What do I talk about in therapy?

Have you wondered about how you would start talking in therapy, and has this put you off from making the first appointment? Perhaps the task feels daunting.

Is there so much to unravel about your life that you don't know where to begin? Maybe you fear that you'll get lost in the details. When I say "unravel", it brings to mind big balls of wool that have become tangled together and knotted up. Where is the beginning of one ball and the end of another?

You will likely have many questions about starting therapy. In this article, I hope to offer you some answers, to give you an understanding of what you can expect when you come to a session. 

Choosing a model of therapy 

Firstly, it's important to note that the model of therapy which you choose can mean that not all counsellors start a session in the same way. Regardless of the model they work with, counsellors should have a working agreement with you. This forms a safe boundary around the work. 

Many models have questionnaires and forms, to begin with and focus exactly on the ongoing issue of the day. Other models of therapy take the lead from the client. These are client/person-centred and go with what you want to talk about.

What is integrative counselling? 

Some counsellors, like myself, are integrative. This means they combine their ways of working to suit the client's issues.

An integrative counsellor will attentively listen and begin with whatever thread you choose to work from. You might start off with one topic, move to another and then even another, going off on tangents and feeling like you're not making much sense.

It's the counsellor's job to stay with you as you pick and drop, helping you to look through the pieces as an empathic witness to your story, and help you unwind these pieces and store them in your mind.

I'm now comparing that to a yarn holder, you are sorting through the threads and the counsellor is holding the wool.  

Finding the right therapist for you

Research has found that the relationship you form together has a direct effect on the outcome of the therapy (Michael, Lambert & Barley, Dean 2001). 

It's important that you feel connected and the way that the relationship forms is from a foundation that the counsellor offers. The person-centred model of unconditional acceptance, empathy and understanding and the counsellor being genuine help to bring the right conditions for a positive therapeutic outcome. The counsellor needs to be 'present' in the relationship, with you fully in your exploration of self.

What do I talk about?

As sessions continue, your counsellor will help you to identify and focus on the parts that need exploration, in order to make more sense of them or come to an acceptance of them.

Sometimes, the client presents with one issue and further down the therapy decides to open up about a different issue.  

Words and silences help. Don't be afraid of 'drying up' or not knowing what to say.  Finding words to express feelings can be difficult. If you struggle to express yourself in this way, art and creative therapies can be useful.

No one can change their past, so therapy aims to find sense and meaning to yours.  

If you'd like to start working on your inner self, get in touch by email and we can begin the therapeutic process together.