Format & Frequency
Many who seek out psychotherapy have a rough idea of what they are looking for, what they are troubled by, what's no longer working in their lives (...or never was), what intuitively feels unbalanced, unhealthy, limiting, self-defeating, or self-destructive.
But many struggle with understanding what types of counseling are available and appropriate to treat their issues.
And, even if you have a good feeling regarding finding a practitioner who resonates with you and a general impression that you trust, then what? What kind of investment can I make in therapy? How often do I need to go? What results should I expect? Does this even work? How long is this going to take? Do I really need it after all?
Are you one of these people? Of course you might be confused or mystified, or somewhat hesitant about the process and what to expect, you are probably not a psychologist!
Since this is such a normal and quite common part of addressing the presenting problem during new inquiries and initial intakes, I wanted to offer some thoughts and guidelines so that you might be more informed heading into this rather mysterious, ambiguous process called therapeutic relationship. My hope is that with this information, we might be more intentional and powerful in clarifying our aims and working relationship then if we just "take the plunge" and dive right in (which, interestingly enough, does end up working, because what needs to be known and worked through does find a way...).
Firstly, I notice there are two general categories of psychotherapy: these different forms of psychotherapy look and act somewhat different in practice, and of course there is a spectrum between them. Psychoanalysts, for at least seventy years, have also classified psychotherapy using these useful categories, so I am drawing on both my clinical experience and the larger tradition of analytic psychotherapy in formulating these guidelines (though I am taking out technical terms here and favoring a practical way of talking):
1. Brief, or short-term psychotherapy: Many clients come to therapy because of a single, troubling life experience, a current, problematic situation, or a recent breakdown in coping regarding something specific. Examples of this type of presenting problem are:
a. finally wanting professional help as a loved one of someone struggling with a substance abuse problem,
b. the onset of a phobia (or intense fear/panic) around one or two feared situations,
c. needing help with one difficult relationship with, for instance, an overbearing boss, a depressed spouse, or a child with behavioral difficulties,
d. wanting to develop some skills and resources regarding unmanageable stress in daily life,
e. wanting to develop insight and the possibilities for change around a few "bad habits", such as overeating, procrastinating/avoiding, underperforming, or having angry outbursts with loved ones.
Another common variation of this type, so common I found it important to point out on its own, is excessive difficulty with making a big life decision. This usually involves an unresolved, inner conflict that can reach epic proportions and can disturb all areas of functioning (work, relationships, family, sleep, eating, general wellbeing). This is not a small deal, but should be classified as an issue that is limited and much more workable than issues that require longer-term psychotherapy to understand and resolve. I have had success working with clients, using existential questions and Gestalt approaches, in facilitating a true resolution of a choice that needs to be made, or wants to be made, regarding identity and life direction.
For people in this category, I find the format of weekly psychotherapy for an unspecified, but time-limited, number of weeks the most helpful. The model of psychotherapy I practice is collaborative and open, so this is only a recommendation that is not mandatory. It can be, and should be, tailored to your unique needs and schedule constraints, made with thoughtful consideration and planning. For some, due to other commitments, their preference in terms of pacing, or budgetary concerns, meeting every other week is more feasible, still for even others, meeting monthly is most preferable. I find that whatever frequency you can work with that commitment to that frequency, and a commitment to working at the issue persistently and systematically, until it is resolved, creates the best results and the most satisfaction from the therapy experience.
2. Long-term psychotherapy: Many clients come to psychotherapy with a history of multiply determined, mutually interacting, psychological problems that, most of the time, require many years of work to get out from under and to disentangle, in order to experience possibilities of true change at the character, or personality, level. Do not be daunted if this is you! I have had great success working with people who require this long-term work who, after uncovering and correcting many imbalances, attitudes, traumas, and dysfunctions, come to experience greater ease, joy, and balance in their everyday lives, after many, many years of turmoil, chaos, disorganization, self-doubt, and debilitating anxiety and depression. I just want to properly inform those in this category of what it takes (and this is just how it goes, it's not your fault): it takes a lot! A lot of patience, fortitude, commitment, and tolerance of the ups and downs of progress and regression (or succumbing to that part of us that is entrenched in what is sick, stuck, small, comfortable, complacent, or young).
If you are looking to:
a. seriously restructure your personality,
b. significantly change the way you relate to yourself, life, and other people,
c. get out from underneath complicated patterns of self-defeat and self-destruction,
d. work through significant disturbance in the equanimity of your psychology (if you experience severe or recurrent patterns of mood instability, disorders of energy or mood such as complicated, bewildering patterns of severe anxiety, depression, unexplained fatigue),
e. work through significant disturbance in the steadiness of your work life, love life, family life, and personal life,
f. work through a lifetime of traumatic, unprocessed, upsetting life experiences
Long-term psychotherapy is, in my opinion, your best option. Most of the time for most people. For people in this category, I find the format of weekly psychotherapy for an unspecified number of years, usually multiple, the most helpful.
Another way to handle therapy if you fall into this category and this model is simply too much investment (of time, energy, financial resources), is to spend a number of initial sessions charting a road map of personality dynamics, and then systematically, over a long-term process, peeling back the layers of dysfunction. Neurosis is like an onion and when one level of dysfunction is relatively resolved, another is revealed. Over time, perception, and perception of the self becomes progressively clearer and clearer. The hardest work is the initial work!
How this plays out is by working on one issue, usually the most chronic, the one most "in your face", persistently until it is resolved (such as in a weekly psychotherapy format). Then, taking a break from therapy for some time, until the next issue comes more clearly into focus, and renewed energy makes it possible to start another round of psychotherapy again. In this way, deeper work and deeper change progressively make themselves available as we powerfully work through the personality. I use a depth-oriented, Jungian approach in doing this kind of work that I take quite seriously. This kind of work facilitates none other than the truest expression of the personality, and its unfolding, in what Jung called "the individuation process."
Having been in private practice at my office at 2305 E Arapahoe Rd. #123 for nearly a decade, I enjoy holding space and being a container that is stable and available for returning clients who want to pursue deeper work as it becomes necessary down the road.
Do not be daunted! This is the deepest, most challenging quest, the quest of Self!
But many struggle with understanding what types of counseling are available and appropriate to treat their issues.
And, even if you have a good feeling regarding finding a practitioner who resonates with you and a general impression that you trust, then what? What kind of investment can I make in therapy? How often do I need to go? What results should I expect? Does this even work? How long is this going to take? Do I really need it after all?
Are you one of these people? Of course you might be confused or mystified, or somewhat hesitant about the process and what to expect, you are probably not a psychologist!
Since this is such a normal and quite common part of addressing the presenting problem during new inquiries and initial intakes, I wanted to offer some thoughts and guidelines so that you might be more informed heading into this rather mysterious, ambiguous process called therapeutic relationship. My hope is that with this information, we might be more intentional and powerful in clarifying our aims and working relationship then if we just "take the plunge" and dive right in (which, interestingly enough, does end up working, because what needs to be known and worked through does find a way...).
Firstly, I notice there are two general categories of psychotherapy: these different forms of psychotherapy look and act somewhat different in practice, and of course there is a spectrum between them. Psychoanalysts, for at least seventy years, have also classified psychotherapy using these useful categories, so I am drawing on both my clinical experience and the larger tradition of analytic psychotherapy in formulating these guidelines (though I am taking out technical terms here and favoring a practical way of talking):
1. Brief, or short-term psychotherapy: Many clients come to therapy because of a single, troubling life experience, a current, problematic situation, or a recent breakdown in coping regarding something specific. Examples of this type of presenting problem are:
a. finally wanting professional help as a loved one of someone struggling with a substance abuse problem,
b. the onset of a phobia (or intense fear/panic) around one or two feared situations,
c. needing help with one difficult relationship with, for instance, an overbearing boss, a depressed spouse, or a child with behavioral difficulties,
d. wanting to develop some skills and resources regarding unmanageable stress in daily life,
e. wanting to develop insight and the possibilities for change around a few "bad habits", such as overeating, procrastinating/avoiding, underperforming, or having angry outbursts with loved ones.
Another common variation of this type, so common I found it important to point out on its own, is excessive difficulty with making a big life decision. This usually involves an unresolved, inner conflict that can reach epic proportions and can disturb all areas of functioning (work, relationships, family, sleep, eating, general wellbeing). This is not a small deal, but should be classified as an issue that is limited and much more workable than issues that require longer-term psychotherapy to understand and resolve. I have had success working with clients, using existential questions and Gestalt approaches, in facilitating a true resolution of a choice that needs to be made, or wants to be made, regarding identity and life direction.
For people in this category, I find the format of weekly psychotherapy for an unspecified, but time-limited, number of weeks the most helpful. The model of psychotherapy I practice is collaborative and open, so this is only a recommendation that is not mandatory. It can be, and should be, tailored to your unique needs and schedule constraints, made with thoughtful consideration and planning. For some, due to other commitments, their preference in terms of pacing, or budgetary concerns, meeting every other week is more feasible, still for even others, meeting monthly is most preferable. I find that whatever frequency you can work with that commitment to that frequency, and a commitment to working at the issue persistently and systematically, until it is resolved, creates the best results and the most satisfaction from the therapy experience.
2. Long-term psychotherapy: Many clients come to psychotherapy with a history of multiply determined, mutually interacting, psychological problems that, most of the time, require many years of work to get out from under and to disentangle, in order to experience possibilities of true change at the character, or personality, level. Do not be daunted if this is you! I have had great success working with people who require this long-term work who, after uncovering and correcting many imbalances, attitudes, traumas, and dysfunctions, come to experience greater ease, joy, and balance in their everyday lives, after many, many years of turmoil, chaos, disorganization, self-doubt, and debilitating anxiety and depression. I just want to properly inform those in this category of what it takes (and this is just how it goes, it's not your fault): it takes a lot! A lot of patience, fortitude, commitment, and tolerance of the ups and downs of progress and regression (or succumbing to that part of us that is entrenched in what is sick, stuck, small, comfortable, complacent, or young).
If you are looking to:
a. seriously restructure your personality,
b. significantly change the way you relate to yourself, life, and other people,
c. get out from underneath complicated patterns of self-defeat and self-destruction,
d. work through significant disturbance in the equanimity of your psychology (if you experience severe or recurrent patterns of mood instability, disorders of energy or mood such as complicated, bewildering patterns of severe anxiety, depression, unexplained fatigue),
e. work through significant disturbance in the steadiness of your work life, love life, family life, and personal life,
f. work through a lifetime of traumatic, unprocessed, upsetting life experiences
Long-term psychotherapy is, in my opinion, your best option. Most of the time for most people. For people in this category, I find the format of weekly psychotherapy for an unspecified number of years, usually multiple, the most helpful.
Another way to handle therapy if you fall into this category and this model is simply too much investment (of time, energy, financial resources), is to spend a number of initial sessions charting a road map of personality dynamics, and then systematically, over a long-term process, peeling back the layers of dysfunction. Neurosis is like an onion and when one level of dysfunction is relatively resolved, another is revealed. Over time, perception, and perception of the self becomes progressively clearer and clearer. The hardest work is the initial work!
How this plays out is by working on one issue, usually the most chronic, the one most "in your face", persistently until it is resolved (such as in a weekly psychotherapy format). Then, taking a break from therapy for some time, until the next issue comes more clearly into focus, and renewed energy makes it possible to start another round of psychotherapy again. In this way, deeper work and deeper change progressively make themselves available as we powerfully work through the personality. I use a depth-oriented, Jungian approach in doing this kind of work that I take quite seriously. This kind of work facilitates none other than the truest expression of the personality, and its unfolding, in what Jung called "the individuation process."
Having been in private practice at my office at 2305 E Arapahoe Rd. #123 for nearly a decade, I enjoy holding space and being a container that is stable and available for returning clients who want to pursue deeper work as it becomes necessary down the road.
Do not be daunted! This is the deepest, most challenging quest, the quest of Self!