What to Expect

What should I expect from psychotherapy?

Essentially, psychotherapy is a conversation between two people: the patient, who is suffering, and the therapist, who is in service to the patient. The conversation is focused on increasing the patient’s self–awareness and understanding. Having the opportunity to discuss painful experiences or negative feelings in a confidential setting can feel as if a burden has started to lift and many patients report feeling some degree of relief when they start telling their story. However, it is not uncommon to go through a period of feeling worse before starting to feel better. As the poet Rumi wrote, “the cure for pain is in the pain.”

Although it is important to feel that your therapist is compassionate and caring, that does not mean that difficulties or challenges will not emerge in psychotherapy or in the therapeutic relationship. For example, patients may feel therapy isn’t helping or that they are stuck, or even feel angry or upset by something the therapist has said during a session. Research on psychotherapy reports that patients frequently leave therapy prematurely because they don’t want to address these concerns. Under no circumstances should a patient feel pressured to return to therapy if they wish to leave; however, it is important to note that negative feelings towards the therapist and the therapeutic process are not unusual.

I encourage patients to risk voicing all negative feelings, particularly those they feel about the therapy process and me. I welcome patients’ concerns and challenges because they are often therapeutic opportunities that contribute to further growth and reparation. For example, if a patient can successfully process uncomfortable feelings they hold towards me, this increases his or her chances of being able to process difficult feelings towards significant others in his or her life. As a therapist, if I am unwilling to learn from my patients, then my effectiveness diminishes.


When does a person need psychotherapy?

As with most emotional or behavioural problems, early intervention can reduce the risk of developing a chronic psychological condition. Also, participating in couples therapy and marital therapy before problems become entrenched can help to prevent relationship breakdown.


How often and for how long will I need psychotherapy?

Frequency of sessions is dependent on a variety of issues including, motivation, level of distress, timing, and financial feasibility. These issues are discussed during the initial consultation session. People often attend psychotherapy on an “installment basis”. For example, they start with regular appointments for a stretch of time to work on certain issues, returning periodically when issues arise in their lives or they are going through major transitions.

Another common question about psychotherapy is when should sessions end? Although I explore this issue with patients, I generally leave the decision up to them. A useful guideline offered by Sigmund Freud, the great–grandfather of psychotherapy, who states: “Therapy is over when the patient (one who suffers) becomes an agent in his or her life and is happy in work and love.”

That criterion doesn’t sound too bad to me.