Therapy has for most people been associated with something mystical. Before I started with psychology myself, I also had my mental images of it, and knew about the standard Freudian couch where you simply said whatever you wanted. I`ve heard about Freud, and knew you probably had to talk about your childhood, but had no idea how a typical therapist or patient looked like.
For people who haven`t been in therapy, it is often still a mystery. A lot of my friend have asked me, isn`t it hard to hear about so many horrible things, every day? But it’s basically what we all do, every day, anyway. We see films, listen to our friends, read books and watch news about what`s going on. Of course, we don´t have the “obligation” to do something about that, so people might feel that it`s different, but I promise you, a therapist is not more than a personal trainer cheering the clients on. We always stand by our patients sides when something needs to be done or untangled.
Even if I am a therapist, I still love to go to therapy or supervision myself. I don`t respond to the words, but simply to the fact that I talk with a human being about myself. It’s good to have someone there, who just say “it truly sounds like you had a rough time”.
This might still be a bit vague. You might think: Well, that`s fine: But what do you exactly DO in those 45 minutes? To make it more concrete, I will try to write a bit more of what therapists do in therapy. Since we can`t talk about patients, I must underline that I don`t describe any patients of mine.
Of course there will be variations in how we work and approach problems, but I always have some basics that underlie everything I do: Respect, curiosity and an attitude of “everything is possible”. I truly believe that, no matter how far someone has fallen, with motivation and hard work, nothing can´t be done.
A typical morning for me is getting to work, looking through my calendar and appointments or maybe attending a meeting if its monday or Wednesday. Normally I have about four sessions every day, with people who have a variety of diagnosis. If we have our first meeting, I have to go through some standard questions, but mostly I try to get a description of the problem as they see it. Sometime I also give them some surveys that should be filled out before the next session, but personally I prefer to not use too much time on those, as I find talking to people and hearing their story more important.
In addition, people might get a bit annoyed if everything is about answering questions on papers. I also explain why they have to answer them: So that we can choose a treatment that fits people who generally score the same on those surveys. And of course, if they have a diagnosis where medications is necessary, I can`t ignore that. For very depressed, bipolar people, AD/HD or people with psychosis, conversations might not be what we focus on in the beginning. Sometimes I contact a doctor so that we can secure basics like sleep. For some people, collecting energy will be the first thing we do. It’s can be saying no to people who drain energy, working with attitudes about how perfect everything must be, or simply making a schedule where they put in healthy food, physical activities and “alone-time”. Some people worry a lot, and then the goal might be to set up experiments where those worries are put to the test. For example, people with panic attacks, might worry about fainting in public, and after a while they start to avoid situations that they feel are dangerous. An example that I actually saw on television, was a woman afraid of hurting kids if she had a knife in her hand.
After a while, she stopped using knives, and even made sure to lock them in. She also developed a fear where she worried she might accidentally kill someone while driving. After a while she simply stopped driving, because she didn`t want to take any risks. The therapy for her was rather concrete: She had to expose herself to what she feared, like being in the area where kids could be WHILE she carried a knife, and drive a car where people could potentially be hurt, without turning back to check if she had run over people.
I work mostly with traumatized people and people with personality disorders. I usually follow a model where I first focus on collecting energy, before we work with specific traumas that give them flashbacks, nightmares and disrupt them in their daily lives. I use EMDR for this work, which is basically using eye movements while thinking about traumatic memories. I ask them to bring forward a memory that scares them, and to think about the worst part of it. Then they keep that picture in their mind’s eye, while following specific movements I do with my fingers. I monitor their discomfort on a scale from 1-10, where 10 is the worst discomfort they have ever felt, and 0 is completely calm, and keep doing the finger movement until they feel calm. I will write more about EMDR later, but it the main point is that afterwards, it`s easier to live with what happened. People have described it as “earlier I felt the past was as real now as then and now it feels like it`s finally behind me”.
The last “phase” is to talk about ending therapy. We go through the work we have done, and talk about how it will be to say goodbye. This is important, because separations is something a lot struggle with. I must make sure that people don’t feel abandoned, that they can take with them some part of what they learnt in their hearts. I have also talked to a therapist once, and when I feel especially low, I still hear her voice saying: “Take care of yourself, dear”. I say this to my clients: If you take some of what you have learnt here with you, I am happy. I also say that they can contact me later, if they need to. It’s just a way of saying that goodbye is just “Now you can continue on your own. I wish I could walk every step of the journey with you, and in my heart, I will”.
A lot of my jobs is actually just being there. Far too many think they aren`t good enough. It doesn`t matter how many times they have been told or have read that they have worth, it still FEELS like they haven`t. Sometimes its all about stating the obvious; I see how kind-hearted they are (most people are really wonderful), how hard they try, how much suffering they had to go through, and remind them off this, when they think they are terrible people. Therapy is about never leaving, and making sure that they never give up.
I truly care about my clients. When they manage to do something good for themselves, I cheer them on and feel real joy for them. When they change, it feels like magic. It gives me hope, because no matter how bad the past has been, there is nothing that can`t be achieved.
- EMDR therapy: faster relief for overcoming trauma (firefliesofhope.typepad.com)
- Therapists: Peddlers of hope and how to choose one (voxxi.com)