You’ve surely watched movies featuring therapy sessions. A laid-back therapist with a slightly expressionless face listens to a patient who is angry, sad, desperate, sarcastic, or elated. After a while, the therapist interjects, evoking interest, worry, irritation, sadness, surprise in the patient. Then silence ensues, and after a moment, the therapist asks what the patient is thinking. And so on…
When I see such films, I rarely recognize myself. It’s probably not because they are poorly made but because I experience the therapy session from within. Firstly, I’ve undergone therapy myself, as all therapists should. Secondly, I focus on what the patient is conveying, without a thought of “how does this come across through the camera lens?” Given this reservation, we can say this about a therapy session:
The dialogue is focused in the sense that the patient wants to tell something important, and I am there to listen. It’s also asymmetric: they seek help from me, not the other way around. So, there’s no shared experience like one has with a good friend. The conversation is deeply personal for both patient and therapist. The patient wants to unravel something difficult or embarrassing that he or she doesn’t understand about himself/herself. The therapist, on the other hand, utilizes “countertransference,” the reactions one experiences while the patient speaks, which helps understanding better the patient’s issues.
In the therapy room, you’ll find two chairs. One is mine, and the other is reserved for you. Many therapists, especially analysts, recommend lying on the couch. It may feel more relaxed, and perhaps the analyst also feels more at ease to contemplate what you’re sharing. Today, hardly any analyst insists that you should sit or lie down. Instead, you and the therapist can discuss the matter, so you decide how YOU want to proceed.
Psychotherapy consists of a series of non-directive conversations. No one can predict how it will unfold. On the contrary, we therapists encourage the patient to speak their mind and be honest. Lastly, not everything in therapy revolves around words. Much happens beyond words through gestures, intonation, facial expressions, and body language. They may reveal problem areas affecting you in ways you may not even notice yourself.
So, what does the therapist do? An essential task is to listen to what the patient conveys— but from a different perspective. Hence, new views arise, such as: “You said you’re feeling great, but I got the impression there was another feeling too.” Many so-called interventions aim to connect the patient’s communication to what we call transference. For instance, your story about disappointment at work might also say something about how you perceive our contact.
Through experiencing and processing many of these interactional situations, I hope that your ability to feel and reflect on your experiences will increase. Similarly, the courage to address them grows, both when contemplating a current problem and when needing to resolve a conflict with someone else. Because therapy isn’t about navel-gazing. On the contrary, a vital aim is for you to gain access to richer, deeper, and warmer relationships with other people.