Do you need psychotherapy or not? A few points to keep in mind when considering therapy

© Jorgan Harris. jorganharris.co.za

You may struggle with the nagging question of whether you should go for psychotherapy or not.

Perhaps you’ve never been in therapy. You may not know what to expect. You may perhaps not know what to say or what not to say. Is therapy really necessary? Can you actually solve your problem? Do your need more medication? Are you wasting the psychologist’s time? What if he’s going to think you’re out of your mind?

If you are struggling with these questions, this article written for you. I hope it can answer some intriguing questions about therapy for you and help you to make your decision.

Below are 15 points regarding what therapy consists of and what it can do for you. What you should keep in mind when you are considering therapy, but are unsure.

This article consists of three main points:

  1. Is therapy really needed and how do I choose a therapist?
  2. How is therapy seeing you?
  3. What can you expect from therapy?

1. Is therapy really needed and how do I select a therapist?

1.1  Is therapy really necessary?

Before choosing a therapist, you may want to decide whether therapy is really necessary for you. What is psychotherapy? Is it just an expensive way to get someone to listen to you?

Therapy is much more than to go for a walk, getting peace of mind or to live in a house in the country with your dog or to be close to nature to clear your mind.

Therapy is an active form of objective and empathetic listening. It is much more than just telling or informing someone what is bothering you and much more than just a friend or a family member listening to you.

Therapy is also much more than to just talk about your problems. Therapy is an evidence-based science and an art that requires skill and creativity. Therapy is about helping you gain new insights about your challenges, to better master your problems and to help you function better.

Therapy is not just a listening and understanding, but it is also a guide to help you overcome your problems. Therapy should always be objective. A therapist will never choose your side or anyone else’s side. A therapist will simply observe and reflect his or her observations objectively.

Therapy does not necessarily have all the answers. Therapy is indeed a journey in search of answers. A psychologist knows that you have all the answers within yourself. It is the therapist’s job to work with you, through your own history, pain, trauma, fear, etc. and to guide you to find the answers in yourself. The therapist will sometimes make suggestions, but it’s still your choice to decide whether his or her suggestions would work for you or not.

1.2 A psychologist or a psychiatrist?

Do you need to see a psychologist or a psychiatrist? I hope the following will help you.

The similarity between a psychologist and a psychiatrist is that both know psychopathology and how to make a diagnosis.

The main difference between a psychologist and a psychiatrist is the difference in treatment. A psychiatrist is a medical doctor who specialises in psychiatry and will treat your problem medically. He might be able to give you some advice for your patterns of behaviour but they are focusing in prescribing you the right medication.

A psychologist is a human scientist addressing your problem by focusing on your thoughts and your actions. He has some knowledge of medicine but focuses on helping you overcome your problem.

The difference is well illustrated by their different views on something like depression. Depression is the result of a lack of production of serotonin in your brain. A psychiatrist will prescribe you an anti-depressant to help you increase your serotonin production in order to overcome your depression. A psychologist will assume that your brain is not producing enough serotonin because of your negative thinking. As soon as you start thinking rationally again, your brain will automatically produce more serotonin.

The psychiatrist will focus on genetics and will want to determine whether there is a genetic problem or not. If you have a family history of depression or anxiety, you may have a faulty gene. The psychologist, on the other hand, may argue that it might be the result of learned behaviour from childhood.

Your grandfather might have been depressed because grew up during the Great Depression. Due to his upbringing, he might have conditioned your father that the world is a bad place. Your father might have believed that and suffered from depression too. He might have conditioned you that the world we live in is a bad place to live in. You might also have believed it until you ‘ve learned that the world is indeed not as bad. By changing your view of the world and life, you literally unlearn to be depressed.

In my practice, the emphasis is therefore placed on the psychological hypothesis although I’m not opposed to chemical treatment. Chemical treatment can help you feel better about your problems and address them more objectively.

1.3  What if I do not have much in common with my therapist?

If your therapist is for example unmarried, or have no children or if he or she might be suffering from anxiety or depression- it does not mean that he or she does not understand your problem. It may even be to your advantage. It might even help him/her to remain objective.

A good therapist will, regardless of his/her own preferences, age or culture, move his preferences aside to be able to transcend his/her understanding to your world. For example: I have, (regardless of my own view of reality) advised a traditional African client to sacrifice an ox to his ancestors. I have suggested for a Muslim client to consult his Imam, I have even suggested to people to “cross-over” to communicate to people who have already gone to the other side.

No matter our differences, we always have one thing in common: we will always have a need to be heard and understood.

1.4  What is a worthwhile therapist?

How do you know that you are seeing a respectable therapist?

There is an upward trend for people to go for therapy. The reasons are that stigmas and prejudices against psychotherapy are declining and people feel more confident to go for therapy. The reason for this is that therapy really works.

It is true that a good therapist has studied at a respected university? A respectable therapist’s qualifications should be important. A good therapist may have published and may have been widely cited. A good therapist may use effective techniques but it is not enough.

Research has shown that therapy, more than anything else, is a therapeutic relationship and an interpersonal relationship. Even hypnosis is defined as a relationship of trust more than anything else.

A good therapist is warm, caring, empathetic, respectful, knowledgeable, unconditional in acceptance and concrete. A good therapist will never pass judgement. I will later return to this point.

My practice focuses on the above-mentioned principles. It is also important to me to solve a problem as quickly and effectively as possible, without sinking into the rabbit hole of sympathy or to milk your medical aid. Although we are focusing on results – the value of the relationship of trust between two people will never be underestimated.

1.5 Am I safe in the process?

You might have realised that your safety is a very important priority. I want you to feel safe and comfortable to be who you are and to say what you want. Knowing that the information will be handled with the greatest respect and confidentiality. You should never feel as if you are being judged. No well- respected therapist will ever judge or expect you to fit into their own subjective value systems.

Should it ever happen that I’m requested to write a report for and about you, you will always have full knowledge of it. I will always ask your permission and you will always have the right to refuse to share any information.

Any report written will be presented to you for approval. You will have a copy of the final report, thus knowing exactly what is written.

It may happen that the court will oblige me to testify. This has only happened on two occasions. Even in court, I will do everything in my ability to protect your identity, privacy and confidentiality.

You are protected by law. Your confidentiality is guaranteed by law. Feel free to ask our receptionist for your copy of the Code of Ethics.

There are many counsellors, life coaches, therapists, hypnotists and many more out there. You might want to decide to see one of them. Many of them do a great job, but you still do not have the necessary legal protection for confidentiality and ethical conduct.

Your file and information are always securely locked up in my filing cabinet. It remains there until our next appointment. Should you ever run into me in a mall, I will walk past you without greeting you – because out there I do not exist for you. If you feel comfortable enough to greet me and chat- I will do that with great pleasure.

2. How is therapy seeing you?

2.1 You are not your diagnosis

This brings us to a very important concept. This concept deals with so-called “labels”. When you give someone a name (or a label), you tend to limit your own options and outcome.

When you receive a diagnosis, rest assured knowing that it’s just an indicator of where to focus our work. If I diagnose you for example with depression, it means that you have depression. You are fortunately not your depression. You remain a healthy person with a problem to be solved. You can, as a human being, never be a “depressed” or an “anxious person.”

The world of NLP (Neuro Linguistic Programming) refers to this as “nomina- lisations”. A Nominalisation is anything that you can’t put on a wheelbarrow. Anything you can’t put on a wheelbarrow does not exist. You can never put depression, anxiety, a weakling, a loser or whatever on a wheelbarrow and therefore it does not exist.

You remain a perfect creature of God who picked up a problem somewhere down the road of life. You ARE not a problem, you HAVE a problem.

Feel free to read more about this on my website: jorganharris.co.za.

Check my blog for the article titled: “Princes into Frogs” regarding my views on “diagnoses”.

2.2. No one is weak or sick

You don’t come for therapy because you are weak or sick. You will never be seen in such a way. You are indeed strong and willing to not only improve your life, but also face your problems.

Everyone has endless resources and talents. Some of them simply hide under a bushel. Sometimes you might just want to tip the bucket to see is hidden underneath. You might discover things about yourself that you could never have thought possible.

You have a complete toolbox to fix your problems yourself. A good therapist will help you use your own toolbox as effectively as possible. To date, you may have used pliers to beat a nail. It worked (with great difficulty), but the therapist knows that you may have a hammer and will help and learn to use your hammer to hit the nail on the head.

The therapist never knows better and therefore never offers advice. He/she could never be you. My hammer, nail or wall is not the same as yours. What works for me, may not work for you and vice versa. Therapy can actually help you recognize your own strengths and creativity.

2.3 Therapy does not have a final goal

In a perfect world, everybody should attend therapy once a week for the rest of his life. There is a ceiling and that ceiling can never be reached since we live in an imperfect reality. Therefore, we must reach a logical point where you feel well enough to continue on your own with your life. You will reach a point where you instinctively realise that you can go on your own.

Therapy will not always help you to be happy all the time. “Life happens” and no one can stop pain, since it is part of life. There is no such thing as eternal happiness, but therapy can help you work through life events as they happen. Therapy will help you be content” with life and things as they happen.

2.4 It is nobody’s fault

The fact that you have an uneasy feeling or discomfort during certain situations is not your fault, or due to your past, or because of people around. Guilt is anyway the most useless emotion that you can ever experience.

Therapy is rather about the present, how you think about it and how you interpret the past.

You may even come for therapy to wash your dirty laundry. To wash dirty laundry is still an attempt to clean your clothes. I will neither judge you nor the other people you are involved with, simply because I would rather identify the source of your discontentment or situation.

2.5 Therapy is fun

Actually, life is simple. Even the Bible mentions (more than 360 times) that you need not to worry.

Therapy becomes fun once you realise that nothing is ever that serious or terrible.

Therapy becomes fun when we can start to laugh at ourselves and see how absurd life and its problems really are.

We will never joke about you as a person, but we will joke about how easily resoluble your problems at the end of the process really is.

Research on the therapeutic value of laughter proved that once you start laughing at your own problems you will realise how silly they are.

There is nothing wrong with you. Therapy can help you see these problems in your life as.

There is no such thing as “crazy” people. People attending therapy simply do it to better understand themselves and to discover all the choices they have.

3. What can you expect from therapy?

3.1 You can just be yourself

It is important for you to feel safe in therapy, to be yourself and say whatever you want to say in whatever way you want to say it.

The atmosphere in my office is relaxed. You can be your own unique self in my office. If you want to, you may even sit with your feet on the couch, swear if you have to or even attend your therapy wearing your pyjamas. You may tell me about your craziest secrets and dreams should you wish. You do not have to tell everything should you not feel safe to do so. You do not have to go into detail. A good therapist should be able to help you with the bare minimum information – without you feeling in the spotlight.

Remember – I think it is Mark Twain who said that you should slaughter a pig when angry. If you are very angry- swear!

We are on first name terms. I’m not a ‘doctor’, ‘sir’ or a ‘mister’. Although I am a specialist in psychology, you are a specialist in yourself. As little as you know about psychology, as little do I know about you. That is why we are, in contrast with a doctor, two specialists in the office. In a certain way, we even become colleagues.

Therapy is all about the relationship. You know yourself best and it is your right to tell your therapist your likes and dislikes. You may therefore complain should I do something you do not like or that makes you feel uncomfortable or uncertain.

The therapist’s feelings are not important. Your feelings are important. At the same time, you will instinctively know when your therapy sessions are over. You might feel better, or you might feel you do not get anything more out of the therapy, or you may just instinctively know, without being able to explain it, that therapy is over. Therefore, you can terminate therapy whenever you are ready to do so.

3.2 You will never be judged

It can be intimidating to see a total stranger and to discuss your most intimate problems with him/her. However, I would like you to know that you can feel safe to be yourself in a psychologist’s office.

The therapist will never judge you because our walls, hammers and nails are different. Anyone who who judge put you in his/her shoes. Just as you can’t stand in your therapist’s shoes, he/she can’t stand in yours.

Only a bad therapist will judge you because he or she does not have the insight to see you as a person created in your own right.

Then there is the big question of what is ‘normal’ anyway. We do not know what “normal” is. The answer here is that we are all uniquely different. However, we are taught from a young age what we should do and be. Therefore, we allow other people to decide for us what is right and wrong. Truth for me is not necessarily truth for you. You have the choice and freedom to do whatever feels right for you.

Perhaps you are somewhat weird. Perhaps this is the reason why you are unique. “Normal” people are boring. Personally, I enjoy weird people because they are creative and intelligent.

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Therapy may even appreciate it when you hammer a nail with a screwdriver. At least you’re creative and you can never be wrong. You can, however, do it more effectively. You can even teach your therapist how to hammer a nail with a screwdriver. I learn from my clients every day!

3.3 You will always be respected

It is not my job to judge you since I am not an ethicist or a minister of religion. My responsibility is to help you discover all the resources you have and to help you use them.

You will always be treated with the utmost respect as a human being.

Nothing is ever ridiculous. Nor ever stupid. The time you spend with your therapist is your time. You are paying for it and it is your right to discuss anything that is important to you.

People tend to think their problems are too silly or too stupid to discuss with a therapist, thinking they are wasting the time of the therapist. Please keep in mind that this is your time. You have “bought” it.

Whether it is a problem you have with your colleagues at work, the death of a pet, whatever – it is still important to you and because it is important for you, it will always be of utmost importance for your therapist.

The principle that applies here is that there is no universal truth and that your truth is your truth. My truth is not necessarily your truth, but a good therapist should be able to understand your truth and be able to move comfortably around it.

3.4  You are in charge of the process

As you have noticed – the whole process is a respectful process. As you already know, we have two experts in the room. I specialise in psychology and you specialise in yourself. We are therefore a team working together to solve a problem. Someone once referred to it as a “therapeutic we-ness”.

You know yourself better than any other person. Therefore, you are in charge of the process and you decide the way forward.

A doctor will examine you and tell you what’s wrong. He will tell you which medications to use and what to do to be healthy. A psychologist will ask you what’s wrong and will make suggestions to you. You will decide the course of therapy and what should be done, with the help and support of the therapist.

I will never tell you how many sessions you may need, as I will never tell you when to stop or when you are done. I will, however, give you an indication, but the final decision is still yours.

Since therapy enables you to get in touch with your deeper inner self, you will have a “gut-feel” whether or not you need more sessions. You will instinctively just know.

3.5  Finally – therapy is a relationship of trust

I hope you realise by now that you can totally feel comfortable in my office. You may feel free to say anything, without any fear that your therapist will think you are crazy or stupid or that he/she will condemn you.

Once again, I would like to emphasise that the relationship is of the utmost importance. If you have any questions about me, please feel free to ask me.

I hope you will feel free to discuss anything with me. After more than 20 years’ experience, there is hardly anything I have not heard before.

Whether you have lost a budgie through death, have erection problems, or were abused as a child. No matter if your life is permissive or if you do drugs, are addicted to gambling or addicted to porn. Whether your husband is cheating, or wearing women’s clothes, you have infertility issues, even if you fantasise about having sex with a robot – you can feel safe to discuss this with your therapist.

It all boils down to trust. Your therapist ought to see everything in the light of all behaviour has a positive intention.

If you have any uncertainties that are important to you, but not addressed in this article. I hope you have enough confidence (to not hesitate) to discuss them with your therapist and get clarity.