Sometimes big celebrations and family gatherings or the lack of them, like Xmas makes us realise we need help with relationships, stress or a whole host of issues.
Accessing help is one the most difficult decisions we make as it can feel like a weakness or shameful. But once we make the decision what can we expect?
The first thing we need to be aware of is the different types of therapy that is available.
Psychotherapy works on many levels by helping us to understand our emotions and actions. It often looks at past issues and their impact on the present by using creative ways to access hidden emotions and issues. It then empowers us to make the changes we need to make in order to feel better. It really works with issues that have built up over time.
Counselling is a form of therapy that helps with changing behaviour and gaining an understanding of behaviour and feelings by empowering us to find our own solutions. It works well with clients who are already aware of their emotional state. These two therapies can be combined to create individual help for clients.
CBT (Cognitive Behavioural Therapy) focuses us on how we think, which affects how we feel and behave. By identifying and changing our thoughts we can change how we behave and feel. It is short term therapy and doesn’t look at the root cause of our issues but gives us coping skills. CBT is available from the NHS and that will normally only last for 6-12 sessions and will deal with one specific issue. CBT is also available from accredited professionals and the best place to find these is BABCP website that has lists of accredited CBT counsellors in your area – http://www.babcp.com/Default.aspx. Any employer, solicitor or insurer will only look for CBT professionals who are BABCP accredited. Being BABCP accredited means they have completed a very high standard of training, a continued commitment to the practice of CBT, supervision and continued development.
When looking for a counsellor or psychotherapist who is not CBT based there are some things we need to be aware of, including whether they are a member of UKCP or BACP, as this means they will have completed a set number of hours, have kept up to date with the latest developments in therapy and have a certain level of qualification.
All counsellors and therapists no matter how they work will have ongoing clinical supervision and the therapeutic theory(s) they use will be checked. We need the one that fits our needs best. Remember, we can try more than one therapist!
Once we have chosen our therapist, our first session usually starts with some small talk to make us feel comfortable and settled in this new situation. Then the sessions look at what we want to achieve, how we will work with the therapist, confidentiality and contracting. But then again if our need to let out our emotions is overwhelming us; a good therapist will let that happen above all of the above.
There are some things we have to be aware of when we start any kind of therapy. Firstly, we have to want the therapy and not be told we HAVE to go to get help by someone else or allowing someone else to make the appointment for us. If we feel coerced, the therapy won’t work. The first thing we need to do is tell our therapist how we feel about being there.
We have to be sensible about what we want to achieve. Many years ago, I went into therapy and said I wanted to be happy all the time. My therapist’s response has stayed with me – “Elaine, they’ll lock you up if you are happy all the time, we are designed to feel all the emotions we have”. Our goals must be realistic and will not happen overnight. Real change takes time and no matter how much progress we feel we have made, we need to walk before we can run.
We need to be connected with the therapist, who will be able to find the best way to be with us. This will allow us to take risks and share some uncomfortable feelings. We need to feel we can trust the therapist and the process. Our therapist will not fix us or make us better. We do that ourselves with the therapist’s support. The answers are in all of us. We just need help to find them.
Therapy is not like talking to our friends nor can our therapist be our friend. Therapists are qualified professionals who are actually there for us without agenda or past history. They are brilliant listeners, who are able to hear us, hold our pain and empower us to change at the pace we can cope with.
Over time we build trust with our therapist and start to share more and more of our feelings, fears, judgements and details of our life. This will be difficult, but this is a key part of the process towards recovery. The sessions will be non-judgemental, empathic and open. Our therapist will not tell us what to do or how to get better. They may help us explore our choices and options or make suggestions, but we as the client, will make decisions.
We have to accept that we will change during therapy. We cannot go backwards and return to who we were before. Our experiences, both good and bad change us, and recovery will also change our perspective and coping strategies. The whole therapeutic journey is full of changes for us and we have to embrace our new ‘normal’ as it starts to emerge.
The process will be tiring and, at times exhausting, so self-care is essential. If we want to go to sleep at 7.30pm we need to do it, if we need to take time out from work we must do it, if we need to be alone then we have to ask people to give us space. Self-care, resting and getting our needs met is a key part of our recovery.
We have to do what works for us. This could be writing journals, drawing, yoga, running or just making ourselves get up and do something. We do need to be aware of the advice of ‘concerned friends and relatives’ who want to give us advice about what is the best thing to do but it’s our decision as to what works for us. It’s also worth remembering what works at the start of therapy may not do so later on.
Therapy sessions will sometimes feel like nothing happened, or be incredibly emotional or seem like a major breakthrough. It’s not possible to predict what will happen or when, but every session is valuable to us. Change or realisations can come days after our session, as the brain can often take time to process what we felt, thought, or did in a session. Memories may come back to us days or weeks after we spoke about a particular issue or event. A picture, smell or taste can take us back to something in our past.
Over time the therapist and client will decide together when therapy comes to an end. We can deal with just one issue or we can work on our self-development and really get to know ourselves as the choice is always ours. Ending may take place over a period of time so it is not an abrupt end. The therapist will check we have the support we need in place outside of the therapy room and that we both have to agree that our goals have been met. We should have a gentle and happy ending, remembering we can always go back into therapy if we need to.
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