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What Is Psychotherapy Really Like?

At the Ball via WikimediaAbout six months ago, a few days of self-reflection showed me something I didn’t want to see: I needed help. Life had gotten to overwhelming and I just couldn’t do it on my own anymore. I started looking for psychiatric care.

There had been many difficult weeks and months over the past decade or so in my life when I’d asked myself, “Do I need to see someone?” But the idea of therapist made me nervous. I didn’t know what to expect from psychotherapy, and I wasn’t sure what being in therapy would mean about myself.

Finding the right therapist was one of the biggest steps forward in my psychological care, so I want it to make it easier for others to find help, too.

What Isn’t Therapy Like

Before I started therapy, I had several misconceptions that held me back.

  • Therapy isn’t self-indulgent. Even though I suspected I was depressed for a long time before my diagnosis, I resisted seeing a therapist. After all, what seems more self-indulgent than lying on a couch, paying someone else to listen to you for an hour? It turns out that therapy isn’t just about rehashing your past; it’s about relearning the habits that will help you function better in life. That means therapy leads to better relationships with family, friends, and strangers. And being a better wife, husband, friend, and neighbor doesn’t seem that self-indulgent after all.
  • Therapy isn’t just for people who are “really crazy.” I waited until I was really ill to seek help. As a result, my first therapy session ended with a referral straight to the hospital. The earlier a person seeks help, the faster and more easily she can recover. Most open-minded people can benefit from therapy, so no therapist will make you feel foolish for seeking help. If you think you need therapy, it’s worth finding a therapist to evaluate you.
  • Therapy isn’t surrender. This time last year, I thought that, if I fought hard enough, I could think my way out of depression. Seeking professional help would have been giving up—and, as a person of faith, a sign that something was wrong with my spiritual life. But therapy absolutely isn’t surrender! It’s more like a personal trainer for your brain to strengthen your ability to heal yourself.
  • Couples’ therapy is only for people with failing marriages. Finally, a note about couple’s therapy. A good friend and confidante with post-partum depression suggested that Adam and I consider couple’s therapy after my diagnosis. I thought she meant that depression would put my marriage in serious jeopardy. Instead, couple’s therapy gives Adam and me time to work through the little things in our marriage and daily routines that don’t work quite right. It helps us make our good marriage even stronger.

Who Needs a Therapist?

Most open-minded people who are eager to learn better mental habits can benefit from therapy. But there are some special signs you may need the extra help:

  • You can’t function as well as you normally do—especially because of anxiety, irritability, or sadness. Unexplained medical problems like chronic pain, exhaustion, or trouble concentrating may also be signs of mental illness.
  • You’re in a new and difficult situation. Many people benefit from therapy at major transition points in their lives such as college graduation, marriage, and childbirth. Other traumatic events, like the death of a loved one or a sudden job loss, count too.
  • You’re haunted by past events or habits. A therapist can help you finally let go of difficult feelings from your past or recover from traumatic experiences—in my case, like a terribly botched labor and delivery. He or she can also help you understand and change bad habits for thinking about yourself or interacting with other people.

Psychology Today also has a helpful self-assessment to evaluate their own needs.

What Happens During Therapy?

If you think you may need therapy, here’s a general idea what to expect.

  • Most therapists will want to speak with prospective briefly over the phone before a first appointment. A potential therapist will ask you a little about yourself and your goals to make sure the two of you are a good fit. You may also talk about scheduling, payment, and other practicalities.
  • Most forms of therapy boil down to talking. Your therapist will ask you a little about yourself and what brings you to therapy. Depending on your therapist’s style, she’ll either take the lead by asking you questions or listen while you explore your ideas aloud.
  • Therapy isn’t just about having someone to listen. It’s about doing serious work digging into your past to explain your current behavior, and then building better habits for the future. Your therapists may ask you to elaborate, gently disagree with your interpretations of events, or problem solve.
  • In couple’s therapy, your therapist will listen to both of you. She may mediate problems when they come up, but she is more likely to ask you both directed questions to help you see from each others’ perspectives.
  • After your first appointment, your therapist will probably ask you how the appointment felt. It is okay to discuss what helped and what didn’t. The two of you may choose to part ways—that’s totally okay. She may even have suggestions for therapists who might be a better fit.

How Do I Find a Therapist?

The term “therapist” describes a variety of different professionals. Most licensed professionals are qualified to provide the same level of care, although each professional has her own niche.

  • A psychiatrist is a medical doctor who manages mental illness with medication, as well as through other means. Most psychiatrists do not work as therapists. If you’re seeing a psychiatrist already, she may also be able to refer you to the right therapist.
  • A psychologist is a doctoral-level, licensed professional who often treats patients using different kinds of talk therapy. Along with psychiatrists, psychologists are the most qualified to make specific diagnoses.
  • A social worker has a master’s degree in social work. She may also use talk therapy, but she has specific training in helping patients take advantage of resources in the community.
  • A counselor, such as a marriage or family counselor, is also a masters-level professional. Most counselors don’t have experience providing specific diagnoses, although the can still be a valuable resource to improve your mental health.

One you have decided what kind of professional you would like to see, try using Psychology Today’s therapist search to find someone in your area. (Many therapists don’t deal directly with insurance, but it’s a good idea to look for someone who takes your insurance. You can search by insurance at Psychology Today.)

My therapist is a psychologist with a cognitive behavioral therapy background, which means she focuses on helping me change my thoughts and behaviors. I like her because we don’t focus on my childhood or wallow in my perceived failures. And she doesn’t just sit back and expect me to talk. Instead, she gives me clear strategies to meet achievable goals.

Adam and I have also seen social worker who specializes in couples’ therapy. She was very encouraging about the state of our relationship, telling us that—even though we were facing some specific challenges—we were still good communicators. She helped us work through some problems so our lives could be easier and happier.

I am not a professional. This isn’t medical advice—it’s just a description of my own experiences in the mental health care system. If you think you need help, talk to a professional right away. Remember that suicidal thoughts are an emergency.

4 responses »

  1. Pingback: What Is Psychotherapy Really Like? « Experimental Wifery « PerformanceVertical Perspectives

  2. This was a hugely insightful read! My partner has suffered from depression for a long time but only recently sought professional help (after considerable encouragement – he was embarrassed to admit he needed help).

    He’s been referred for cognitive behavioural therapy, which from your description will likely be incredibly beneficial for him. I’m so happy to be able to read about and learn from your experiences and hope this will help me better support (and reassure) him that he’s made the right decision.

    Thank you!

    • I’m so glad you found the post helpful. I wish you and your partner the very best of luck.

      Depression is a very difficult disease to face, especially alone. I’m glad he has your support!

  3. Pingback: Lessons Learned from Two Speeding Tickets | Experimental Wifery

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