Psychiatrists, psychologists, and other mental health professionals are renowned for listening. But there’s actually a lot they’d like to tell you about how therapy works—including the fact that the old lying-on-a-couch stereotype is so out-of-date. Here’s what we found out when we asked them about their feelings.
Cast off the stigma of mental illness. "The truth is that current psychological research and intervention takes aim at building a better brain, rather than labeling it with a psychopathological name," says psychologist Jeffrey L. Brown, PsyD, ABPP. "Today, therapy offices are filled with intellectually sharp individuals who are trying to harness the power of their brains."
You comparison shop for cars and TVs; do the same for your therapist. Most have an online presence that offers helpful clues as to whether you’ll click. "Through my website, blogs, and articles, you’ll get to see what I look like, what my style is, and my types of clients," explains Paulette Janus, LCSW, a social worker who provides psychotherapy services.
Most therapists offer a free consultation, or will at least answer initial questions by phone or email. "Ask about my typical sessions, treatment approaches, areas of expertise, and ways of monitoring progress," Janus says. "And don’t be afraid to say that we’re not a good fit. I won’t take it personally."
Yes, medications are effective against depression, anxiety, and similar conditions. But studies show they work best in combination with therapy, and sometimes therapy alone proves superior. “Medication can be a Band-Aid that’s helpful while you are in psychotherapy to get to the root of your problems,” says psychiatrist Carole Lieberman, MD.
"Many times, individuals will think a therapist can help them get sober or stabilized by seeing them once a week," says Lisa Bahar, LMFT, LPCC, a licensed marriage and family therapist and professional clinical counselor. But serious cases need medical stabilization. That typically means treatment by a psychiatrist, a medical doctor with an additional three to four years of combined internship and residency.
Your session is yours, and you’re free to spend it updating your Facebook status. But often, patients use technology to avoid issues they don’t want to face. You’ll probably get more out of your time by turning your ringer off and keeping your phone in your pocket.
"We live in a culture where we've been conditioned to believe we can have whatever we want when we want it. This simply isn’t the case with therapy," Dr. Brown says. "Therapy is a collaboration, not a magic show. It’s a process of change and life improvement."
Check your shame at the door. "Patients are most embarrassed describing sexual issues, but they needn’t be since mental health professionals are trained in sexuality -- and engage in sex, too," Dr. Lieberman says. If you want help changing your behaviors, your therapist needs to know the whole truth.
Arrive with an understanding of your copayments, the office policies on payment—and your checkbook, if needed. Many times, payment is required at each session. "Therapists may become resentful if they are not paid, and that only hurts the client," Bahar says.
"Therapy is about dealing with difficulties," Janus says. "You have to delve into the tough emotions and situations in order to process them and change." Understand that there will be ups and downs along the way, but also speak up to your therapist if you’re frustrated by your progress.
Don’t expect your therapist to make decisions for you. "That’s simply not our job," Dr. Brown says. But do expect honest feedback about your emotions and behavior. "We may point out your blind spots in order to help you, but a good psychotherapist never judges or criticizes," Dr. Lieberman says.
Some styles of therapy result in a phenomenon called transference. Angry or hurt feelings toward others may be shifted to your therapist as you work to address them. Professionals are trained not to take this personally, and also to manage it so you continue to make progress, Bahar says.