Two of the concerns that people often have when considering going into psychotherapy are that it takes too long and that it’s too expensive. You might want to make significant change in your life, but you don’t want to be there ‘til the cows come home or have to take down Citibank to pay for it. As a somewhat compulsive person I can relate: I have no trouble spending time or money, but I absolutely hate wasting either one.
I don’t believe in rushing therapy; I practice depth therapy, or psychodynamic therapy, in which our goal is the healing and growth of the whole personality, not just the removal of symptoms. Based on my experience and reading of the research (see for example Jonathan Shedler’s article in American Psychologist), especially if you’ve experienced trauma, I believe that depth work is actually more effective in the long run.
But I also don’t believe in dragging it out. While getting to the bottom of issues and making lasting, meaningful change may take time, there are things that you can do to make sure that you don’t waste time in achieving your goals. Here are some keys to making your investment in therapy the most effective it can be:
1. Forge an authentic connection with your therapist.
Telling your therapist what you really think and feel, not just what you think you’re supposed to think and feel, is an important start. This may seem obvious, but it also applies to those thoughts and feelings that you may have about your therapist. Keep it real. If you’re not authentic, your therapist is treating the polite part of you, not the whole you. And that will make it take longer to reach your goals.
So your therapist showed up late last week. You had rushed to be there on time and were in the waiting room when she meandered in ten minutes late. You tried not to be annoyed and just spoke about other things, but it was still in the background for you much of the session, and you really weren’t fully present. Don’t avoid talking about it: let her know what’s really going on inside of you. Here’s your opportunity to exercise being direct.
2. Don’t spend all of your time focusing on what other people have done wrong.
Yes, it’s important to vent, and your therapist needs to know what you’ve been through. But if you spend too much time simply unloading you won’t understand why those situations get to you so much, whether your response is adaptive or not, and what you need to do differently to make your life better.
Your boss is an unnatural disaster: Hannibal Lecter, Attila the Hun and Nurse Ratched all rolled up into one. Your husband can’t listen to it anymore. Take some time to vent about your boss in session but then step back and explore how you take it in and how you react. Even if everyone knows that he’s a monster, it can be productive to understand why he gets to you so much. Then you can see what you can do about the situation, whether that means changing how you respond, or how you interpret what happens between the two of you.
3. Identify and focus on your core conflicts.
A big part of your therapist’s job is to connect the dots to help you see the patterns and stories that underlie all the issues that you want to work on. But you can help her with this. Therapy is most effective when the two of you work together to identify your core conflicts and how to resolve them. If you just try to solve different situational problems each week, rather than seeing how each one manifests ongoing, underlying issues, therapy will take longer.
You’ve got six things to talk about in your session this week. OK, but what are the common denominators? How do they relate to what you spoke about last week, and your relationships, your issues at work and what’s come up in session with your therapist? Figure that out and you’ll take lasting wisdom with you when you finish therapy.
4. Take it to the streets.
You’ll need to apply what you realize in your sessions to what you do outside of sessions. Talking with your therapist will bring some change and relief, but there is no magic here. Don’t wait until it feels comfortable; that could take a long time. Changing behavior first also changes feelings.
The two of you spoke about that dream where you were saying goodbye to your old girlfriend. You know it’s about leaving behind an old way of life. But what actions will you actually take to make that real, not just an idea?
5. Take time to talk about leaving before you stop your sessions.
Yes, stopping therapy can be a good thing. But if you stop without processing it for a few sessions you’re missing an opportunity to look at the big picture and have closure. It would be like selling stock when the market is low. Your therapist’s job is not to tell you when to stop, but to help you to make the decision consciously.
You’ve been in therapy for what you feel is a long time and you’re getting restless. It sure would be good to save the money and spend the time at the gym instead. Maybe so. But also look a little deeper to see if you’ve met your goals and if there is anything that you’re avoiding. Like that bit that came up last week that made you uncomfortable. It would actually be more wasteful to leave without a mindful termination process.
Your time in therapy is valuable. Make the most of it. For more ideas about how to do that take a look at my book: I’m Working On It In Therapy: How To Get The Most Out Of Psychotherapy.