What to expect from psychotherapy

Mertha Mo Nyamande

PSYCHOTHERAPY is a complex space, where both the therapist and client explore known and unknown territories.

It is a space where you can get lost, together. However, you can get assistance to find a way to a place of contentment.

Often, clients come with a lot of fears and worries about past experiences, and, at times, they do not even know their real problem, apart from stating that they are just unhappy, unsettled or even confused.

The journey of therapy becomes one of finding someone who can accompany you through those dark and scary places, and help you come out through the other end, having confronted your fears enough to begin the healing that you need.

Ground rules and orientation

Therapy is a very personal space, one that requires building trust, especially in those whose hope has been shattered in past experiences. Confidentiality and creating a safe space for this work to occur becomes the cornerstone for whatever modality you engage in.

Another critical aspect of therapy is to establish healthy routines.

The most difficult aspect of therapy is to have your beliefs about life and how you see yourself, others and the world challenged.

Mental state examination

There are other things that occur in therapy that you may not necessarily get to know about, but your therapist uses this information to evaluate your progress. These are things like your mental state examination, which looks at your appearance and behaviour. How you appear helps to inform how you feel; whether you put in a lot of effort or you just turn up unkempt.

How you behave towards yourself and others also says a lot about you and your progress, whether it is appropriate or otherwise.

Speech

The tone and rate of your speech, as well as the content thereof, also give an idea of your thoughts and the thought patterns – whether coherent or distorted. All this is helpful towards understanding the work that needs to be done to help you make the progress you need. How you feel (your emotions) or any difficulty in this regard is a very important part of the work to be done, as it helps to understand your thought patterns. It also helps to inform the behaviour these produce.

Other daily functions like sleep and whether one is restful or restless are also useful in understanding the unresolved issues. This can also be complemented by the nature of one’s dreams and or nightmares.

The energy you will have upon waking up helps to indicate the nature of your sleep, and this contributes towards your emotions, especially irritability or excitement.

As chewing food requires a lot of effort and coordination, your appetite may be affected if you have not rested well at night, thereby creating a cycle of events to be aware of during therapy and assessment of your needs. Another very important part of therapy is assessing risk in every session to ensure you remain safe in order to get to your required destination.

If any risk issues are identified, they will be discussed and measures agreed on to ensure your safety.

Should you feel suicidal or homicidal or have any thoughts of harming yourself or others, you should discuss these during therapy so that you and your therapist can come up with better ways of managing whatever difficulties you may have.

Types of therapy

Depending on the nature of your therapy, you may have SMART (specific, measurable, achievable, realistic and timely) goals you want to work towards, and these should be discussed and reviewed throughout your therapy. Cognitive behaviour therapy (CBT), especially, is very focused on goals, while other therapies like psychoanalysis may not have any specific goals but timed sessions that will be structured and reviewed at specific points.

Therapy is best conducted on a weekly basis to ensure there is adequate time for reflection, homework and experiments.

This also gives you time to practise and gain the empowerment and strength not to become dependent on your therapist.

The goal of therapy is to ultimately help you become your own therapist through giving you the understanding of your deeper issues and the skills to address them in productive ways. In the next article, we will get into a therapy session, assessing an imagined problem. If anyone wants to have their problem analysed, you can write to us.

Mertha Mo Nyamande is a psychotherapist. He can be contacted on [email protected] or @ www.i-wellbeing.weebly.com