Being in therapy can be a daunting process. It's hard to tell your most difficult thoughts to someone every other week, and to work on things that make your life slightly better by small degrees whilst fighting an internal battle as to whether it's worth it. This week I wanted to focus on what it's like on the other side of the fence, with the things that your psychologist probably wants you to know.
We do talk about you - and think about you - when you're not there
In the UK, Clinical Psychologists have supervision on the work that they do - regardless of their skill level or the amount of time since they qualified. This means that they speak to another qualified Clinical Psychologist, every other week or every month, about the people that they see and any difficulties that they may be experiencing. This is a good thing, because it means that if your psychologist is stuck on how to best help, they can get some advice and understanding from someone else - and all of this is completely confidential.
Outside of this, your psychologist shouldn't be talking about your care to anyone else - but we do think about you sometimes. If I know my patients are going to a funeral on a particular day, or I see something that reminds me of them, it's normal and human to think about them. I might spend some time between sessions thinking about what we're going to do in the next session, or sometimes I might make a random association between other things that helps me understand one of the difficulties I might be having working with a particular person. If you find that you're thinking about your patients more than you expect to, maybe that's a conversation for supervision - but most people think about work a little bit when they're away from work, and psychologists are no exception.
We're not always impartial
I personally believe that it's almost impossible to be impartial in therapy - you're building a relationship with another person to work together on some very difficult issues. You're probably going to have some opinions about the situations your patients bring to therapy. Whilst it's obviously important not to jump to any conclusions, I'm not going to be impartial when it comes to issues like the things you say about yourself - anxiety and depression are liars, and I'm not on their side! People often interpret therapists trying to be "neutral" as being cold or aloof, and that can impact more on the relationship than carefully showing that you're on the side of your patient in lots of ways.
We're not here to solve your problems for you
Problem-solving is a vital skill to learn in therapy. Psychologists have got some skills in helping people make links that they might not have made before, and manage distressing situations, but ultimately they are not living your life and any suggestions that are made, whilst based on research and theory, need to be applicable to you. Rather than spending most of your sessions explaining in detail why the things your therapist has suggested won't work, it might be more useful to take the principles of the idea they're trying to explain and see how you can make it work in your own life. Of course, a therapist that won't help you to do that and sticks rigidly to strategies that just don't work for you probably isn't the right therapist for you (see below).
We're not perfect and we don't know everything
Psychologists make mistakes. At the end of the day we're just humans, we're not magic. We're highly trained and try really hard to make sure we don't make too many mistakes, but we still screw it up sometimes. When we do, I hope that we apologise and try to make things right, but I know that's not always the case.
Also, despite what some people would have you think, psychologist don't know everything. We might not be able to help you with a specific solution to your difficulty - that's because every person we see is unique. We're going to do our best, but we don't always get it right and we don't always know how to fix it.
We might not be the right therapist for you
Whilst all of the above is true, if you feel like your psychologist really isn't helping you, it's okay to ask for a different one. An important part of therapy is the relationship, and whilst you don't necessarily need to like your therapist in order to do the work that needs doing, if they make you feel worse every single time you go, or you feel patronised by them or - even worse - frightened or intimidated by them, that's going to make it harder to discuss your difficulties and try out the solutions you both come up with. It's completely fine to try a few different psychologists (if you're paying for therapy in the UK) and see who is the best fit for you. On the NHS it's a bit harder to switch therapists, but it's always worth asking.
We can't always articulate exactly what is going to happen in therapy
Some of the hardest conversations I have with people involve them expecting me to walk them through the exact steps that therapy will follow in our first assessment session. If I could, I definitely would, but then it would be more like surgery, or giving you medication, and you wouldn't need to come back to see the therapist again. We have goals to work towards, and a good idea of what might help, but we can't just tell you how to do things. That can be frustrating when you need clarity and concrete answers, but if those worked you would have just done it yourself by now! Psychologists recognise that people are smart, and that if it was a case of one simple thing changing everything, therapists wouldn't be needed. Trusting that there are things that can be done to help, but that it's a process, is a really hard but necessary component of therapy.
So there you have it! I'm aware that this is a fairly personal blog post based on my experience - if there's anything you wish your therapist knew in return, or for the psychologists out there if there's anything you want to add, let me know in the comments.
Dr Sarah Blackshaw: Clinical Psychologist, blogger, tea drinker, interested in dinosaurs and shiny objects