Getting the Most out of Your Therapy

Therapy isn't magic, and it's not liable to work if you don't make it work.  Here's some thoughts on how to get the most bang for your therapy buck:

1. Thinking it’s only the therapist who’s responsible for making it work.

Getting help in therapy just isn’t comparable to getting a good car wash; you have to participate actively. Once you’ve found a therapist you like, be as honest as you can be about what’s happening in your life. Follow directions. Talk about what you need and want. If the therapist isn’t helpful, say so with an open mind.

2. Thinking it’s only you who’s responsible for making it work.

Bad therapy doesn’t help you grow. Sure, you’ve got to do your part, but if you’re not getting any help, say so.

3. Not sure the therapy’s working? Ask for a consult.

Many therapists will recommend a colleague or colleagues with whom you can meet to discuss your treatment and get a “second opinion” on whether therapy is working and what it may need to improve.

4. Getting in a rut with a therapist you don’t like or who you don’t find helpful.

Sure, this post is all about the patient taking the reigns to make the therapy work better, but if you’ve tried to make it work—asked for what you need, raised what’s not working for you and you still don’t find it helpful, leave! There are many great therapists out there.

5. Getting in a rut with a therapist you like a lot.

Plenty of people tell me they love their therapist—they’ve worked with him or her for years, they’ve built a lot of trust. But it’s important periodically to check in on whether things have perhaps gotten too comfortable. Is the therapy still challenging? Do you find your therapist saying things that are important but hard to hear? These activities are essential to good therapy.

6. Lack of (emotional) ambition.

Whether the result of bad experiences in therapy, or any of the myriad causes of a short-sited view of what’s possible, many patients come into therapy with low expectations. I’ve head patients say, “I know I probably can’t have X but I just want a little bit of help with Y.” Ask for more. Think bigger. Not good at that? Ask for your therapist’s help.

7. Doing friendship instead of therapy.

Many of my patients consider me a friend, and I’m proud of that. Often they’ll ask me how I am, or inquire about a persistent cough or a new haircut. I appreciate that, and try to be open and honest in my answers. But that’s not the same thing as doing friendship. You’re the one paying for therapy. If it feels like you’re just hanging out with your therapist, it might be time to check in on whether the work is as growthful as it could be.

8. Expecting your therapist to be perfect.

Mistakes in therapy can turn out to be some of the best opportunities for growth: scheduling mishap, a billing error, forgetting the name of an important friend or family member. See these as opportunities to get closer and to learn more about your own struggles with perfectionism and making mistakes.

9. Thinking that going to therapy is the only thing you need to do to change your life.

That 45 minute session (or two... or three) a week is only helpful if you’re willing to (keep) work(ing) outside of therapy. Just as it’s your responsibility (along with your therapist) to build the therapy, so is it your job to build all of the relationships in your life (including that irritating co-worker) as well as with non-human relationships in your life (like your health and your finances). Good therapy shows us (and produces the development for us to create) is that we are the architects, engineers, and builders of our lives.