What happens in a counselling session?

Many people are simultaneously fearful and fascinated by the prospect of undergoing counselling or psychotherapy session. It's the combination of ignorance and those over-dramatic interpretations of the therapeutic process that television and film so love which are to blame. Continue reading to find out what's it's like to be in a counselling or therapy session...

Time

Time is everything in counselling and psychotherapy, including the need to arrive punctually. Seeing up to nine clients or patients each day psychotherapists and counsellors have no alternative but to stick to a fixed timetable, with as little as 10 minutes between each person. Appointments last for a therapeutic hour - 50 minutes.

Should you arrive late for a session, the counsellor will still need to finish that session at the scheduled time. If you're someone who likes to be at appointments early, find out whether the counsellor has somewhere you can wait - if not, you'll have to find somewhere other than the counsellor's office - in your car, in a coffee shop maybe until your allotted time, since it's likely that your counsellor will be seeing somebody else.

Note: Appointments are set up so that there is no risk of patients running each other. It is not a good idea to wait outside the counsellor's door if you are early - if you do, you will run into the patient who preceded you - it can make for an awkward moment and disturb concentration for both of you.

Once the session starts, it is the counsellor's responsibility to look after time. If you're new to psychotherapy or counselling, chances are you'll be thinking 50 minutes seems way too long. However, your actual experience is likely to be just the opposite - time will race by - you'll have just started opening up, only to find your counsellor telling you it's time to wrap up.

There are occasions when it feels very hard to be forced to stop when you're in the middle of something, but once it's out in the open, it becomes something you can access, both in the session and out of it. You may sometimes find it helpful to spend a quiet ten minutes gathering yourself before speeding off to your commitment.

It's not you, it's me

Many people find the conventions of the counselling room unnerving at first. The normal chit-chat people share vanishes and is replaced by a focus on you. The counsellor will rarely, if ever, speak about him or herself, nor is s/he expecting you to ask about her. Your counsellor avoids these normal social actions, not because she or he is a cold character, but because such conversation is a distraction from the main work, which is about you and the ways in which you see and order your world.

What will they do to me?

While many forms of counselling focus on speaking, this is not the only medium used in the therapeutic process. Other mediums include the use of art, play, drama, writing, massage, exercise, body awareness and breathing techniques. Some counsellors may give you tasks to complete at home.

Some practitioners may give you "homework", i.e tasks to think about or complete between sessions. Whatever medium is used, the counsellor will explain his or her methods before you commit to anything - you will never be coerced into doing something against your wishes by a reputable practitioner.

Couch or chair?

Unless you're seeing an analytic psychotherapist, you will probably spend at least the first few sessions of counselling on a chair rather than a couch. While therapists recognise the benefits of lying down in terms of improving the degree of reflective space available, this benefit is often outweighed by the difficulty beginning patients have in taking that space in an alien environment.

As you become more comfortable with the process, your therapist may invite you to lie on the couch if one is available, but taking up this invitation is by no means vital to the success of the therapeutic process - it's entirely up to you.

Silence

Silence is often regarded as something of a hurdle for beginning counselling and psychotherapy patients. Sessions are frequently punctuated by long silences. These silences are nothing to fear. Rather than worry about what the counsellor is thinking, try to focus on what's going on for you in the silence. Can you get beyond the feeling awkward? What comes up? Your counsellor is very used to working with silence and sees it as a therapeutic tool rather than a failure of social discourse. Try it - you might like it!

Attachment/transference

Transference is something the media is fond of portraying when it dramatises the therapeutic process. Transference refers feelings a patient projects onto the counsellor which are really about his or her other relationships, but feel like they are about the counsellor. Your counsellor or therapist can to feel like a very important person in your life.

A counsellor or psychotherapist who works with the transference will help you use these feelings to comprehend more about the ways in which you relate to people in your life outside counselling, and in doing so, help you avoid repeating past patterns.

If things go wrong

Patients have a very positive experience of counselling in a large majority of cases. However, as in every other profession, things can and do sometimes go wrong. If your counsellor is accredited within the United Kingdom, he or she will be a member of a professional association which has a complaint and disciplinary procedure which will listen to your case. If you don't know which body your counsellor is a member of, you can do a search of the database for each of the professional associations.