April is “Counseling Awareness Month” so I thought I should take a moment and share with you what to expect when you come and see me or any other counselor. Now, not every counselor is the same and our offices often reflect who we are as individuals and counselors, so you may not have an exact experience like this, but hopefully you’ll gain some insight.
First a little self-disclosure. I remember a time in my life when I was going through a difficult time. I decided I needed to see a counselor. I had called my EAP coordinator and said I urgently needed an appointment. She contacted an affiliate provider who reached out to set up an appointment. When the provider ended her voicemail, she said “Breathe deeply into your belly and have a blessed day.” There’s nothing inherently wrong with this statement. In fact, now that I’m a therapist I see great value in it. However, at the time I was a stressed out business woman who felt like her life was falling apart and all I wanted was to go and have someone help me figure it out. I thought, “Oh, this is going to be WAY too touchy feely for me!”
I arrived the day of my appointment and the room echoed the same feeling I got from the voicemail. The walls were light sage green with a gold leaf pattern that was very subtle. There was a fountain in one corner. A teapot with a variety of herbal teas and an aromatherapy diffuser diffusing lemongrass throughout the room. Overhead, a new age style instrumental track was playing and there were a number of signs reminding us to be calm and serene and to breathe deeply while waiting for our counselor to pick us up. ACK! Way too feely!! Right? Then, I could hear a voice in my head say, “You pay extra for your pedicures so you can have this type of environment instead of feeling like you’re being pushed through. Relax. Pretend she’s going to rub your feet.”
And that’s how my first experience of working with a counselor started. It didn’t take long for her to figure out who I was and what I needed in forms of communication style. She expertly balanced psychoeducation, cognitive restructuring, validation and behavioral challenges. But I will never forget the courage it took just to get inside the room. So maybe you’re feeling that way too. I want to address a couple fears and misconceptions that some people experience.
The TV Shows and media have it wrong. I have a friend who loves to watch dark tv series or crime based ones and to then call and ask me if this is what I do. Inevitably there’s a psychologist, psychiatrist, counselor or other mental health worker who is usually dressed very severely (black suit and white shirt). They meet with their “client” in a darkly lit room and using a low monotone voice begin probing into the “crevices of their psyche”. Nope. Not what I do.
Some therapists dress in suits, some in business casual, and some in very casual. However, unless you find yourself cast in a movie, our job isn’t to go digging in your psyche to find information of value for other people. Instead, we use conversation and interventions to allow you to explore what’s coming up for you. I know that sounds touchy feely, but bear with me. Have you ever known you needed to do something, but not known how or where to start? Well, a counselor has often walked this journey before either personally or with others and can help you get started. One of the biggest differences is we will never ask out of our own curiosity or to find “evidence” for someone else. Our motivation is to find ways to help you live the life you want to live.
There’s a couch, but you don’t have to lie down. Often we use couches in our offices. This is because while sometimes we’re only meeting with one person, sometimes we have multiple people present and having various seating options is crucial. Further, our goal is to create a place that is comfortable enough that you have space to be vulnerable and do the work you came to do.
The picture of someone laying on a couch with the therapist behind them dutifully taking notes is a powerful social image. It comes from psychoanalysis, a very specific type of therapy. While some still practice psychoanalysis or psychodynamic therapy, I personally don’t know anyone that still uses the strict interpretation of tabula rasa (blank slate) that would require this kind of setting. If you are going to work with someone who is listed as doing psychoanalysis, go ahead and ask them about their seating arrangements, they’ll be happy to explain ahead of time so there are no surprises. And trust me, you won’t be the first to ask.
The first session feels like an interview. So, while we don’t just go digging willy-nilly through your psyche, we do have to get to know you rather quickly. And unlike meeting someone at the bar, where you will only generally discuss what’s going on right now, we have to ask some questions about your past. What are we looking for? Well, a couple of things:
* Symptom information: What’s been happening, how long has it been happening, how intense is it, and how is it getting in the way of you living the life you want to live.
* Relationship History: I am a firm believer that as humans we were created to live in relationship with others. So exploring how you’ve both successfully and unsuccessfully navigated relationships helps me understand where you are and where you want to go.
* Cultural History: We want to understand the world in which you live. So whether it’s a discussion of race, gender, sexual orientation, sub-culture or other factors we will be checking in to make sure we meet you where you are to the best of our ability.
* What you’ve already tried: Most people don’t come to counseling the very first time they have an uncomfortable or distressing feeling. Most people have stuff they’ve done that worked, some that didn’t work at all and some stuff that used to work and is now getting in the way.
* The Miracle Question or what you want: Every theory of counseling I am aware of has some version of the Miracle Question. This question asks, “If this wasn’t an issue anymore, what would you do? How would your life be different?” We’ll work together to set some goals and to determine what the values are that you want to move closer to.
As you can see this is a lot of information to gather in 60-90 minutes and it may leave you feeling like we only asked questions and you didn’t make any progress. And you’re right. The first session is often not very much “counseling” and much more of an interview. While sometimes you just don’t click with a therapist and you need to switch, I always suggest waiting until after the second visit to decide in order to get the interview out of the way.
We’re not here to tell you what to do. Going to a therapist is not the same as talking to a friend. We can help you make decisions and we can elucidate some potential benefits or consequences you may not have already seen, but at the end of the day we want you to live the life YOU want. So we won’t tell you what to do. You keep all the power for determining your own choices.
Sometimes things get worse before they get better. When you set out to do spring cleaning do you ever realize that you’re at a point where there’s more mess, more trash, more clutter than when you started? It’s the same way with healing. Sometimes as you do the work of healing, things get harder before they get better. If you stop in the middle of that mess, you may feel (and rightfully so) that you are worse off than when you came. Stick with it. Keep up the work. Treatment works and healing and recovery happen.
The other way things may get harder before they get better is that we live in relationships. Sometimes the people most important to us don’t heal at the same rate. Sometimes they’re not sure how to respond to us now that we’re “different” than we have been. This is a normal part of the process and one you should definitely share and explore with your therapist.
I’m here as long as you need me AND our time together is limited. In a lot of ways my job is to work myself out of a job. For some of you our journey together may last years and others, only a few sessions. Some of you will come back and see me years from now to work through something else, others I’ll never see again. I am honored that i have gotten to walk portions of the journeys of so many. I never get to see the whole journey. But literally from the moment we meet, my job is to figure out “How will we know when my part of their journey ends.” You and I will talk about this a lot.
Research has some evidence to show that individuals who have a final session with their counselor have a better prognosis for long-term benefits of treatment. The final session is sometimes hard and it is a hard that holds a ton of beautiful moments. If you’re tempted to skip your final session with your therapist, I encourage you to reconsider. After all, you’ve worked so hard to get where you are ,why not make sure you celebrate it and give it the best chance of long-term success you can!
As I was typing this blog I realized I could probably write for days on this. If you’re thinking of reaching out to a counselor, I hope that this gives you courage to pick up the phone. No one counselor is right for every person, AND I firmly believe that there is one that can meet you right where you are and help you get where you want to be.