Pushing Through A Therapy Rut

Melody Mickens, PhD on Nov 10, 2022 in Mood and Feelings

A sinking feeling filled my stomach as I left his office. Was that how therapy is supposed to go? Why do I feel so — unsettled? I knew I'd be seeing him next week, but did I want to? Did I do something wrong? My mind harkened back to a current TikTok video and left me asking, "Am I the villain?"

Ugh. Therapy is designed to stir up some of our best-kept emotions, and what we forget is that a lot of what happens in the therapy session isn't what we discuss but rather how we relate to our therapist in the room. Just as with any other relationship, we bring our past history, our narrative of how others perceive us, our conscious and unconscious beliefs, our psychic defenses, and our desire to be perceived well. Our therapists bring this too.

As a clinician trained in interpersonal psychotherapy and psychodynamic psychotherapy, I am frequently reflecting on the non-verbals, the defenses I encounter and bring to my sessions with clients, and what we in the therapy world refer to as transference and countertransference — or those past relationship patterns that my client brings and assumes (transference) and my response to them (countertransference).

When we hit a snag or there's weirdness in the room, that's a good time to check in with our therapists about how our relationship is going and how we are relating to our therapist. One of my favorite aspects of therapy is the experiental nature and the ability to recreate our relationship patterns in a safe way and in a therapeutic setting that helps us take the risks we need in order to grow and stop hurtful patterns.

But how can you do this if you aren't even aware of what's going on in the room or if you don't know how to approach this with your therapist?

1. Acknowledge that something feels off and try to explore this with curiousity alone. Ask yourself, "When was the last time I felt like this and with whom?"

2. Journal about this feeling and this experience. Include information about how you have been affected by your therapist and the therapy relationship or what is holding you back in this relationship.

3. Talk with your therapist. Sometimes broaching the subject seems awkward or out of place, but as a therapist, I can tell you my job is to create a safe environment so that my clients can grow. I want to know these things. Your therapist probably does too. You can reflect on your experience and ask your therapist to help you better understand why you feel this way (i.e., "When I left I felt really unsettled; can you help me figure out what happened in our last session?")

4. Let your therapist know if something is or isn't working. Communication with us is a risk but well worth the reward. We want you to grow and need more information about your experience of us and therapy to guide you.

Melody Mickens is a Clinical Psychologist in Pittsburgh, PA.
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