Want to take your psychotherapy to the next level? Ask for what you want.

29/12/2017 16:58 GMT | Updated 29/12/2017 16:58 GMT
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It’s the dawn of a new year, so it’s as good a time as any to think about self-improvement. For many, this is a time of year to start something like psychotherapy. For those already seeing a therapist, it might be time to make sure you’re getting what you need from it.

Good therapy isn’t just about seeing your once or twice a weekly sessions, it’s about getting the most out of them. When starting therapy, just getting things off your chest can be a great relief. But once you’re chugging along nicely, it can become an opportunity to dive deep and evaluate and confront patterns in your life that aren’t working. If you’re already in therapy for the long haul, have you thought about how it’s going? Is it time for a psychotherapy MOT?

People often talk to me informally about their therapy. In general, they tell me that it’s good. They get a lot off their chest, and then go into the rest of the week with a sense of relief. However, if I press further and ask if it’s really working for them, people tend to prevaricate.

“What do you mean by working?”

And this is a very good question. Therapists have had a lot of training to do what they do, so they should know, shouldn’t they?

United Kingdom Council for Psychotherapy (UKCP) registered psychotherapists will have often spent a minimum of five years training in their profession, had their own personal therapy, and continue to learn through their professional lives through required continued professional development and regular clinical supervision. While all this training provides a great knowledge base for exploring the mind – it can also prove to be rather myopic. For therapists, seeing the woods for the trees can still be difficult: we get stuck in our habitual ways of working too.

What therapists can learn from personal trainers

Some years ago, I gave up my own personal therapy in exchange for personal training at my gym. I figured after so many years of working on my psyche, it was to do something similar for my body. I was surprised to find that it was also one of the most invaluable lessons I’ve had in practicing psychotherapy. No, my trainer was not interested in my personal history – with a good personal trainer it’s less talk, more sweat.

It’s hard enough to get to gym in the first place, but once there and exercising away, I’m not so keen on being told that I should do four more pull-ups when I feel I’ve reached my limit. It hurts, I’m tired, and frankly, I could have had another hour in bed. However, with a bit of firm but supportive encouragement, I find that I can do a few more pull-ups and exceed my previous limits in other areas too - leaving the gym feeling accomplished, satisfied, and physically strong.

There’s something about exercising with a trainer that holds you accountable to yourself – to ensure you’re not slacking. Sure, you can go and run on a treadmill three or four times a week and this will keep you fit. But do you ever think you might need just an extra push to see what you can really do? To surprise yourself? To push through your wall and see what it feels like on the other side?

Get off the therapy treadmill

By English: Cpl. Gabriela Gonzalez [Public domain], via Wikimedia Commons

The same is true for psychotherapy. You may find yourself in a place where seeing your therapist is like that treadmill. Sure, you get stuff off your chest and leave feeling better, but is your therapist holding you accountable to your very best self? Is your therapist, in a similar way to the personal trainer, saying “Do you think you can do four more? Are we working to your full capacity?”

Oftentimes clients can find themselves dancing rings around their therapist, filling every session with verbiage while avoiding the hard graft. Well-intentioned psychotherapists are likely to err on the gentle side. They rightly let their client lead because they understand that therapy can be difficult and should be paced carefully. They may be less likely to challenge unless they know it’s in their client’s best interest: and sometimes they need help from their clients to make that judgment. Starting soft is important. Psychotherapy is built on trust and creating a space where your thoughts and feelings can generate material naturally and uninhibited. It’s not supposed to be boot camp and should never be brutal. But you don’t want it to be too gentle either. You can tell if this is happening if you might find yourself avoiding challenging material and loitering around “weekly reviews”, when limited time may be better spent on more fruitful (if challenging) material.

Therapists and their clients, just like anyone else, can fall into bad habits. They can start to feel that simply doing therapy once or twice a week is enough, like going for that slow jog on the treadmill. Perhaps this kind of maintenance is exactly what you need. But even if you’re going for “maintenance” it’s good to be clear about that. Often, upon investigation, you may find that you want to up your game. Add in a new exercise, discover something different about yourself. Challenge yourself to learn more, and seek the support to do so.

Tell your therapist what you want

It’s fine if you don’t know what you need exactly, you can work it out together. Or perhaps you have a sense of a direction you’d like to take in which case you might say, “I would like to focus on this, can you help me to do that?” or “I would like you to challenge me more about my ...” Perhaps you want to focus on a particular area of difficulty or maybe you’ve find you’ve been holding back in which case you might spill the beans and say, “it’s very difficult, but I’d like to try and talk about this . . .“ This will be very helpful to your therapist.

Unfortunately, many people think that you can’t ask these sorts of things, but you are the client. It’s fair game to make a request, a suggestion, and to ask for more. Your therapist, of course, reserves the right to sit with your request and explore that with you – to “check it out” with you. Hopefully you can come to some kind of agreement about how you might move forward with this new insight to work the therapy where it is now, not where you started.

Never forget that you are the biggest stakeholder in your own therapy, and while your therapist will be bringing their skill and experience to the table, you are the one who knows best what you need, even if sometimes that’s a little push, so don’t be afraid to ask for it.

By the way, this works in the reverse too – if you feel you’re too challenged, and need a bit more of supportive space, you can ask for that too. In my experience, however, therapists are better at the latter than the former, and might need permission from their clients to be more challenging rather than less. But all the same, it’s your therapy.

If I’ve learned anything about psychotherapy from that most unexpected place, the gym, it’s that sometimes we need someone to hold us to a standard higher than the one we think we’re capable of ourselves. There’s an art to ensuring that this challenge is deployed well, respectfully, and thoughtfully. A personal trainer should no more push a person past their physical limits than a therapist should push their client past their psychological ones. This comes from a foundation of trust. When our limits are skilfully, respectfully, and thoughtfully challenged, we might find ourselves surprised at how far we can actually go.