What is Therapy? Part II

Good afternoon all- I'm back with Part II of my "What is Therapy?" series. Today is Monday, right? :)

Today I will be discussing the roles in therapy- those of the therapist and the client. Like I mentioned on Friday, opinions about these roles may vary among therapists so this post will reflect my point of view. I'll start with the therapist.

The media has provided a variety of images of the therapists- they range from neurotic to pensive/quiet to Freudian (e.g., a couch and questions about the client's mother). I had no experience with therapists or therapy prior to beginning my master's and doctoral studies, and during my first couple of years of grad school I "acted like a therapist"- my version was pensive, quiet, staunch, and very neutral. I later learned to "be myself" as a therapist (go figure! novel concept!) versus trying to ascribe to a "type". Therefore, for me, how I present as a therapist is pretty close to how I interact with others in my outside life.

Moving on to what a therapist actually "does". First- it is true that as a therapist I listen to my clients- but that's not all I do. As I'm listening I begin to paint a picture of my client. I think that therapy- as the therapist- is like putting together a puzzle: I start with a picture of the person (e.g., how they look, the initial statement of the problem/concern that brought them in, and other demographic information) but must then put all of the pieces together. At my initial client sessions I like to draw a Genogram, which is a "family picture"- who is in the immediate family (e.g., a client's parents and siblings or a spouse/significant other and children) and how these members interact/get along with one another and the client. I believe that there are generational connections between a client's current functioning and past (and present) family relationship experiences. This is my starting point in therapy. So, while the client is sharing relevant information about his/her past I am piecing it together by making preliminary hypotheses about links to present behaviors/concerns etc. Sometimes the piece is a "fit" and other times it's not- just like putting together a puzzle.

After gathering background information I ask the client to share his/her goals for therapy. This is part one of the client's role in therapy. Sometimes clients have clear goals for therapy (e.g., to improve a relationship, to be less anxious or depressed, etc) and other times they are not sure- either is okay. I help the clients with clear goals break each goal down in a way that we may observe the changes (e.g., I will have fewer arguments with my significant other) and help those without goals formulate them. At subsequent sessions I ask that my clients come to session with things to discuss. I generally ask clients something like, "How have you been since our last session?" and let them go from there. While the client talks I keep the goals in mind and observe ways in which movement towards (or away from) the goals occurred during the previous week.

In summary, my role as the therapist is to listen and integrate and the role of the client is to provide us with a starting point at each session (e.g., "I had a good/bad/ok week").

I will probably have more to say about this over time. Look for Part III of "What is Therapy"- the title will be, "How long do I have to be Here?!".

Be well-

Dr. Stanley

What is Therapy? Part I

Welcome back to PsychoBLOGgle! As promised, today I will share my thoughts on therapy- so let's get started.

First and foremost: therapy is a relationship, and it is most effective when a comfortable and collaborative relationship is established between the client and the therapist. Research has consistently demonstrated this (e.g., Frank and Gunderson, 1990), and I have experienced this in my own work with clients. I have had more than one client share with me that he/she terminated therapy after a couple of sessions due to a lack of comfort with the therapist. This does not mean that some therapists are better than others, but instead demonstrates the importance of the "therapeutic alliance" in the therapeutic process.

So now you may be wondering how this relationship is formed- this is a complex question that I can not answer. Think of your own relationships- why are you drawn to those who you have chosen to have in your inner circle? There may be tangible reasons, like shared interests or experiences, but there's probably an element of "je ne sais quios"- that thing you can't put into words but contributes to the bond you share with those close to you. I believe that the "je ne sais quios" plays a large role in the development of the therapeutic alliance because the more tangible elements of a "traditional" relationship are not present.

The therapist/client relationship is an unusual one. I use the word "traditional" above to describe relationships in which there exists mutual exchange among the participants. The therapeutic relationship differs from this because it is a one-sided relationship- all of the energy and attention is focused solely on the client's needs. Clients sometimes struggle to adjust to this reality, especially the ones who are used to focusing the majority of their energy and attention on others. To many it feels odd to sit in a room with another person for about an hour and talk only about oneself- I have actually had clients tell me this directly. It may feel uncomfortable at first but over time clients adjust to the process and understand the role that each person (e.g., the client and the therapist) holds in the relationship.

This seems like a good stopping point for now. When I began writing this morning (yes- I started this post this morning!) I realized that I have a lot to say about therapy and should take my time walking through the process with you. Look for Part II of "What is Therapy" on Monday- at that time I will discuss the role of the therapist and the client. One thing to keep in mind- and I will remind you of this on Monday- is that therapists may have differences of opinion about their role and the role of their clients due to philosophical differences. So the post on Monday will reflect my philosophy of therapy.

Be well this weekend and enjoy your rest.

Dr. Stanley

Welcome

Welcome to PsychoBLOGgle! My name is Dr. Stanley and I am a licensed Psychologist in the District of Columbia. I provide individual, family/couples, and group counseling services to adolescents and adults. I believe that therapy can be a very useful tool, but I am aware that the process of therapy and mental health issues remain a big mystery to a large portion of the general population. Some believe that therapy is reserved for "crazy people" (their words- not mine!) or that seeking therapy is a sign of weakness in "normal" people. Additionally, some assume that therapists "just listen" to their clients and some even believe that therapists brainwash their patients! I plan to address many such questions and concerns and to provide general information about the mental health field.

The name of the blog is a play on the word "psychobabble", which is defined as "Language characterized by the often inaccurate use of jargon from psychiatry and psychotherapy" (The Free Dictionary by Farlex). My hope is that this blog will demystify the process of therapy and provide more accurate information about the field of psychology than what exists in the media, pop culture, etc.

Before I get started I have to provide some Disclaimers:

This blog is for informational purposes only.

The opinions expressed on this blog are my own and are based on my experiences and personal philosophy of counseling/psychotherapy.

I DO NOT provide online psychotherapy and this blog was not created for that purpose. I will answer general questions about the field of psychology and psychotherapy but WILL NOT give advice or guidance about personal problems or situations etc. My next blog post will provide an overview of therapy, which will explain the importance of the relationship between the therapist and the client. I do not develop therapeutic relationships online and will not do so through communications through this blog. Additionally, it takes time for me to get a full picture of a client's concerns, and I don't generally give "advice" (which will also be discussed in my next post). So, to reiterate, this blog WILL NOT provide online therapy.

This website and the information provided is not to be used as a stand-in for therapy or mental health treatment. If you are in need of either I can direct you to websites that may provide you with resources for locating services.

If you are in crisis, dial 911 to access your local hospital and emergency services providers. I DO NOT RESPOND TO PERSONAL CRISES ONLINE.

Thank you for your cooperation and I look forward to sharing with you through this blog!

Dr. Stanley