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Really, Really Tough Questions About Therapy

July 7, 2017
by Brian Baumal  |  Add Comment

A) I don't get how therapy works - explain it to me
B) In therapy I will blame my parents
C) Maybe I should just take a vacation instead
D) There is a stigma attached to therapy
E) How can working on my past help me now?
F) What's the difference between therapy and coaching?
G) Is it true I may get worse before I get better?
H) I might feel foolish
I) Why can't my friends and family help me?
J) I feel weak if I have to ask for help
K) Will a therapist put some weird ideas in my head?
L) Why should I pay money just to talk to someone
M) Why do some people call it "cycle-therapy"?  Will I stay in therapy forever?
N) Do Therapists Have Flaws?
O) Can Therapists Read Minds

A) I Don't Get How Therapy Works - Explain It To Me: There are two parts to therapy - The Therapeutic Relationship & The Therapy Technique.  Every form of therapy requires a good relationship, one where you can feel free to talk about anything or nothing, one that is emotionally responsive and one where you don't feel judged.  Consider the relationship like the therapist's "bedside manner".  The Therapy Technique is like procedure that the therapist uses - there is CBT, DBT, Present-Centered, Existential, Gestalt, Adlerian, Rogerian, Psychoanalytic and the list goes on.  When you talk about yourself in this kind of environment, and when you examine parts of you in a different light than before therapy begins to work.  Within a few sessions you will know whether talking to the therapist is going to produce results.

B) In Therapy I Will Blame My Parents - No you will not.  It is should be obvious that parents do play an important part in your life, so that means we will discuss them, but it does not mean we will blame them, nor will I force you to  "over discss them" or draw conclusions about you that don't make sense.  Your relationship with your parents is treated with the importance and care.

C) Maybe I Should Just Take A Vacation Instead - I am all for vacations helping mental health.  In fact I remember one medical doctor, specializing in treating certain chronic conditions saying to me "I wish all my patients would take a vacation" for their mental health.  I then asked "Well, does the vacation cure them of their condition, and if not so, why are you in business?"  Of course, he got the joke that vacations are helpful but not curative.  Basically, one needs to do everything they can for their mental health.  Vacations, yoga, spas, new-age techniques and therapy all work together to give you a fighting chance for a life you want.

D) There Is A Stigma Attached To Therapy - You bet your life there is, and brave souls need only apply.  On a more serious level, taking a step towards any change is difficult, and at the same time it is a great act of courage.  I can guarantee that the people who will make an issue out of you being in therapy do not have the courage to do it themselves.  You have my permission to look down your nose at them knowing you are the better person ;)  Note too that therapy is not just for mentally ill people.  In the 100 years since therapy has been around, it has evolved to help people in all walks of life.  As a therapist I am amazed at the number of well-adjusted  people I meet and talk to who say to me "Hey I was in therapy for a while."

E) How Can Working On My Past Help Me Now?  It is a huge misconception that therapists "work in the past".  We talk about the past but work in the present.  The misconception comes from two areas.  First, everyone thinks that therapists are like Sigmund Freud and his ability to say something like "your mother didn't breast feed you when you were young, and this is why you cannot hold on to money, you're cured."  Though Freud's shadow does still loom large over psychotherapy, much has changed.  It's just like you would never expect to ride on a commercial jet liner that was 100 years old either.  The second truth about therapy and one's past is that therapy talks about the past, but it works in the present.  For example, you may be talking about an issue that happened in childhood, and I may say "looking back at that experience, what do you wish you had then that you have now?"  The goal is to simply mobilize some of stronger, more adult parts of you that are resources to you in the present (e.g. bravery, intelligence, humour) to help put the past into some context.  In this way, you actually give your present resources a renewed sense of strength. 

F) What Is The Difference Between Coaching And Therapy?  Psychotherapists in Ontario are regulated and have to meet certain standards of education and conduct or face discipline.  Beyond this coaching helps people reach certain goals - along the way, they may find out stuff about themselves.  Therapy works in the opposite way - people find out stuff about themselves and then reach goals.  It's a much more open-ended exploration.  I have found that patients can chose the form of self-help that best suits them.  However, those with serious psychological conditions should consult a therapist, or even their family doctor for self-improvement issues.

G) Is It True That I May Get Worse Before I Get Better? Sometimes the therapeutic process can be new and seem unknown for the frst few sessions.  The best thing you can do is talk to your therapist about these as they happen - in fact within the first few sessions you should feel that you could talk to the therapist about anything, including ambivilent feelings and know that the therapist will be able to address your concerns.  In fact the therapist can often use them to propel your growth and change.

H) I might feel foolish - It is really difficult to really open-up to a stranger.  In fact, one quickly realizes in therapy how different it is to open up to a therapist than it is talking to a friend or family member.  You have probably never opened-up like this before.  At the same time, as a result of taking that risk you will learn more about yourself and will eventually become more comfortable with revealing your feelings. When you have achieved that degree of trust, you will have unlocked your potential for growth, self-discovery.

I) Why Can't Friends And Family Help Me? Friends and family definitely can help you, and they should.  What you may tend to notice about friends and family is that you get to a limit with them.  You may not be able to discuss certain topics (money, sex, illness, other family/friends), and they may not be able to provide the help you need.  Sometimes a friend or family member just may not have the time you need in order to be helped.  In many cases, people may avoid discussing real issues, or seeking too much help from friends and family for fear of straining the relationship.

J) I Feel Weak If I Have To Ask For Help. There was a commercial a long time ago for a dandruff shampoo, where someone says to a person using the shampoo "Hey, I didn't know you had dandruff" and the shampoo user says "Exactly."  However, the shampoo user may have had difficulty using it, or lifting it off the shelf - but the benefits are clear.  It is difficult to ask for help, especially when we feel we have so many other ways to try to cope with our problems.  Therapy is but one way of dealing with the issues we have, and there is nothing wrong asking for help.

K) Will A Therapist Put Some Weird Ideas Into My Head?  I certainly will not, and neither should any other well-trained psychotherapist who practices a recognized form of psychotherapy.

L) Why Should I Pay Money Just To Talk To Someone? I would wittily argue that you're not paying money to talk to someone but that you're paying someone to listen - and that should largely answer the question.  However, the person to whom you are paying the money is trained to move you forward - so you should be getting good value for your investment.

M) Why Do Some People Call It "Cycle-Therapy" And Will I Stay In It Forever?  The length of time you stay in therapy is dependant on a number of factors, but I can assure you that my goal is to get you out of therapy so that you can tell others that I've done a good job ;)  On a more serious note, there's the standard answer that therapy will uncover other issues that need to be worked-on and the process thus goes on-and-on.  This is sometimes, but very rarely true.  If you have come-in for a specific goal and feel you have reached it, you can and should consider terminating, even if there are other issues you wish to work on - you may find other ways of dealing with them.  Also, certainly the severity of the condition will dictate the length of time involved.  What I will say though is that my goal is to resolve the issue you came in with quickly and efficiently - and on average this takes about six months.

N) Do Therapists Have Flaws - You bet we do.  Two points on that.  First, woud you rather speak with someone who has experienced and understands the issues you are going through, or would you rather have someone who's had the life of Brad Pitt for example?  Second, the reason we don't talk about our flaws is that the session is YOURS, not OURS.  If we open-up too much, we run a number of risks including taking time away from your issues and making you feel less comfortable talking about certain aspects of your life.

O)  Can Therapists Read Minds - Alas, we once could.  However, now it seems that every time we try, we are now prompted for a password and the name of your favourite pet in school.


Brian BaumalBrian Baumal is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario.
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