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In the Room Where It Happens: My totally unofficial 2024 guide to therapy, part 2

In my last post I talked about how to find a therapist.


If you’ve navigated that far, we can talk about what happens when you show up. (And for the record, I know that “the room where it happens” may be wherever your laptop or phone is.)


You’ll receive paperwork to fill out before your first session. It may be on a clipboard in the waiting room, but increasingly therapists send it out ahead of time. Part of that paperwork will be an explanation of policies. In my state it’s called a Client Disclosure.


Don't skip over that quickly. Part of being an effective therapist is holding good boundaries, and these policies will explain part of those boundaries. (Boundaries are what helps to create a safe space for you to do your work.) What happens if you forget and miss a session? Therapist policies vary on this. Can your therapist be your friend? (Short answer: No) Can your therapist be your boyfriend/girlfriend? (Short answer: REALLY BIG NO.) If you have questions about anything in your therapist policies, ask them about it. By the way, your therapist also should not ask you to pick up their dry cleaning, pet sit their dog, or go into business with you. (I’ve known of variations of all of  these things happening.)


Therapy happens on two levels: the content and the process. You may come to see me because you’re grieving the loss of a loved one. That’s the content. The process is how you tell me about that loss. Are you apologetic for “being weak”? Do you apologize for crying? Is it hard to talk about the good about that person… or about what wasn’t good? When you’ve never been allowed to have feelings or shamed for having them, even a little bit of emotion feels like too much and all wrong. 


Put another way, the content is the outline of a picture. The process fills in the colors. 


This isn’t to make you feel awkward and self-conscious as you talk in session. It’s to reassure. I may look like I’m just sitting there nodding my head as you talk, but in reality I’m putting together what you're telling me with what you’ve already told me – or haven’t told me. I’m listening for those seemingly insignificant, throwaway comments that in truth point to a door that needs opening. 


I firmly believe that therapy is a partnership. My role is to help you clear out and/or heal whatever is getting in the way of your living your fullest and most authentic life. If you're frustrated with something in the process or don’t understand why we’re doing what we’re doing, say something. 


Part of my challenge in starting work with a new client is figuring out how you best work. Some clients work well with humor; others don’t. I work with a lot of  creative people, and we can utilize that creativity in a session. How I work with an engineer is going to be different from how I work with a storyteller. Neither one is wrong. They are just different.


On social media someone responded to a meme by commenting that therapy was sitting in silence for 45 minutes until you finally got the courage to speak but you had no time left to talk about this hard thing. I responded that as a therapist, I’d never do that. I’m not afraid of silence in a session, but also will ask, “What are you thinking?” or “what's going on?” I also said that if her sessions weren’t working for her she could say something.


(Her response was that I was full of **** so I don't think my response was heard.)


You have a right to be heard not only in the content of your sessions but also in the process. I may not be able to give you everything you’d like. Insurance may restrict how long your session can be. I may think that it wouldn’t be helpful from a clinical perspective.


For example, a tech company that offers therapy by text, phone, or online touts the “benefit” that you can talk to your therapist any time. A while back I wrote an article about why that's a bad idea


If you don't understand, ask. 


If you don't understand the policy…

If you don't understand why the sessions are happening as they are…

If you don't understand how you should be utilizing this time...

If you don't understand how your therapist can sit there and listen to you….



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