Sometimes you can tell that therapy is going well and you have a satisfying sense that something is shifting inside of you. But at other times it’s not so satisfying, and you may wonder if you’re wasting time in therapy.
If that’s the case, tell your therapist what you’re feeling.
But there are also checkpoints you can ask yourself about to see if there is more you can do to make it effective. We’ll explore five of those today.
This post is for people who are concerned about wasting their time in therapy. If this isn’t you, please don’t take it as a lecture on how to do therapy. But for many people who read this blog, urgency and efficiency are an issue.
And if you’ve been reluctant to start therapy for these reasons, this blog’s for you.
I want to reassure both groups of people that you can make it efficient and effective.
Some habits that bring you into therapy could slow your progress down, but some of your personality traits, used consciously, could speed you up. This is the nature of therapy, and working these through is what makes it brighter on the other side. Any effort you put into making therapy work will also make your life work.
Think of it this way: You’re going on a trip in a car. How fast that car goes depends somewhat on what habits you fill the car with, and also which personality traits you use to fuel the car. Some things will weigh you down, and others will speed you up. Sorting out bad habits from potentially good traits helps not just therapy, but life as well.
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Working On It In Therapy
There’s plenty of research demonstrating that therapy is effective in promoting change. But we also know that it helps some people more than others, and that some people get better faster than others. Just why that’s so is a complex question that I can’t explore thoroughly here.
But I can say that a lot of research indicates that one of the most significant factors in whether therapy is effective is your own contribution to the work.
Well, OK, but what does that mean? What am I supposed to be doing?
You don’t need any more “shoulds” in your life so we’re not going to get heavy with this stuff. But, because what you can do to make therapy effective isn’t so clear, I think it’s worth discussing a few things you can do to improve the outcome.
Therapists can try to explain what it means to work in therapy, but it’s difficult to briefly describe how the process works, and delivering even a short discourse in session can disrupt the natural flow of the work.
The content of therapy — the specifics of what clients talk about in sessions — differs widely from person to person, and can’t be prescribed. But the process of therapy — the how — includes essential practices that are helpful to be aware of, whether it’s depression, work addiction, anxiety, general well-being or other issues that bring you into therapy. These tools constitute the heart and soul of “working on it” in therapy.
Using Compulsive Traits in Therapy to Not Waste Time
In this post I’ll focus on five tools to help you use your time, and your personality traits, in therapy efficiently. While anyone can use these tools in therapy, I’ll describe how these tools specifically apply to people who are perfectionist, obsessive-compulsive, workaholic and Type-A. (I describe these tools and others in more depth and for a more general audience in my first book, I’m Working On It In Therapy: How To Get The Most Out Of Psychotherapy.)
Learning to use these tools consciously and intentionally, both in and out of session, helps clients who go to therapy continue to benefit from the process long after they’ve stopped seeing their therapist. These tools are no secret, yet they are not well known.
The process of therapy may seem counterintuitive for those of you who are compulsive. Where you usually tighten up, you may need to loosen up. Where you tend to use control, planning, and willpower, you may need to use the natural diligence that fuels those habits instead to let go, be spontaneous, and focus on feeling rather than productivity. You can use your healthy compulsive tendencies to integrate new ways of seeing and being.
It’s the same energy and meticulousness you use to clean a closet, plan a trip, or immediately catch every single formatting error your colleague made in the slide presentation the two of you need to give to your manager tomorrow. But now, use this energy lightly–without the do-or-die intensity that fueled the bad habits before.
And remember, while we don’t want you to waste time in therapy, we also don’t want you to rush through it like you’re racing in the Daytona 500. Your standards for how efficient the process should be may be on the high side. Don’t let the perfect be the enemy of the good by insisting on immediate progress. Rather, use your determination to stick with it for the long haul. Faster isn’t always better.
Five Tools
So, here are five tools to help you make progress in therapy. The point is not to execute them perfectly, rather to notice when they are difficult and use that as an opening to work on your issues in your sessions.
1. Focus on what’s within your control and mourn the rest.
If you focus too much on what’s wrong with your partner, kids, boss, colleagues, or universe, you will be weighing down the car and slowing progress down. Instead, focus on whether part of that situation could be your responsibility. Here’s where compulsive conscientiousness comes in handy. What gets triggered in you? How could you respond differently?
It’s very tempting to spend your time in therapy explaining and venting about how unconscientious, stupid and lazy other people are. Don’t. A small amount of that feels good and is helpful at first, but the returns diminish quickly. Use anger for change and grieve what you can’t control.
Randall came to therapy at the suggestion of his son’s therapist. He took his role as a father very seriously and was determined to give his son, Mason, a leg up in this competitive world. But Mason was far more interested in playing video games and reading fantasy fiction than searching the Fiske Guide to Colleges for his academic Shangri-la. This was not what Randall had in mind for his son, and he felt compelled to spend his time in session explaining every week how frustrating it was to watch Mason wander without a career direction, and why it was a bad idea to let him wander like that.
Eventually he had to accept that Mason was largely beyond his control at this point, and offering support for what Mason did like was far more effective than trying to steer him into more “reliable” interests. Unconditional love is more effective than achievement-based love. Randall used his capacity to target problems to make that his new focus. This meant that rather than spend time in session talking about Mason’s inevitable downfall, he spoke more about his own reactions, fears and background so that he could let go of the overly-specific dreams he had for him, which was the most helpful thing he could do for his son.
2. Focus on recurring themes and patterns, not just the crisis of the week.
Identifying the recurring challenges of your life can help you name your goals, which serve as good fuel for your trip. If you aren’t focused on them, you may be wasting your time. Seek out the recurring themes and patterns. One-offs are not worth digging in to. Monitor your obsessive tendencies to make sure you don’t get bogged down in extraneous, singular detail rather than seeing the common denominators that shape your ongoing experience. Explore whether you reacted to challenges this week as you did in previous weeks and years, or with more mindfulness. The more you can track these during the week and bring them back to the session as raw material, the better.
Naomi settled quickly into therapy and had no difficulty finding things to talk about. The problem was that there were so many different incidents in her week, that she mainly just reported what happened each week, with little progress being made on her perfectionistic tendencies and rigid reactions.
Eventually her therapist asked her what all these incidents had in common. Naomi was stumped at first, but then realized that each of these incidents pushed her buttons because the people involved were violating what she saw as fundamental morals, and she felt it was her responsibility to set them straight. Having been a parentified child that had to manage her family from a young age, she needed to sort out where her responsibilities ended, and to let others go their own way.
3. Allow yourself to feel and express emotions.
It helps to balance your focus on goals (the future) with feeling and spontaneity (the present). Don’t try to be productive or reasonable all the time. Speak in 1st person (“I”) about your personal experience, rather than make generalized statements about what most people are like. Expressing feeling is a powerful tool in rewiring old memories and overcoming old ways of coping with whatever you had to face. Emotions are like a lubricant for the brain to run smoothly and change.
Sure, you could wait and force your therapist to ask the inevitable question: “And how do you feel about that?” But wouldn’t that take longer?
Bruce didn’t know what his therapist meant when he asked about feelings. He did know that he felt best when he was working, but he had no words for the discomfort he felt when wasn’t working. As a professor, he was apt at expounding on his thoughts at great length, and as a researcher he could easily lose himself in numbers and writing. He genuinely loved thinking. Feeling was a void, one he avoided without knowing the costs.
His tendency in session was to make generalized statements, and to try to home in meticulously on why he was the way he was. Insight is valuable, but real understanding and change comes more from exposing ourselves to deeper levels of feeling, not just from intellectual analysis.
But his dreams of being chased and running frantically into the library were not lost on him. It took persistence from him and his therapist to hold up a STOP sign every time he left first person for third person in his mad dash for the security of the intellectualized library. But eventually he was able to identify the fears that lead him to run away from feelings he did not want, and begin to move toward what he did want.
Even a happy place becomes a prison when it becomes a habit of escape.
4. Let your therapist know if you have concerns about your work in therapy.
Don’t like what your therapist is doing? Tell her, not the hundreds of thousands of people on Quora (the social media platform where people ask questions) who have no idea what’s going on in your sessions. This is partly so she can better help you, but it’s also a matter of learning about yourself.
You might be tempted to hide any critical, perfectionist thoughts you have about them. Or you might want to inform them of every mistake they’ve ever made. Either way, you can use the therapeutic relationship to see how you manage your perfectionism. Your reaction to whatever is happening in the therapy office may tell you a lot about yourself and serve as fuel for your trip. To use your time effectively, mine the setting for all you can.
Sigourney couldn’t stop noticing that her therapist, Theadora, always took her side when she spoke about what had happened with her wife Alison each week. In a way she couldn’t blame the therapist, because she did report, adamantly, how difficult Alison was and how difficult it was to get along with her. She feared pointing out Theadora’s over-reliance on supportive techniques. After all, she was being very nice to her, and besides, she was the professional and knew what she was doing.
But Sigourney also knew that she would only get limited help if she just had her feelings validated week after week. So, after much handwringing and apologies, she told Theadora she needed to be challenged more. Her therapist was then able to acknowledge that she was being too careful, to explore what had led her to do that, and to give Sigourney more feedback on what she could do differently to improve the marriage. At least as important, speaking directly to her therapist, and not being so “nice,” was an experience that helped her to be more confident in speaking her mind.
5. Bring an open mind.
Compulsives have difficulty delegating because no-one else will do anything as well as they themselves will. And therapy does require some delegation to arrive at new perspectives. This doesn’t mean believing everything your therapist suggests, but just giving their ideas a chance, and observing how your critical tendencies might show up in your sessions. The ideas that seem the most foreign may prove provide the most valuable fuel.
Max was very self-observant and questioned whether any therapist could ever really understand him better than he did himself. He acknowledged that he relied on extremely meticulous lists to organize his life. He believed that lists were simply the most reasonable and effective way to organize one’s life. But his lists became dictatorial, overshadowed his relationships, and sapped his happiness.
When his therapist suggested that he experiment with going list-less on occasion, it didn’t go over well. Going into the world blind and unprepared was not on Max’s list. But his therapist felt that not making so many preparatory lists might help him experience directly the fear that he was trying to avoid. This seemed like malarkey to Max, but he agreed to try it, just for the sake of trying something new on principal, even though he knew it wouldn’t make a bit of difference.
His determination to do the “right” thing served him well here. When he did take a small trip and managed to restrain himself from making a list, he became aware of his fear that if he did forget something he would get in trouble, a visceral, indescribable and irrational core fear. He did forget something on that trip, yet nothing terrible happened. He was gradually able to see his use of planning as a defense, stare down his fear of getting in trouble, and allow his life to evolve more naturally.
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These are suggestions for an optimal approach, not rules or rigid imperatives. You and your therapist may have your own way of approaching therapy; my intention is not to challenge that, but rather to deepen and complement the work you are doing. If there appear to be discrepancies between what I suggest and what’s happening in your work with your therapist, speak with him or her about it. Discussing what’s happening in your sessions can be some of the most valuable work you do there.
I also want to be clear that I’m not recommending that anyone dash through therapy. It’s understandable to you want to get better sooner, and save time and money, but some things you can’t rush. You are adding new neural pathways to override the old ones, and that can take time.
Besides, you probably live with too much urgency, unnecessary urgency, already. You may recognize that you’re already using the tools I have suggested here. Hopefully that reassures you that you’re already making progress.
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