Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist - Part 1

In prior articles, I discussed some of the myths and misconceptions that people often have about psychotherapy (see my articles:Common Myths About Psychotherapy: Going to Therapy Means You're "Weak",  Common Myths About Psychotherapy: Psychotherapy Takes a Long Time and Common Myths About Psychotherapy: Therapy is "All Talk and No Action").  In this article, I'm focusing on another myth that many people, especially if they've never been in therapy, which is that therapy is something that happens to them as opposed to therapy being a co-created process between the client and the psychotherapist.

Psychotherapy as a Co-Created Process Between the Client and Psychotherapist

What Does It Mean that Psychotherapy is a Co-Created Process?
As opposed to going to see a medical doctor or your dentist, good therapy is a collaborative process between the client and the psychotherapist.

In other words, in good therapy the client and the therapist work in an interactive and dynamic way to help the client to define and resolve his or her problems.

In the past, psychotherapy was a more hierarchical process where psychotherapists believed they knew what was best.  They made interpretations about clients' problems and expected the client to either agree with the interpretations or work on the clients' resistance to the therapist's interpretations (see my article: Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy).

There are still some psychotherapists who work this way, and it works for some clients.  But the vast majority of clients want a more collaborative process where the client and the therapist both have input into defining the problem and working on a resolution.

Psychotherapy as a Collaborative Process Rather Than Something That is "Done" to You
Rather than seeing the psychotherapist has someone who has "all the answers," most clients are comfortable with the idea that the psychotherapist has a particular expertise in helping clients to work through their problems, but they also recognize that, as clients, they need to participate in the process (see my article: Why It's Important For Psychotherapists NOT to Have "All the Answers").

Rather than seeing therapy as something that is "done" to them, clients who have experience with contemporary psychotherapy know that the therapist can help to facilitate the process, suggest certain ways of working in therapy, help the client to develop coping mechanisms and internal resources, help the client to develop insight into his or her problems, assist the client to make changes, and point out self defeating patterns or defense mechanisms getting in the way, but the therapist can't tell you what to do or wave a magic wand to make the problems go away.

I'm mentioning this because many clients who have had brief experiences with psychotherapy will often say that they left a particular psychotherapist because the therapist didn't tell the client "what to do."

Similarly, people who have never been in therapy might expect the therapist to give them advice.

It's easy to see why people with no or only brief experience with psychotherapy might think that the therapist is responsible for giving advice or resolving problems.  These clients might have gone to school counselors or other types of counselors in the past where advice is often given.

But psychotherapy is different from counseling in that psychotherapists help clients to explore problems and come up with solutions as a result of that exploration, but they don't tell you what to do.

This is why it's so important for psychotherapists to provide clients with psychoeducation during the initial phase of psychotherapy, especially for clients who have little or no experience with psychotherapy (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

In my next article, I'll discuss further aspects of the co-created process in psychotherapy.

Getting Help
Everyone needs help at some point in life.

Often, family and friends aren't helpful for particular problems and you need the help of a licensed mental health professional.

Many people avoid starting psychotherapy because they have misconceptions about therapy or they don't know what to expect (see my article:  The Benefits of Psychotherapy).

When you see a psychotherapist for an initial consultation, you would benefit from asking questions about psychotherapy, the therapist's background and training, and how this particular therapist works.  You're not only entitled to know these things, you will benefit from knowing it.

Rather than suffering on your own, you could benefit from seeking help from a skilled psychotherapist who can help you to work through your problems (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

See my article: 
Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist - Part 2

How to Recommend Psychotherapy to a Friend

Recommending psychotherapy to a friend can be a sensitive issue.  While it's true that seeing a psychotherapist no longer has the same stigma that it used to have, especially in New York City, there are still many myths and misconceptions about therapy. There are still people who think that that going to therapy means you're "weak" or "crazy"  (see my articles: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak", Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Therapy is "All Talk and No Action."

How to Recommend Psychotherapy to a Friend

So, if you have a friend that you think could benefit from psychotherapy and you know your friend might be offended by the suggestion that s/he go to therapy, you need to proceed with sensitivity and tact and find the right time and way to approach your friend.

Suggestions For Emergency Situations
Take Action in an Emergency:
The suggestions that I'm offering below are for non-emergency situations.  If your friend is threatening to hurt him or herself or someone else, don't minimize your friend's threats.  You need to get your friend immediate help by either calling 911 or bringing your friend to a hospital emergency room.

Suggestions For Non-Emergency Situations

• Start By Listening and Finding Out What Your Friend Needs:  If your friend confides in you that s/he has been anxious or depressed and s/he's not suicidal or homicidal, you need to start by listening.  In some cases, your friend might just want emotional support.  S/he might just need you to listen.  You can let your friend know that you're available to listen and provide emotional support.  In other cases, your friend might need more than just emotional support.  S/he might need help from a licensed mental health professional.

• Normalize Your Friend's Problem (if possible): Sometimes people feel that there's something wrong with them because they have a particular problem.  It's often a relief to them to hear that you and many other people have struggled with the same type of problem.  It can help your friend to feel less ashamed.  So, to the extent that you can, try to normalize your friend's problem by telling him or her if you can relate to the problem.  If you've never experienced this type of problem, be as empathetic as possible to show your friend that you care.

• Ask Questions About What Your Friend Has Already Done to Resolve the Problem:  If your friend is open to therapy then there's no problem.  You're not going to risk alienating him or her with a recommendation that s/he attend psychotherapy.  The trickier situation is when a friend has misconceptions about psychotherapy and would be insulted if you suggested it.  In a situation where you think your friend would be offended by a suggestion to go to therapy, you could start by asking your friend what s/he has already tried to resolve the problem.  Very often, people with longstanding problems have tried many different things before they consider psychotherapy.  Someone who has tried many different ways to resolve a problem might be more open to considering psychotherapy.

• Talk About Your Experiences in Therapy:  After you listen to your friend describe his or her efforts to resolve the problem, you could talk about your experiences and how it helped you, if you feel comfortable doing this.  Knowing that a close friend was or is in therapy helps people to feel more comfortable with the idea of going to therapy themselves.

• Talk About the Benefits of Going to Therapy:  After you describe how therapy helped you, you could also talk about the benefits of going to therapy and address the misconceptions that your friend has (see my article: The Benefits of Psychotherapy).

• Help Your Friend With Suggestions About How to Get Started in Therapy:  If your friend is open to the idea of giving therapy a try, but s/he doesn't know where to start, you could tell him or her that a primary care doctor or health insurance can provide a referral.  Your friend can also find out from other friends if they would recommend a particular psychotherapist.  You can stress to your friend that s/he just needs to take it one step at a time.  The first step would be going to a consultation with a psychotherapist, which does not obligate your friend to continue.  The consultation would be an appointment with a therapist to talk about the problem in a broad way, ask questions, and to see if s/he feels comfortable with the therapist.  Your friend can also have consultations with a few psychotherapists before choosing one (see my article: How to Choose a Psychotherapist).

• Be a Good Friend:  If your friend isn't open to considering psychotherapy at this point in time,  don't push it.  If you push it, your friend might be less likely to get help.  You can just let him or her know that you're available to continue the conversation at another time.  Your friend might need time to absorb the information that you've provided, so let him or her know that you're open to continue the dialogue.  Your role as a friend isn't to convince your friend to go to therapy.  Your role is to be a good friend who listens, provides emotional support and psychoeducation about psychotherapy to the best of your ability.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article: see my article: The Therapeutic Benefits of Integrative Psychotherapy).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.

Some Thoughts About Autumn and New Beginnings

My school days are long behind me, and yet, even as an adult, whenever autumn rolls around, I feel the same type of anticipation I felt when I was a student.

Autumn and New Beginnings

I can still remember the excitement and anticipation about starting a new school year and everything involved with preparation for the new year:  getting new outfits for school, buying new pens and pencils, and wondering what my teachers would be like and who would be in my class.

To this day, even though I have a Smart phone where I could schedule my appointments, I still use an academic appointment book that runs from August to September because that's how I still experience the year.

To me, September feels like the beginning of the new year--not January.

As a child, I experienced that last day before going back to school with a sense of wistfulness.  I still feel that way as summer ends and autumn begins.

Up until that last day,  summer seemed to go on forever.

It's interesting how we experience time as children as opposed to how we experience it as adults.  Now, of course, each summer seems to go by faster and faster.  

I had a cousin who would lay around brooding all day long on the day before school started because she wanted to make that day feel like it lasted a long time.

Autumn:  New Beginnings

Somehow, for me, Autumn still feels like it's the time for new beginnings.

After taking it easier during the summer, Autumn brings a sense of starting something new, whether it's new projects, new commitments that we make to ourselves or a new perspective that we hope to develop.

Starting Therapy

After being away for all or part of the summer, along with all the other changes that people anticipate, many people consider starting therapy in the fall.

If you're considering starting therapy, whether it's for the first time or you're returning to therapy, I hope you will enjoy reading some of these articles and that they'll be helpful to you:

The Benefits of Attending Psychotherapy
Common Myths About Psychotherapy: Going to Therapy Means You're "Weak"
Common Myths About Therapy: Therapy Takes a Long Time
How to Choose a Therapist
Overcoming Your Fear of Attending Therapy
Starting Therapy With a Sense of Curiosity and Openness
Starting Psychotherapy: It's Not Usual to Feel Anxious and Ambivalent
Psychotherapy and Beginner's Mind
A Strengths-Based Approach to Therapy
Why Is It That It's Usually the Healthiest Person in a Family That Goes to Therapy?
Getting the Most Out of Your Therapy Sessions
Psychotherapy and Compassionate Self Acceptance

About Me

I'm a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or send me an email.

Common Myths About Psychotherapy - Therapy Always Takes a Long Time

In recent years, I've found that most people who call me to set up a psychotherapy consultation tend to be much better informed about psychotherapy than even a few years ago.  When they call, they're often asking about particular types of psychotherapy, like EMDR, clinical hypnosis or Somatic Experiencing.

Common Myths About Psychotherapy: Therapy Takes a Long Time

Often, they've been in psychotherapy before or they've done their research online or spoken to friends who have been in therapy, so they are coming to therapy as "informed consumers."  But I find that there are still many people who have misconceptions about psychotherapy due to the many ongoing myths about psychotherapy.  So, I thought I would start with one of the most common myths--that therapy takes a long time.

There Are So Many More Choices For Therapy Now: 

I can't even count how many times new clients have come in and said, "I don't want to be like Woody Allen--in therapy for 50 years."  Unfortunately, this is one of the biggest misconceptions about psychotherapy, complete with the client lying down on the analytic couch free associating to whatever comes to his or her mind and the therapist (usually a man looking very much like Sigmund Freud with white hair and a beard) sitting silently behind the client taking notes.  

This stereotypical image is a throwback to the days when the only type of therapy that was available to clients was classical psychoanalysis.

As a therapist, my original training was in psychoanalysis.  If a client is interested in psychoanalysis, I'm happy to engage them in the psychoanalytic process.  But, even if we are working psychoanalytically, I usually work in a very contemporary, dynamic and interactive way.  I combine many different types of contemporary psychodynamic ways of working, including a post-Jungian dream work called Embodied Imagination.

 On the other hand, if a client prefers to work with more silences, I am also trained to work in this way.  So, there are choices.

Progress in Psychotherapy:

I also like to see clients making the kind of progress in treatment that they're seeking.  How"progress" is defined is also very specific to the client.

It doesn't necessarily mean that the client leaves therapy feeling good after each session or that each session brings about revelations every time.

For some people, it might take a while for them to even  trust the therapist to open up and be able to talk about their problems.  For them, this is progress.

For other people, progress might be gaining insight into their problems and being able to take action in their lives.  A lot depends on the client's internal motivation, willingness to make changes, the therapist's skills, and whether the client and therapist are a good match.

Aside from being psychoanalytically trained, I'm also certified in mind-body psychotherapy.  I'm trained in EMDR, clinical hypnosis and Somatic Experiencing, which tend to be shorter forms of therapy as compared to traditional psychoanalysis to clear up certain types of trauma.  So, my approach is eclectic and flexible. 

When clients ask me "How long will I be in therapy?," I tell them that therapy is a very individual process.  It depends on what they want.  Some clients come in for a very specific problem that they want to overcome.

If they don't have layers of trauma and the problem is not related to deeper issues, short-term therapy can help them to clear up the problem.  For other clients, their current problems are part of many layers of trauma that began since childhood.  This type of problem is more complicated and would probably take longer.  

Getting Help in Therapy:  Start Therapy with a Consultation:

At the beginning of therapy, it's helpful to talk about the problem that brings you into therapy and what you would like to accomplish.

Of course, you're not required to know this beforehand in order to come to therapy.  For instance, many people know that they're "not feeling right" and they're not sure what the problem is, so this becomes part of the work in therapy with the therapist helping the client to understand this.

But for those people who do know what they would like, it's helpful to define the problem and what would constitute success in therapy.  This can help to give the therapy clarity and direction, but nothing is carved in stone.  There's flexibility and there are choices.

In future blog posts, I'll address the other common myths about psychotherapy.  

If you're interested in finding out about the various types of therapy that I've mentioned in this blog post, you can find more information on their professional websites:

Resources:

Clinical hypnosis:  American Society of Clinical Hypnosis

Somatic Experiencing:  Somatic Experiencing Training Institute

EMDR:  EMDR professional association

About Me

I am a licensed NYC psychotherapist, hypnotherapist,  EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 or email me.


See my article: Common Myths About Psychotherapy: Going to Therapy Means You're Weak

Also, visit my Psychotherapy Daily News for updates on mental health issues, health education, and science news.