Every therapy session is unique and caters to each individual and their specific goals. It is standard for therapists to discuss the primary issues and concerns in your life during therapy sessions. It is common to schedule a series of weekly sessions, where each session lasts around fifty minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors. It is important to process what has been discussed and integrate it into your life between sessions. For therapy to be most effective you must be an active participant, both during and between the sessions. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives. Let me give you an example.
I worked with a client – whom I will call Bob - who sought help because of issues at work. Bob recently started a new job, which he had worked hard to get. Even though this was a dream job, Bob reported a significant amount of stress and anxiety that seemed to get worse as each day wore on. We worked for several weeks on coping skills and understanding triggers without much relief. Finally, one day it just all came together. We were discussing the actual physical feeling the Bob felt, and he said “this is what shame feels like”. I asked a simple question, “when were other times you felt shame”? Bob listed several other shameful experiences and then the proverbial lightbulb went off, “oh my gosh, I know what it is…”.
Bob went on to describe how his father used shame at the dinner table. If Bob’s Dad felt like we were eating too much he would make hurtful or sarcastic comments to Bob or his siblings like, “geez, did you get enough” or “oink-oink”. Bobs new job provided lunch for employee’s in a small cafeteria. Each day at lunch the chef would stand at the end of the buffet line to refill dishes or make sure none of the employees were taking more than their fair share. This chef was essentially supervising the employee’s as they dished up their food and this reminded Bob of times at the dinner table with his father. Every time Bob went through the lunch line at work this chef unconsciously triggered him, then he would spend the rest of the day miserable because he had no idea why he felt so unsettled – or in this case, shameful.
Once we identified this dynamic as the cause for Bob’s stress and anxiety at work it quickly subsided. Just knowing exactly what, and why this was happening, it practically made the disturbance go away. In the rare instance it resurfaced, we identified coping skills for Bob to use moving forward. Another benefit, which was more important is that Bob now understood this type of dynamic happens to us every day. Most of the time we feel unsettled or emotional it is due to some unconscious trigger we are experiencing. From this day forward Bob could understand that he needed to be more mindful about his emotions and what he was doing with his emotions. For most of us, we go through our day on auto pilot, not bothering to really examine what, and why we feel the way we feel.