Getting the Most From Therapy – Openness and Holding Back

Posted by James Driver, With 0 Comments, Category: therapy, Tags: , , ,

Sometimes we can be our own worst enemy in therapy. We come to the experience wanting help with a problem, wanting to be open, wanting to be able to trust the therapist and hoping that they can help us – but then often hold ourselves back in ways that makes it hard for us to benefit.

This is normal. I don’t think anyone comes to therapy without a fair amount of hesitation, uncertainty and protectiveness – it’s a strange and vulnerable experience, after all. As a result, at the same time as we want help with a particular problem we can often be reluctant to talk about it completely openly and honestly. Part of us is telling us ‘go on, tell him what you’re really thinking and feeling’ while another part is saying ‘don’t tell him what’s really on your mind, he’ll think you’re crazy/terrible/overdramatic etc.’ What we then sometimes end up doing is trying to allude to the issue, or say what we’re thinking or feeling but in a more ‘sanitised’ form than the reality. So rather than saying ‘I felt completely devastated’ we say ‘It was pretty difficult’.

It would be a bit like if you went to the doctor and when they ask ‘what’s the problem’ you point to somewhere fairly close to the injury but not the injury itself. Which makes sense of course, because you know that if you point to the actual injury they’re going to start poking it to work out what’s wrong and that’s going to hurt. Or they might ask awkward questions like ‘how on earth did you manage to get injured there?’ Of course the problem with this is that they then go to work trying to find out what the problem is, but they’re not really looking in the right place. Which means you go away with some suggestions or solutions that don’t really match the problem.

The same thing happens in therapy, except even more so because unlike a bleeding wound or a broken bone, our emotional wounds and injuries don’t have such obvious signs that point to what’s wrong. In order to get the most out of it, it’s important to help guide the therapist towards the things that really do hurt the most, towards those things that you least want to explore.

I remember when I was in my own therapy I often found myself wishing that the therapist would think to ask certain questions, would realise that he needed to ask me about particular topics or dig in deeper on certain issues. Of course, he rarely did – because at the same time as I wanted him to ask about those things, another part of me was steering him away from them by not bringing them up myself, by giving short or disinterested answers when he did ask related questions – basically by giving all the signs that those were not topics of much significance or not things that I wanted to address.

So how can you overcome this and get the most out of therapy? The first thing is to become aware of any possible topics that you have these mixed feelings about. That is, things that you both do and don’t want to talk about. A good way to identify these things is to ask yourself ‘Is there anything that I really wish my therapist would ask me about but hasn’t?’ or ‘Is there anything that I wish my therapist would dig into more deeply than he/she has?’ Sometimes the reverse question is also helpful, ‘Is there anything I really hope my therapist doesn’t ask about?’ If you can identify some of these things, then the next question to ask yourself is ‘Why would I want to/not want to talk about that topic, and how would I feel about it if I did?’ In many cases when you think about this you may find that it comes down to thoughts about how the therapist might react if you discussed it, or what they might think or feel towards you.

For example , a client might find himself wishing that his therapist would ask more about the relationship with his wife because he feels scared and intimidated by her and it is making him very unhappy. At the same time, he doesn’t want to talk about it because he has the thought ‘my therapist will think I’m weak if I’m feeling scared of my wife’ or ‘my therapist will think I should just leave her if I bring it up, and I don’t want to do that’.

Or another example, a client might want to talk about how overwhelmed she feels by her anger towards her young daughter and might bring this up with the therapist – but then holds back from telling the therapist that sometimes she feels like she hates her daughter or feels like hitting her because she has the thought ‘my therapist will think I’m a terrible person if I hate my own daughter’.

In general, the things that feel most uncomfortable to talk about or that provoke anxiety about how the therapist will respond are often the most important things to discuss! If you can identify things like this for yourself – that you both want to and don’t want to talk about – then the next step is to try and find a way to bring this into the therapy room. Sometimes a good place to start with this is by talking about the fear of talking about it, or the thought that you worry the therapist might have. For example, ‘There’s something I wish you’d ask me about, but I worry that you’ll think I’m pathetic if I talk about it’. Or ‘I know we’ve talked about my anger before, but I find it hard to tell you how bad it gets sometimes becomes I’m worried you’ll think I’m a horrible person’. Very often, naming the fear can make it more manageable and can make it something that you and the therapist can work with together rather than feeling stuck with it on your own.

Getting the most out of therapy means being as radically, open, honest and vulnerable as we possibly can be. Which is to say, doing something terrifying that would likely be a horribly bad idea in nearly every other situation in our lives – and so unsurprisingly a part of us wants to stop us and interrupt us from really doing this. Catching that part and bringing it into the light along with the fears that it has – the fear that if we’re really honest we won’t be accepted, or loved, that we’ll be hated or rejected – is crucial to overcoming that fear and moving towards accepting ourselves as a complete person with all our thoughts, feelings and needs.

The ways in which we hold ourselves back in therapy often make a lot of sense – perhaps we’ve had negative reactions to the things we want to talk about before, or have been judged by others in the past. But they can also stop us from getting the most out of the experience, and in some cases can get in the way of making much progress at all. I encourage anyone who is in therapy to ask themselves the question at the end of every session ‘Was there anything I wish I’d said or asked today that I didn’t?’ and, if there was, to find a way to bring it up next time.