Written by Jeanette Raymond, Ph.D.

Click here to contact Jeanette and/or see her GoodTherapy.org Profile

If you are considering entering into psychotherapy chances are it is because of a strong sense of unease within yourself. There is a powerful urge to get rid of that discomfort no matter how it is manifest. It may be anger, jealousy, guilt, feeling constantly wounded, fear of losing an important relationship, or a sense of frustration/dissatisfaction with the way  life is. Often there is a need to feel in control of your life, or a desire to discover if you are lovable no matter how bad you think you are. Sometimes there is a massive fear of change and needing a place where the world can stop for a while. Whatever the initial reason for seeking psychotherapy the basis for the work will mean exploring the relationship you have with yourself. The process can be long and arduous and it takes courage and forbearance. It requires allowing yourself to pass through many stages of self-discovery while you get relief from your discomfort.

You may use your therapy and your therapist in many and varied ways at different times during the journey. At times you may want soothing and comfort, and at other times you may want to have a teacher, a sounding board, a quiet listener or a coach. You may need praise and acknowledgment, sympathy and empathy, kindness or directness. You may need to explore choices before making decisions, experiment with being assertive, or find ways of filling that emptiness without resorting to food, drugs or other numbing devices. Just sitting in a room with a therapist who accepts that you just feel like being quiet – that you don’t have to perform or be ‘on’ is a wonderfully therapeutic experience. Good therapy happens when your needs can be tuned into and met in a way that maintains your sense of dignity without making you dependent or unaware of your own resources, as well as showing you how and when to use them.

Stages Of Therapy: There are many stages of therapy, and good therapy provides the right experience to match the need at the time. The first stage of a therapeutic experience  is usually to get some relief from overwhelming emotional pain. When your usual ways of coping buckle under the strain it is alarming and de-stabilizing. Having the right therapeutic environment can be crucial in providing some ground under your wobbly psychological feet. Feeling like you have something to hold onto in the form of  therapy, and someone who will hold you in the shape of the therapist creates the security you need to stabilize yourself again. Good therapy at this stage provides as much space as you need to express yourself, so that your toxic feelings can be voided, and  translates your ‘messy’ experience into something you can identify with and process in later stages of therapy. It is the first glance at the script you bring into the therapy sessions about your life.  If you feel heard and understood in a non-judgmental way in the initial stage of psychotherapy, you and your therapist have created the fertile soil for a collaborative revision of the script from one of pain and despair to that of hope, anticipation for the future and zest for making full use of your potential. But it requires the fortitude to look at what does and  doesn’t serve you and be willing to edit the script like any good author.  If you cannot bear to see and learn about all aspects of yourself, you are most likely going to want a quick fix, so you may rework some chapter headings, and quit.  That may be as much as you want or can deal with, so you may end treatments when you feel better.

An example of quick-fix therapy:  Alexis came into therapy very anxious that she was going to loose her boyfriend if she didn’t get some help. Her boyfriend was tired of her needy and clingy behavior and told her to work on it in therapy. Alexis felt helpless and used her  psychotherapy to share her fears and attempt to feel more empowered in the relationship with her boyfriend. The three sessions of therapy that Alexis gave herself involved listening, eliciting feelings and desires and the use of role play She ended therapy saying  she felt more assertive, and accepted by her boyfriend.   Staying in therapy would have made her boyfriend’s description of her as needy come true. Since she couldn’t bear that to be the case, she left. She experienced good therapy in the stage she was in, but ut not the best she could have got. That would have meant having the courage to step into the next and subsequent stages of psychotherapy. It would have entailed discovering why she found it hard to be an equal in a relationship.

An example of good therapy: Matthew, a man in his late twenties, came into his second experience of psychotherapy feeling depressed and “not myself.”  He hated the idea of needing therapy, but after trying several alternative means of finding peace within himself and failing, he reluctantly began a new journey. He was divorced with a young daughter and working for himself. He felt alone and estranged from his family. He felt that no one could identify with or understand what he was going through and was angry about it. He was concerned about paying for therapy with no guarantee of a successful outcome or the length of time it would take. Mathew had many mountains to climb and rivers to swim during his therapy. His therapist held onto him through the difficult times when Mathew wanted to quit by being available and always inviting Mathew to share his frustrations. That acceptance by his therapist made him more trustful and hopeful of the process, and over time he honored the faith his therapist had in him and gained a more accepting and loving sense of himself, which translated into better relationships and an ability to give himself what he wanted. His experience in three phases of therapy are a testament to that faith.

Phase One: dealing with the shame of coming to therapy. During the first nine months of once a week psychotherapy Mathew was always uncomfortable focusing on what was not right with him. He felt shameful talking of it, and expected to be judged harshly just as he had been as a child. He would sit on the edge of the sofa unable to relax and couldn’t wait for the session to be over. Sometimes the only way he could talk about his concerns was via the voice of his daughter. He would disguise his concern by making it hers. After it was out in the open and accepted by his therapist as a legitimate issue, he would then allow himself to own it. When he would get in touch with a strong emotion and try to express it he would feel weak and scared that he was losing control. The next session  would be taken up with telling his therapist how he was in charge, how well he was managing and what he was putting into practice after therapy sessions. That made him feel like he didn’t need therapy and he began to miss sessions. He would not show up or call to cancel. Sometimes he would cancel and then forget to return to the next scheduled meeting. When his therapist contacted him to make sure he was okay, he would be genuinely surprised at his lapse of memory and act like a scolded child. As this pattern repeated over and over again, Mathew was finally able to talk of his fear of having something really wrong with him and how scared he was that he was discovering a cauldron of anger towards the way in which he was made to conform as a child. During this first phase of therapy, he became aware that he had never been allowed to have a voice. Being given permission to speak in therapy was terrifying as he imagined ugly things coming out, alien to his image of himself and everything his parents wanted him to be.

One day Mathew talked of not having enough free time to play as a young boy. He longed to play but always curbed his appetite since that was expected of good boys in his family. His therapist gave him a sketch pad, paint and colored pencils. He wanted very much to use them but was embarrassed. He wasn’t able to give himself permission to do so in his own home either. His therapist then suggested doing some collage with pictures he cut out from old magazines. He sat on the floor and began to thumb through the magazines, choosing things that attracted him.  It changed everything. His whole body relaxed and he began to create images of how he felt, what he wanted that was out of reach, and things that reminded him of good times with his aunt. This one experience brought forth a vital memory of being loved and accepted by his aunt who always had time for him. That led to the next and deeper phase of his therapy.

Phase two: Feeling Safe Enough to Explore and Be Loved. In this phase Mathew continued to bring many issues into sessions through the voice of his daughter, but was making the transition to owning his troubles more often. He could feel angry for her, outraged at the way she was treated by teachers, friends, his ex-wife and neighbors. He couldn’t do so directly for himself.   A dramatic explosion of dreams from Mathew where he was the helpless, tortured and abused child told of his inner torment. Feeling safe enough to bring these dreams into session was a big breakthrough. The dreams spoke in ways that mere words couldn’t. They told of his difficulties integrating his childlike needs and his adult responsibilities. They gave him a voice that couldn’t be ignored. The images of feeling powerless in the face of emotional abuse enabled him to work on his feelings of having to please everyone so that he may deserve something positive in his life. The dream images invited him to appreciate that he had both powerful and helpless aspects within himself. As he explored his dreams he began to experiment with telling those around him what he wanted or didn’t want, and took some baby steps towards asking for what he needed rather than expecting them to come just because he was being ” a good boy.” He was slowly beginning to see that he was both the torturer and the tortured as shown in his dreams. He was continuing the abuse of his childhood by denying himself the right to have a full life. By separating his adult duties of work and parenting from his wish to have fun and play he was living on one cylinder instead of the two he needed for a complete existence. His dreams were vital in showing this to him, giving him permission to integrate the two sides of him and suggested ways in which he may accomplish them.

Towards the end of the second stage of therapy Mathew had made some changes in his relationships with his ex-wife, friends and clients such that he was more in charge of the outcome of interactions. He began to feel the power he had and that it didn’t result in loss or reprimand from others when he used it to take care of his needs. He spoke of his astonishment when he asked for something and got it. He now allowed himself to imagine and wish for better things in his life, such as a nicer car and apartment, and taking art classes. During phase one of the therapy he wouldn’t dare permit his wishes to be anymore than fantasies that had no chance of becoming real. That changed as he began to appreciate that he was the only one stopping himself from achieving his goals. He spoke of appreciating the fact that his therapist hadn’t given up on him in the early stages, when he himself had. He now experienced the calls to check on him when he didn’t show up to sessions as a loving gesture that made him feel he was worthwhile.  He began re-writing his script and enjoyed doing it. He now had a voice and was using it.

Phase Three: dealing with being loved and the fear it may be withdrawn if he didn’t do what was expected. Mathew began to enjoy coming to therapy after the first 18 months, enough that he could put it into words. He knew he was loved and accepted, but still had fears that it was too good to be true. He needed to find out if he could do his own thing and still be cared for. Could he mess with the therapist and still be accepted?  For a time he began to have severe headaches before a session such that he would black out. He experienced stomach upsets, and while in session talked of pain in his legs, head or neck. He began to come late to appointments and wanted to stop paying in advance as he had been. An exploration with Mathew revealed that he was beginning to feel obligated to attend and didn’t want to “dig” into what was going on for him. He was showing the part of him that didn’t want to conform and be good. He was wondering how it would be tolerated. He wanted to do finger painting like his daughter and discover whether his therapist would allow the mess in the room. Would the therapist still work with him if he changed his payment methods? Would the therapist still love him if he came late?

This was one of the most important pieces of work that Mathew needed to do in order to be free to live his life the way he wanted. As he experienced tolerance, acceptance and encouragement from his therapist to access all the parts of  himself, messy and neat, he started to give himself permission to love those parts of himself too. This was  his second major breakthrough. The relationship with his therapist not only survived but became stronger. He didn’t keep having to act like a child who was on notice to be good or else!!

Phase Four: becoming a more wholesome person.  The next 2 to 3 years of psychotherapy were less painful and focused on using his inclusion in life positively. He continued to experiment with taking better care of himself. That meant going after what he wanted without waiting to be given it. It also translated into protecting himself from being taken advantage of by abusive people. He took more pleasure in parenting and saw it less as a duty. He was less afraid of being a bad parent, and allowed himself to have fun with his daughter. He developed his skills and talents and began pondering ways in which he may turn them into profitable enterprises, so that he didn’t have to separate work and play quite as starkly as he had before.

These four phases of therapy were crucial for Mathew to learn to access all parts of himself, use them to his advantage and to have a relationship with himself that was loving. He freed himself from his own abuse by working collaboratively with his therapist despite the painful obstacles that he encountered. His therapist’s faith in him and willingness to hold onto him through his journey, as well as Mathew’s desire to find himself and live made this a good therapeutic experience.

©Copyright 2007 Jeanette Raymond, Ph.D. All Rights Reserved. Permission to publish granted to GoodTherapy.org. Questions or concerns about the article can be directed to the author or posted as a comment to this blog entry. The article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Click here to contact Jeanette and/or see her GoodTherapy.org Profile