your strengths.
How does individual therapy work? Your therapist's job is to create a safe, accepting and compassionate environment in which you can open up without feeling judged. During sessions, you are encouraged to talk about whatever is on your mind. While you talk, your therapist is listening intently and gathering useful information not only about your conscious concerns, but also about your thought processes, how and why you bring up topics, what emotions you express, your expectations of therapy. What may at first appear to be unimportant discussions can lead to valuable insights and deeper understanding over time, as your therapist works with you to put them in context. As
trust grows, a relationship
- or “therapeutic alliance” develops
in which you and your therapist work together on your inner struggles.
Defenses
begin to give way, allowing your
true inner feelings to emerge. There is no specific time frame for this to occur; it
happens gradually, fostered by your
therapist’s non-judgmental approach, which in turn fosters
self-acceptance. You begin to see yourself in your entirety - including
aspects of yourself that you may not have looked at before.
Facing those aspects of yourself with compassion and
understanding allows you and your therapist to work together on them.
During sessions, we unravel your situation and problems. The process
enables you to get in touch with your feelings and to develop a clearer
understanding of yourself and your situation. In successful therapy, you
get to the truth of how you feel, what you believe and how you act. You
begin to feel different and to integrate your new awareness and use it
in your own behalf. The
relationship with your therapist is important for another reason. In
therapy, you play out the expectations, perceptions and projections you
bring with you to your own life. This
living example of how you relate to the world provides helpful insights
for the therapeutic process. For
example, if you bring an expectation that your therapist will rebuke
you, the expectation itself becomes grist for the therapeutic mill.
It brings up the question of whether you expect or perceive the
world to be harsh and critical in general - and if so, is it because you
have been brought up in a critical environment and come to expect that?
How does couples therapy work? For couples with the goal of preserving and enhancing the relationship, we believe a good starting point is to help each member work on productive communication. Open communication is essential to maintaining a healthy relationship. Couples therapy provides a safe, non-judgmental environment in which individual members are helped to communicate openly with one another. Couples therapy helps you express what you may have difficulty expressing on your own. Equally important, it helps you learn to listen to what your partner is saying. This new, open communication is the first step to helping couples identify and deal with their underlying problems, such as disagreements over how to handle money, control, intimacy, and other issues. An important aspect of couple’s therapy is that your therapist is impartial, and does not take sides. Couple therapy can help you open up and have a more honest, intimate relationship. In other cases, it may be appropriate to help the couple disentangle and help each individual develop the strength to separate. For couples, when the goal is to preserve and enhance the relationship, we believe a good starting point is to help each member work on productive communication.
Why therapy is not the same as talking to a friend. Talking to friends can help you feel better, and may be sufficient if you are recovering from a situational loss, such as a recent death. But feeling better momentarily does not help you change underlying perceptions and patterns that continue to hurt you. When you talk with a therapist, a quite and supportive environment allows you to take the time to stop, reflect and learn. Therapy brings the benefits of professional guidance and deliberate effort to help understand you and your distress. A skillful therapist knows how and where to probe in a respectful and supportive manner -- your therapist is your partner, a skilled ally who listens closely to help uncover underlying causes. This process promotes the insight and self-acceptance that allows you to change. The combination of your therapist's acceptance, the collaborative effort, and incremental gains also work together to help build your self-esteem. For more information see "How Therapy Works". Counseling or therapy is not advice. Advice tells you what to do, but doesn't encourage you to develop your own strengths and resources to find answers for yourself. Advice keeps you dependent on the person or book that supplied the advice. That is why books also usually can't provide the type of help that therapy can. Therapy encourages you to search within yourself to discover your own answers and to develop the courage to act on them. The adage about the fisherman is a perfect metaphor -- it is far better to teach a man or woman how to fish than to give him or her a free meal. A free meal feeds you for one day -- teaching you how to fish allows you to feed yourself for life.
Differences in therapeutic approach While there are many different theoretical orientations or techniques that therapists can study, most share a common goal: to help you be more in touch with the real you, your feelings and needs, to increase your self-awareness and insight, and to help you have the courage and will to act in your own behalf. There are some exceptions to this goal; for example, "brief cognitive" or "behavioral" therapy focuses on specific symptom reduction. Whatever the theoretical orientation of a specific therapist, treatment begins with a compassionate environment in which you can explore your issues and feelings. I believe that each person is unique, that individual therapy should be tailored to your specific needs, and that successful therapy is flexible, pragmatic and interactive. For that reason, many of us have studied and absorbed various theories, and are eclectic, using various techniques in practice. In addition, during the course of therapy, a therapist may discuss and make referrals for medication, 12 step programs, or other specialized adjunct treatment.
What does the term therapy mean ? Although all psychological therapy has its roots in Freud's original theories, most therapists today are not "strict" Freudians, having modified their views in light of more current theoretical approaches. Thus the term "therapy" is generic and can refer to a wide assortment of approaches - most with the goal of self-discovery.
The terms "Analysis" or "Freudian Analysis" (often used interchangeably) both refer to a specific form of treatment practiced by Freud. Therapists who conduct strict Freudian Analysis not only subscribe to his theories, but continue to model their methods based on how Freud himself practiced almost a hundred years ago. Strict Freudian practitioners often see patients several times a week (Freud saw his patients six times a week). They also tend to be less interactive, and may ask you to lie on a couch to enable free association. This approach may or may not be right for you; for example, some people experience therapy from the couch as depriving as you don't experience the face-to-face interaction of other approaches. In adhering to a specific method, this approach is by definition not as adaptive and flexible as others.
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