A Summary of the Therapeutic Process
When people initially come into counseling, there is often some anxiety about what to expect. What is counseling? What happens in this therapeutic environment? What should a client expect from this experience? Unfortunately, the word “counseling” implies for many that the counselor’s job is to tell them what to do. Often, they come looking for someone to give them “counsel.” After listening to the story of dysfunction that brings an individual, I ask, “What are you asking of me?” The response is often, “Just tell me what to do.” But counseling is not advice giving. So, rather than use the word “counseling,” I try to use the word “therapy.” It comes from the Greek word meaning “to heal” and I think is a better word for what happens in the process.
Most often, the presenting issue that brings people into therapy is emotional distress and/or disruptive behaviors. One client comes because of anxiety and panic attacks. Another client comes because there is poor communication in the marriage. Another comes because they need to know how to set appropriate boundaries in a codependent relationship. As a result, relationships are strained, social life is hindered, and life becomes dysfunctional. Therapy offers the opportunity to find resources to deal with the distress.
Rather than dispensing advice, the first job of the therapist is to lead the client to insight. Every person has some blind spots about themselves. Often times, these blind spots are the result of denial or another form of anxiety defense and they are not easily released. For example, the client who needs to set appropriate boundaries may not realize that their own behavior is contributing to the problem. They must learn that it is okay to set boundaries, to say no, and to take steps for self-care. It may take some time before the client is able to wake up to themselves and gain the needed insight.
Once the insight is gained, it can lead to change. It is not enough to simply understand. There must be a willingness to make changes based on the insight. Some clients may become aware of what is necessary, but then resist making the necessary changes. Most of us resist change. One of my mentors said, “Many people don’t want to get well; they just want to feel better. Getting well means making too many changes.” If we refuse to change, the healing stops and the therapy ends.
The therapist will suggest different interventions to help negotiate the changes that are necessary for healing. Different therapeutic theories will offer a variety of interventions. For example, Cognitive Behavioral therapy will look at the client’s thoughts that lead to the dysfunctional behaviors and suggest new ways to think. Emotion Focused therapy will look at the emotions behind the behaviors and suggest what the emotions may be asking of the client. Psychodynamic therapy will look at the unconscious processes that are guiding the behaviors. Each of these theories will use the interventions to promote change.
When the client begins the process of change, a whole new way of life opens. New ways of managing emotions are possible. New ways of being in relationship are navigated. New ways of moving through the normal developmental stages are discovered. As the client follows these new ways of being, the process of healing will continue and a healthy life can be enjoyed.