Counseling 101 - What is Therapy and How Can it Help Me? (Part 1)

If you are new to counseling, what do you expect it to be like? 

Or if you have participated in counseling in the past, can you remember what your expectations were? For many of us, our exposure to “therapy” or “counseling” in the absence of first-hand experience comes from media, most prominently through television and movies (as far as I know, there is no blockbuster video game related to counseling... yet!). Therapists are frequently portrayed as either all-knowing gurus or, on the truly disgraceful end of the spectrum, as ethical violators, with the inevitable development of a romantic and ultimately destructive relationship between therapist and client. 

Unfortunately this image obscures the nuanced and often slow-and-steady reality of counseling and sets both clients and therapists up for disappointment. The fact that therapy is inherently confidential and individualized doesn’t clarify things for us much, either, as two people working together toward change is inevitably both an art and a science. Which means the path taken can be difficult to articulate even in retrospect once goals have been accomplished (as any experienced and honest professional will readily admit).

So to clear some things up, I’d like to discuss some expectations about what therapists CAN and CAN’T do that will hopefully help you to get the most out of your counseling experience, right off the bat. Without a doubt, therapists differ in their treatment approaches, relational styles and level of self-disclosure toward clients. But I think I can speak for the vast majority in sharing this list, as our ethical codes and core motivations, despite our stylistic differences, are fundamentally the same. I hope it will be useful not just in setting expectations, but in equipping you to help your therapist help you- maybe not in the sudden, superhuman way that you might like (and wouldn’t we all appreciate that!), but in the more realistic, relational and life-grappling manner that leads to authentic change. Maybe, just maybe, this list will help you to appreciate your therapist’s uncanny knack for bouncing questions back at you (“...and how did that make you feel?”; ...“what do you think you should do in this situation?”) for their true purpose, rather than presuming they are well-honed methods for wiggling out of giving you the concrete advice that you would like.

This week, let’s talk about what counselors and therapists can’t do. Next week I’ll focus on what they can do.

Things therapists can’t do:

  • Your therapist cannot choose your goals. Every therapist I know operates with a very high value on “self-determination”. This means that you set the course, and we help you get there. If you are seeking counseling, you probably have a goal in mind, even if you haven’t articulated it to yourself yet. Even if your goal is initially just “to stop feeling bad”, share this with your therapist and be patient over the first several sessions as you and they work together to make this goal more specific. A good therapist will not tell you during the initial session, “You should…”. You are making a time commitment and a courageous decision to enter therapy, and you should have a reason that’s clear enough to you to initiate this journey.

  • Your therapist cannot make your decisions.  While your therapist may be able to help you reflect on which of many possible choices might be most in line with your values (e.g., you are saying you want to lose weight, and trying to make a choice between donuts and salad for dinner.) But they are not going to live the consequences of actually walking down that path. You are. More importantly, feelings of indecisiveness can have a deeper meaning and even a purpose that remains unexplored, so a hasty decision might actually harm your personal growth. Be patient with yourself if you don’t know where you're headed, and expect your therapist to be ok with that, too.

  • Your therapist cannot change your behavior. You might identify a pattern of behavior that you would like to change (or, maybe more commonly, that someone else wants you to change). It might take some time in counseling to get to the root of the issue and to start identifying the tools that you can use to chart a different course. When that time comes, you must act. Your therapist will not use punishment, star charts (most likely, unless you are under the age of 10), shaming, ridicule or other coercive techniques to make you change. The results of your behavior change (or not) will be yours alone to claim. The credit for this change will be all yours to claim, too.

  • Your therapist cannot end your relationship. This is really a sub-point related to the above. One of the biggest and hardest life decisions that we face is ending an important relationship. Sometimes relationships have become abusive, coercive or otherwise irreparable. If it is not within your therapist’s jurisdiction or capacity to change your behavior, it is most definitely not possible for them to tell you definitively that a relationship needs to end. We all have varying degrees of tolerance for relationship challenges, our own reasons for staying, our own reasons for going. Your therapist will walk with you, listen to you, engage with you about feeling stuck, and be there to help you work through the fallout of your decision, whatever it may be.

  • Your therapist cannot fix your problem. This might be the most controversial one on the list! And the hardest for many clients and therapists to admit. In some cases, therapy can help clarify changes that you need to make in your life/relationships and encourage you to make these reality. But I would argue that when problems are “fixed” in therapy, it is just as often the case that we have learned to relate to them in a different way rather than that the problem itself has disappeared. For example, most clients I have worked with on anxiety complete therapy acknowledging that they will experience worries and fears for the rest of their lives. But the most significant change happens in knowing that fears and worries don’t have to keep them from living the life they want to live.

What about you? As you embark on your therapy journey, what do you need? How can you reflect on this and communicate this to your therapist so that h/she has the best opportunity to serve you?

Next up… Things your therapist can (and will!) do.