Most frequently asked questions from the therapy-curious

If you’re new to therapy you may be confused about what therapists actually “do,” and wonder what you will get out of therapy (you could just go vent to a friend for free, right?!). Below are some questions and answers that may be helpful as you consider your therapy journey.

I really need to vent about my boss/partner/kids/parent/etc. Therapy is absolutely a place to get things out—to vent and share intense feelings, receive support and validation in your human experience. It is also a place to consider the ways in which you may be locked into a frustrating situation, conflictual relationship, or suffering that brings you in. My job is to provide space to heal, care for yourself, and reach your goals. It is normal to unconsciously begin using the comfortable aspects of therapy to avoid and defend against the inevitable discomfort of change. You can expect gentle prodding and curious challenging throughout the process of therapy. This can be frustrating, but you may also surprisingly notice relief when challenged in this way; it feels meaningful to be truly seen and called back from the distance of defenses.

Will you offer advice? What should I do? In some cases I may offer behavior guidance or suggestions, particularly around safety concerns.  However, for the most part I will remind you that you are on your own path; I am walking with you.  The truth is, I can never know what is best for you.  Therapy is not about advice; it is designed to help you explore options, values, behaviors, emotions and needs so you can live with more vitality. If you are looking for specific guidance or advisory help you will find a life, relationship, or career coach a better fit.

Will the therapist direct the session or am I expected to lead? I’m afraid I won’t know what to say! Every therapist is different in this regard, and every therapeutic relationship is unique. Most of the time I encourage you to begin the session with anything on your mind. Depending on your individual preferences and needs, we continue along with the topics you bring up, or I can help steer the conversation, in service of serving your initial identified goals. I frequently encourage free association (See what to expect page.) No matter who leads, or how the conversation flows I am always working toward full transparency and curiosity in how we both approach your treatment. Nothing should be mysterious about the therapy process. If you are lost, let’s talk about it.

How will I respond to therapy and how do I know if therapy is helping? Catharsis, psychological solace, and symptom relief can happen within the first few sessions and at many points throughout treatment. Another stage of therapy can come with worsening of symptoms, regression, or increased psychological tension. It can be seductive to look at either one of these phenomena as proof that therapy is working or not working. I am here to assist in supporting balance to a tolerable level and to support you in maintaining healthy skills and defenses between sessions. Sometimes we know healing is happening because you are more aware of your internal states in and out of the therapy process; you can move through emotions and experiences with curiosity, compassion and flexibility. Sometimes we know therapy is helping when relationships improve, and you have an increased feeling of connection, or self-worth. We will discuss what healing looks like for you. Not everyone benefits from therapy, and my job is to always to assess if I can be the person to provide you with tools toward healing. Your job is to trust what you believe you need.

How long will I need therapy? What is normal? My focus and goal is on psychological and emotional healing of complex disorders, so I tend to do longer-term, deeper work with individuals, but is no standard or one size fits all. I see some clients very long-term (5+ years) and some as short as 6 months. If you are looking for strictly symptom management and skills building, we may not be the best fit. If you are looking for that type of support I recommend a therapist who uses a structured cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT) counseling model. While I encourage, teach and utilize CBT/DBT aspects in therapy, I view them as tools toward the work, rather than the work itself.