The therapeutic alliance can be a very slippery process. Although at the outset individuals often have clear goals during the course of therapy these can become muddled. There is always the danger of developing a dependency, particularly in longer term work, which is to some extent an inevitable consequence of the process. Time is spent telling your therapist your most personal and intimate details, and it is natural for a relationship to develop. However are these feelings preventing you from looking objectively at what is a professional and often expensive relationship?
With that in mind here are five questions you may want to ask:
If you set goals when you started therapy and you feel those goals have been met, then this typically is either a good time to stop or take a break. There is always a danger that therapy can start to lapse into other areas of your life, it is part of human nature that when one problem is solved, we find another to take its place. However if you came to do something and that has been achieved, this is a good exit point. For example if the goal was improved communication with your mother, and you feel this has been achieved, more or less, then stop. Or to put it another way you may want to stop if you find the sessions are now less focused on communication with you mother and more on communicating with others, or indeed other issues altogether. You need to be clear and honest with yourself whether you want to have therapy over these issue. You can always take a break for a couple of months, see how you feel outside of therapy, and if you then wish, re-engage.
Do you find it beneficial, do you think it is helping you? Do you leave feeling relieved and unburdened? Do you struggle to image how you would cope without these weekly sessions? Do you leave feeling, sometimes rejuvenated, sometimes reflective, but always as if you are taking steps forward? If so, these are good reasons to stay and equally if none of these conditions are being met, perhaps it’s a good time to stop.
Do you leave more confused that you arrived (regularly)? Do you find yourself talking about the same thing every week, almost spinning wheels ? Does you therapist opening by asking you how your week was ? Do you feel the therapist isn’t understanding your issues, or isn’t asking you the right questions, or just doesn’t seem to get were you’re coming from? Before you attend therapy are you desperately trying to think of sometime to say.
And if these are the sort of questions that you have, it’s probably a good time to either review your work with your therapist, and either stop altogether or see another therapist.
Now this in itself can either be a sign it’s not working, or confusingly it can be a sign it is working. The notion of ‘stuckness’ or ‘therapeutic resistance’ is common within therapy and it refers to the period in which the client, having voiced their concerns, and expelled any cathartic emotion, is left in almost a limbo fearful of moving forward. Patterns of thinking, feeling or behaving can be intrenched, and any desire to change needs to overcome a deep-seated impetus to stay the same. So is it this that is making you reluctant to attend? Are you unhappy with the process or the therapist, or are you fearful of moving forward?
If you feel you are being exploited, if you feel unwanted romantic advances, if you feel like your boundaries are violated in any way, if you feel like therapy is going nowhere, just stop. You don’t have to give notice. A lot a therapist make a big deal about giving 1 week or 4 week’s notice, but the reality is if you want to stop, stop. You can email the therapist and simply inform them you are stopping. You don’t have to have a final closing session, or you can make your next session your last. You can chose to tell your therapist you don’t feel safe and/or competently served and let them know this is your last session or not, the choice is yours.
Often making decisions for ourselves is complicated, entangled in our own sense of self, our own critical voices. It is common for clients to feel it is their fault therapy isn’t working, they aren’t doing something right or not understanding something, and these thoughts can get tangled up in our evaluation of therapy. However asking whether you would recommend a friend can provide a more objective evaluation. If not, why not ? And why are you in therapy with someone you wouldn’t recommend ?
In conclusion if you are feeling unhappy ask counsellor for a review. Don’t feel that because a therapist isn’t suggesting a review that they don’t feel one is necessary or are hostile to the notion of regular reviews. This topic can be a potential minefield for therapists. All experienced therapists are aware that their feelings of how the sessions are progressing might not be shared by the client. We may feel these sessions are going nowhere, whereas the client might feel this hour together is a life-line and equally vice versa, we think we’re making great inroads, but you, the client are frustrated by our incompetence!
And the same for regular reviews, for some therapists this feels like an intrusion; it feels almost an extension of the therapist determining what is best for the client. You are ultimately paying for these sessions, and that can feel frustrating if the therapist is suggesting you spend 20 / 30 minutes every 6 session to talk about how things are going. So from our point of view it can be difficult to make a call that won’t offend.
A therapist should be able to deal with any dis-satisfaction you have with the process, and indeed will welcome it. But sometimes, ultimately, it may be up to you to say so.
The following articles are written to help you understand what is this process of
therapy, what actually happens in the room, from finding a therapist to leaving one,
from understanding what a counsellor can help you with and what they can't.
It includes topics on the different types of therapy, to couples therapy, and about the role of diagnosis in mental health.