1 – Pick a Psychotherapist Who Listens to You
When I start working with someone I try to pay very careful attention to what they are telling me about themselves and their situation. I find that a surprising number of conditions, often conditions including quite serious health complaints can be understood and resolved by piecing together the client’s story.
So, for example, a woman in her 40s was referred to me with sleep problems relating to breathing issues and tension in her chest which tended to flare up in the evenings. She was on various medications.
Through carefully talking and thinking together about the history of her condition things started to change.
She was able to make links between where and when the condition had started, and from that to see how different events in her day-to-day life would coincide with the breathing problem. The upshot of this was that she started to become able to relax at night and get some sleep. She also became more demanding of the people who worked for her, including me. She delegated more and, as it were, got some things off her chest.
2 – Avoid Therapists Who Jump to Conclusions
I think it is very important not to jump to conclusions about people’s presenting problems. When I supervise I am often dismayed to hear how quickly a counsellor will develop a hypothesis about a client’s condition. I try to point out that as soon as they start to do this, to jump to a conclusion, that they are closing down all kinds of avenues, and by doing so can get in the way of the client’s insights and recovery.
3 – Is Your Therapist Helping You Piece the History of Your Symptoms and Life Together?
The important thing is to very carefully take as much of a sense of the history of the person as possible.
It is common that I meet with adults who refer themselves to me speaking about problems with depression or anxiety. By the time they come to see me they may have been through several therapists, and be on all kinds of medication. Frequently it becomes clear that the idea of depression has taken hold and got all of the attention in the therapies, but often this is misleading.
4 – Is Your Therapist Able to Think Beyond the Presenting Symptoms?
Depression and anxiety states are often better understood as symptoms of other conditions and experiences that have occurred earlier in life. The important thing is to find a way to open up the work so that you develop a clear picture about where things began. This takes time and patience. It is all too easy to become impatient, perhaps to react like the person’s family would have done, and so close down ways of understanding things.
Often there is a story of trauma underlying the presenting symptoms
Traumatic events overload us, trauma is a kind of shocking experience that is too much to think about.
One way in which we deal with trauma is to split it off from consciousness, we dissociate from the experience, turn away from it, and try to keep living as though it hasn’t happened.
This is a necessary defensive reaction that had to be deployed at the time. So the experience is cut-off and we can feel like it isn’t there anymore, but this is misleading and often the cut-off traumatic content exerts a negative influence on our minds, psyches and bodies.
When this type of thing is left unexplored other symptoms develop, such as depression and anxiety. It is only by carefully building up a full picture of a person’s life that we can get at the root trauma from which the other symptoms develop.
Many people who come to therapy do so because they have had bad starts in life. They may have grown up in homes where arguments were common, perhaps violence and abuse. They may have grown up in traumatising homes.
5 – Pick a Therapist Who is Clear About Their Boundaries and How They Work
Therapists who are very clear about boundaries, who are predictable, do so to enable an atmosphere of trust to develop in the work. If this can happen then some of the client’s defensive postures and reactions may settle down.
- The person becomes more able to be spontaneous
- To play
- To create in the therapy
This spontaneity is a sign that something healthy and healing is at work. I tend to trust that if the therapeutic conditions can be sustained they will enable that to continue. When this happens, I think that the person is getting the chance to start again.
Psychotherapy might be the only relationship someone has in which they get the chance to start over. This is why it is very important to try to pick a good therapist.