How to Get the Most Out of Psychotherapy, a Series
Part 1: Go to Your Appointments
I know, it sounds so obvious, maybe even like I’m kidding, but consistently coming to your appointments is the most important thing you can do as a client to benefit from therapy. Of course, sometimes you or your therapist will miss sessions; it’s expected that both of you will have some days out. However, if you sought out therapy, but you are only coming to 75% or fewer of the scheduled sessions, you aren’t going to get as much out of it as you could.
Committing to a weekly therapy session and protecting the appointment is also an element of how therapy helps. The commitment and consistency are a promise you are keeping to yourself and a message to yourself that you are worthy. Over time, keeping promises to ourselves and showing up for ourselves helps us to trust ourselves more. Trust in ourselves is the foundation of confidence and also helps counter anxiety.
The work of therapy– processing, healing, changing, accepting–is already slow. Missing sessions makes it even slower, which can end up tanking your motivation or making you lose hope. You might think: “Why come more regularly if it’s not helpful already”?
Missing many sessions is disruptive to the flow of therapy. At a weekly rate, there is a shared baseline knowledge of current life events between you and your therapist. You don’t spend too much of the session on general life updates. There can also be some very normal regression after being away. Showing up regularly allows time and space for the deeper, truly transformative work.
If you are missing many sessions, it’s worth getting curious:
What could this be about?
Do I feel undeserving?
Do I have a pattern of deprioritizing myself?
Am I afraid of a certain topic or feeling coming up in therapy?
Do I still want to be in therapy?
Am I more likely to miss a session after we talk about a certain part of my history?
Is there something I’m doing, want to do, or plan to do that I think my therapist will disapprove of?
What are my feelings toward my therapist lately?
Has my therapist hurt my feelings or frustrated me?
Is there a big thing I know I need to bring up, but I’m not sure how?
Are we moving through material at a pace that is overwhelming for me?
Do I feel over-activated before or after sessions and need to ask for some help with self-soothing when I’m alone?
It’s totally appropriate and encouraged to bring up any of the questions above to explore with your therapist. Sometimes, there could be an issue with fit and it could be time to move on, but if you have generally been comfortable with your therapist there could be so many other things that you could benefit from exploring beneath the surface.
When you have missed some sessions, it’s worth discussing to some degree with your therapist. If you do have to cancel, consider if you can make the day up another time. If you find yourself really not wanting to make the day up or go to your sessions at all– that's totally okay and it’s something to bring up with your therapist.
Therapy is a space where you do not have to take care of anyone else. It’s your time and good therapists can tolerate all kinds of feedback. They can tolerate hearing “I really didn’t want to come today”, “I feel too stirred up after therapy”, “I’m not sure you’re a good fit for me” or “You made me mad” and explore that with you without making it about themselves.
There is a perpetual tension in therapy between wanting to change somehow and fearing change. These two, the desire to change and the fear of change, are in a constant relationship that ebbs and flows in each session and over the whole course of therapy.
When something is scary, frightening, or threatening the status quo, our unconscious mind often wants us to steer clear of it, because the unknown can be perceived as dangerous. So trying to notice ways we might be unconsciously avoiding therapeutic work is useful. You will encounter discomfort in therapy and most people have a part that balks at discomfort. It’s just part of our human nature. A huge part of benefiting from therapy is acknowledging the discomfort, communicating with your therapist, and continuing to show up.