Psychotherapy: A Patient’s Perspective
When you visualize the word “psychotherapy”, what do you see? A common visual is a “horribly mentally ill” patient seated with their head in their hands. Maybe you see a war veteran who suffers from PTSD and flashbacks. Maybe you see a teenager with bipolar disorder undergoing a depressive period. While yes, those who suffer from chronic mental illnesses do benefit from psychotherapy, those who’ve internalized a stigma around therapy miss the bigger picture- the fact that therapy works, and anyone can benefit from it.
Psychotherapy, or talk therapy, is a practice used by professionals to help patients discuss their behaviors and over time, change their way of thinking to help overcome challenges and struggles. However, there’s a lot more to the practice than just talking- there’s growth, unlearning, relearning, pain, and lots of healing. According to the Austen Riggs Center, a psychiatric hospital, “44% of the patients who were given 18 months of weekly psychoanalytic psychotherapy no longer had major depressive disorder when followed up two years after therapy had ended; for those receiving the standard NHS treatments, the figure was only 10%” (Gerber and Prusinski, 2015).
In order to get a closer look into psychotherapy, Danielle Koehler, a therapist at Woodbridge Kids Psychology Clinic helped me deconstruct the process. Awkward, difficult, but necessary, here’s an introduction to seeking out therapy, and what that penultimate first session can look like.
Seeking out Therapy
Right off the bat, I want to make it clear that seeking out psychotherapy does not make you weak or crazy. Having trouble with how you feel, think, and/or act is perfectly valid and worthy of your attention. According to the American Psychiatric Association, “Racial/ethnic, gender, and sexual minorities often suffer from poor mental health outcomes due to multiple factors including inaccessibility of high-quality mental health care services, cultural stigma surrounding mental health care, discrimination, and overall lack of awareness about mental health” (American Psychiatric Association). These minorities are also less likely to seek out treatment, which is an issue, as mental health and illnesses can manifest over time.
“The biggest advice I can give someone who is seeking talk therapy, is to be open, willing and vulnerable,” said Koehler during our interview. There are several ways to look into therapy for the first time. Personally, I talked to my family physician. This is useful, as they can refer you to a specialist, while also providing blood tests to rule out conflicting conditions such as hyperthyroidism or hypothyroidism. They can also help choose an appropriate type of psychotherapy for you, such as Cognitive behavioral therapy (CBT) or Dialectical behavior therapy (DBT). Referrals from friends, school/university guidance departments, and insurance companies are all great places to look as well. However, not everyone has access to standard psychotherapy, for a variety of reasons.
When asked about easily accessible alternatives, Koehler stated “Although private therapy is often recommended and provides virtually no wait times, don’t let finances be a barrier for accessing mental health support. Several community agencies offer free or fee-for-service therapy.” Betterhelp.org is the world’s largest online counselling practice, effective for those who value independence and therapy from home. Many local/community mental health centers offer free resources for those who need them, such as the Sick Kids Centre for Community Mental Health. These centers, as well as free local support groups, can be searched for easily online! Many religious congregations offer counselling programs, such as select churches and mosques. Emergency services, such as Kids Help Phone are also available. Unfortunately, the process may take time, but don’t give up hope!
The First Session
When I was driving up to my first therapy session, I was terrified and panicking. I googled what happens during a therapy session and what a first therapy meeting looks like because I had no idea what to expect. All I can say is that yes, it was awkward! It was uncomfortable! I was expected to tell a complete stranger about my deepest, darkest thoughts and feelings! But it’s important to remember why therapy is so valuable; it’s a completely safe space where you can deconstruct your way of thinking and build healthier mannerisms with the help of a professional. “The goal of my first session with a client is to identify the needs/challenges they are facing and co-develop a treatment plan to guide our sessions,” explained Koehler, “I like to make sure the client is open and willing to create their own goals to ensure therapy is helpful for them.”
When asked about what her goal for the first session, Koehler explained, “[A] big component of the first session of therapy is building rapport, gathering information about a client's strengths and interests, to ensure there's a positive therapist-client relationship.” My first session of CBT had awkward silences, carefully planned out words, and a lot of reflection. I was asked about my likes and dislikes, my relationship with my family, what struggles I was encountering, and more.
The more visits you have, the more comfortable it gets and the more progress you make. “Therapy is all about dichotomy and relationships. If a client doesn't feel connected to the therapist it will be difficult for them to share their feelings/fears/insights and utilize any strategies or tools they have been taught,” Koehler admitted, “It’s always rewarding when you see your client’s work through challenging discussions and conflict they are encountering and when they utilize strategies in other aspects of their life.”
The last few years of my life have been difficult. After about 9 months of CBT, I’m still the same me who struggles with a couple of mental illnesses, the same me who suffers from depression, anxiety and complex trauma, but now I feel properly equipped to fight that battle.
Therapy is a wild ride and I’m always surprised to see what I learn about myself each session. According to Koehler, “[I would] suggest to anyone seeking therapy to be mindful of progress. We celebrate big and small successes, and it can take a lot of time for someone to find those successes but they’re possible.” When I started I was numb, confused, and hurting, but I’ve developed coping mechanisms and strategies that challenge the way I think and act. Today, I’m someone who firmly believes that anyone and everyone can benefit from therapy, even if I can acknowledge that I still have a very long way to go. If a friend or loved one is having a hard time, reaching out to them and helping them find services right for them is a huge help; you might be saving a life. It’s no secret that early intervention of mental illnesses is the best way to prevent the illness from manifesting as one grows older. Now with this all being said, the only one who can decide to pursue therapy is you. The path of healing isn’t linear, easy, or simple. In fact, it might be one of the most difficult things you can do. However, taking that first step in the right direction is all it takes to begin that journey.
Special thanks to Danielle Koehler for helping me out, in more ways than one!
American Psychiatric Association. “Mental Health Disparities: Diverse Populations.” American Psychiatric Association, https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts.
Better Help. “Better Help.” Better Help, https://www.betterhelp.com/.
Gerber, Andrew J., and John Prusinski. “The Effectiveness of Talk Therapy Is Not Overstated.” Austen Riggs Center, 2015, https://www.austenriggs.org/blog-post/effectiveness-talk-therapy#:~:text=Among%20the%20key%20results%3A%2044,the%20figure%20was%20only%2010%25.
Howes, Ryan. “Fundamentals of Therapy #2: Finding a Therapist.” Psychology Today, 2008, https://www.psychologytoday.com/ca/blog/in-therapy/200804/fundamentals-therapy-2-finding-therapist.
SickKids Centre for Community Mental Health. “How to get help.” SickKids Centre for Community Mental Health, 2020, https://www.sickkidscmh.ca/Home/How-to-get-help.aspx.
Walton, Alice G. “Research Again Finds That Talk Therapy Can Change The Brain.” Forbes, 2017, https://www.forbes.com/sites/alicegwalton/2017/01/25/research-again-finds-that-talk-therapy-can-change-the-brain/?sh=63cd8ba73278.
World Health Organization. “The World Health Report 2001: Mental Disorders affect one in four people.” World Health Organization, 2001, https://www.who.int/news/item/28-09-2001-the-world-health-report-2001-mental-disorders-affect-one-in-four-people.