A few weeks ago I heard a polite bellow from our waiting room.
"Hello? Your food is here!"
"Oh, thank you! Here, let me just sign this..."
The deliveryman shifted his weight. "What do you all do here?"
"Well we do meditation and therapy. I'm an art therapist."
"Oh!" he laughed, "I tell all my friends I'm crazy! Maybe I should come here! If you think you can handle me!"
This short interaction is fairly common for anyone who works in mental health. There is a discomfort, a feeling of vulnerability or alienation, which sometimes arises when a person who is unfamiliar with the work of therapy is unexpectedly introduced to it. There is a curiosity about something new, but so often it is paired with fear.
"Can you tell what's wrong with me if I draw something for you?"
"Are you diagnosing me right now?"
"Oh no, I shouldn't have told you that!"
To me, these kinds of comments illuminate just how urgent the need for transparency is in mental health. Working one on one in a soundproof room, discussing intimate details of ones experience - and the necessary confidentiality of those conversations - makes it more difficult to openly describe what therapy looks like.
Within that private space we as clinicians are using evidence-based, reasonable, concrete exercises, interventions, and ideas to help people better understand themselves and navigate their world. Unfortunately, if you don't know that, you may assume (as many do) that therapy is something more nebulous or spooky.
One of my biggest priorities when working with my clients is to be transparent in the work. I want to make sure that everyone who comes to see me knows exactly what they're getting into and, as informed and empowered consumers, they are able to make their own decisions regarding their care. In that spirit, I would answer a few questions I've been asked about therapists and the therapeutic process.
Q: Why is my therapist checking the clock? Is she bored?
A: No! As you are talking, your therapist is listening intently to your words and coming up with ideas, questions, or interventions that might help you. If there is a question that could open up a bigger topic, she wants to make sure you both have enough time to get through it.
It wouldn't be fair if she asked a big question five minutes before you have to go. As with any deep conversation, we need to plan for a transition from that depth, to you walking out the door. It feels weird to walk about of therapy without getting yourself ready for the outside world.
Q: Why do we have to meet so often?
A: Thinking of therapy as a medical or emotional intervention can often lead to frustration about scheduling. Therapy is not a doctor's visit. Therapy is more akin to physical therapy, where you are exercising muscles to heal from an injury, or a class where you are learning a new skill.
Therapy can also be seen as regular part of your overall well-being, like brushing your teeth or taking a shower. While some sessions can lead to dramatic bursts of insight or compassion, most of the work is done one small step at a time, as your brain and body reorient themselves.
Q: What if I scare my therapist? How can I trust that he will be able to handle what I have to say?
A: There is a common pop culture trope of the villain going to a well meaning, but incompetent therapist and promptly blowing their minds with thoughts of death, despair, or audaciousness. While your therapist hasn't heard your exact story, he'll be okay.
Most therapists have built a team of support around them to help them process the pain they hear in a day. Supervision, integrated loving relationships, supportive colleagues, and of course their own therapist are all integral to helping him stay grounded. A professor of mine once remarked "anybody can be a therapist, you just have to care. You come to school to learn how to be a therapist and not go crazy."
Therapeutic ethics, boundaries, and professional support are all in place to make sure that you can speak to your full experience, and trust that your therapist can hear you and help you.
If you are interested in therapy, or have questions about your current therapy, please don't hesitate to ask! We love talking about our profession, and sharing just how awesome this work can be.
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