What really happens in the counselling room?

It is becoming increasingly evident that the pandemic and the current lockdown have raised stress levels for many people.  With a heightened focus on emotional health, more people may now be seeking out therapy or counselling. For some, there will be an immediate move to contact a practitioner but for others, there may be some initial hesitation.

This reticence can be around practical issues such as who to contact or the potential cost. There may also be some very real concerns about the actual therapy work.

What happens in the counselling room? What will take place once I step through the door? How will I work with the counsellor? What will we talk about?

An online search on the terms counselling and therapy yields a bewildering array of data. There appears to be a myriad of different forms of counselling. There are certainly many organisations which represent counsellors and a host of directories listing individual therapists. There is a cornucopia of choice relating to both individual counsellors and also the different forms of therapies which are on offer.

Yet, this kaleidoscope of offerings disguises some key similarities. There may be greater commonalities, particularly in terms of process, than would first appear to be the case.

I am reminded of the adage that within all the literature ever produced there are really only a very limited number of storylines.  There is a set of perhaps six or seven basic plots which are constantly recycled. These are reinvented by different ways of presenting the characters and locations, yet the essential story remains the same.

Romance is the obvious example. Two people meet. There is attraction and the start of a relationship. This is intense but then, interrupted by confusion, misapprehension or perhaps a jealous third party, misunderstandings occur. Suddenly the relationship appears doomed. Then there is a clarification and some form of reconciliation. And an ending.  

The writer may change historical settings, use different genders (or none?) mix up ages and alter locations. There are differences but, on closer examination, these can be seen as superficial. The essential storyline is the same.

Well, perhaps there is some aspect of that repetition within counselling work. This is not to confuse client narratives with process. Your story as a client is unique to you. The therapist you choose to talk with should always see you as an individual with a storyline and a history which is yours alone. But, what of the way the counsellor works with you? What of the overall process? And perhaps it is here that we can see some similarities.

There are two core elements of the counselling process which invariably present in most therapy work. The first is the challenge of ‘why’, the second is the work to bring about change.

Why come to counselling?

What has brought the client into the room? And why now? Where has this issue come from?

Some therapists will focus from the outset on this historical narrative. It may be seen as very important to understand what has occurred. The counsellor will want to help the client uncover her or his story, including identifying the potential (and possibly painful) origins of those difficult challenges.

Other practitioners may prefer the client to look ahead with a focus on the future and not the past. Yet, even here, there will be a time in the work when the client is likely to talk about why. Some form of what we can term ‘emotional archaeology’ is likely to emerge during the discussions.

This may come about when the client reflects on why ‘it’ has become an issue now. The extent, depth and breadth of that emotional dig will vary but it is highly likely to occur irrespective of the approach adopted by the therapist.

How can counselling bring about change?

The second part of the common process is the work to bring about change. It is where the client seeks to improve, ameliorate or repair. It may be the prime driver behind the client’s decision to walk into the counselling room. Enough is enough. It is time to change. Things need to be different. There are then two alternative roads which the potential client is likely to be invited to walk down.

The first involves finding a way to face that which is causing concern. There will be encouragement to remain in the moment and to stand her or his ground. The client may be helped to become more assertive, to speak out and to be heard. There may be the development of a more robust way of being which will allow the client to become increasingly comfortable with difficult situations and to find that stronger, louder voice.

In order to achieve this, there will be differing approaches offered, from a mastery of practical cognitive or behavioural techniques through to a deeper emotional appreciation of internal motivators. Counsellor and client will look to find that way of being which will enable the client to deal with the spectre, whatever form that apparition or saboteur may take. The proposal to the client will be to find a way to be able to face the fear, to talk about it and bring that spectre under control.

There is a second route within this core change process which can be seen as an alternative approach. If replaying a particular incident causes emotional pain, if engaging with a certain activity is distressing or if involvement with an unpleasant character provokes anxiety, then this focus is on finding a safe way to stop those engagements.

If involvement brings emotional anguish then we will find an appropriate means to break the contact. Deflect, reject, or stop but to do so in a way which protects integrity, self-respect and identity. Do not force yourself to face the fear just because that is seen as the macho thing to do. Be confident enough to turn your back and walk away with your head held high.

Just how that can be achieved in a way that boosts self-confidence and enhances self-esteem may require very different strategies. This work may involve developing practical behavioural strategies, making cognitive adjustments or fostering deeper emotional robustness.

Nevertheless, whichever approach is employed, the basic storyline is the same. Do not feel that you have to continually expend emotional time and energy in facing and engaging with the spectre. Turn away and allow that fearful apparition to become a ball of harmless tumbleweed which drifts past and out of your life.

These reflections on those two core processes of both understanding and change may provide you with a taste of what to expect in the counselling room. Your story is unique. The challenges which you are encountering are yours alone.

When you walk into the therapy room for that initial introductory session, the counsellor will listen to your story. They will hear it for the first time and respect your individuality. If you then decide to work with that therapist, you will embark on a journey that will be unique to you.

The general processes involved in that work may have a similar structure irrespective of who you talk with. Why is this happening to me? What has occurred in my world to cause this challenge? And do I decide to face it and learn to deal with it or, alternatively, find a way to just close that door and walk away?

In anticipating the first discussion with a counsellor it may be helpful to consider which of those two routes to change is likely to be most effective for you. As an experienced professional, your counsellor may have a preferred approach but they will want to hear your hopes and understand your concerns about the work to come. 

And with that professional support, my expectation is that the road you decide to take will prove to be the right one. The counselling journey you undertake may be challenging but it can be moving and empowering.

I hope you will discover that work in the therapy room can become a real force for positive and lasting change.