Everyone has ups and downs, or feels anger and profound sadness at times. But how do you know when your emotions are of the everyday sort that are likely to resolve with time, or when you could benefit from seeing a therapist?
“Probably the best clue that it’s time to see a therapist is a sense that the way you’re thinking, feeling or behaving has been interfering with your normal life over a significant period of time,” says Kate Scharff, M.S.W., a psychotherapist in private practice in Bethesda, Md., and the author of Therapy Demystified. “You don’t need a clear definition of what’s bothering you before you seek therapy; it’s enough to say you’re feeling overwhelmed, immobilized or out of your depth.”
Psychotherapy is based on the idea that at any one time we’re only aware of a small part of what’s going on in our minds. The part of us driving the way we think, feel and behave, which we aren’t consciously aware of, is called the “unconscious.”
If you’ve ever had a disturbing dream that brought to mind something you hadn’t been thinking before, then you’ve seen the unconscious at work.
“Usually when we have trouble coping with life, it’s mainly ourselves getting in the way, or that pesky part of ourselves that works against change to maintain our emotional status quos,” says Ms. Scharff.
Psychotherapy is designed to help people resolve emotional, behavioral or interpersonal problems. The goal might be to eliminate or reduce a symptom (such as a phobia or feelings of sadness or anxiety) or to improve functioning in any number of areas (such as relationships or work).
Most therapists do “talk therapy.” They understand and help through dialogue and establishing a relationship with the person.
To be successful, the therapeutic relationship must have the following components:
The frame. Therapy works in much the same way as good parenting. It revolves around the development of a healthy relationship. And it must have a thoughtful and consistent structure to be effective. The frame includes a comfortable private setting, a regular meeting time and an agreed-upon fee.
The approach. Your therapist should be well-trained in an approach or combination of approaches that he or she can explain to you.
Nonjudgmental listening. Therapists are just people, and they have their own reactions and opinions. But, to help you, they should keep these to themselves. “You’re the one who has to make your own choices and decisions without having your therapist second-guessing you or telling you what to do,” says Ms. Scharff. “The exception is if you’re engaged in a self-destructive activity, such as drunk driving. In that case, it would be irresponsible of your therapist to stay neutral.”
Trust. For your treatment to succeed, you have to believe your therapist has your best interests in mind and is acting in good faith.
Caring. Even though therapy is a business relationship, it’s a real and caring one. A good therapist is nonjudgmental, but not detached.
Empathy. No one but you can really know what it’s like to be you. But a good therapist, in addition to being warm and caring, should make every effort to understand what it means to walk in your shoes. “The capacity to enter into your experience, to understand you on a gut level, is critical,” says Ms. Scharff.
A good fit. Therapy is most successful when people seeking treatment select a therapist whose personality and way of working are a good match with their own. In other words, find someone you feel comfortable with.
“Therapy is really just you and a well-trained person who cares about you talking and working together to understand you better,” says Ms. Scharff. “And in the end, feeling that you’re profoundly understood will help you get a handle on your problems. No matter who you are, where you live or the nature of your emotional struggles, there’s professional, affordable help available.”
© 2014 Main Line Health