What to Expect in Therapy

All of the patients I see in private practice come to me because they are experiencing some kind of psychological suffering. As their psychotherapist, I want to relieve their suffering, however this can be a challenging task to accomplish. When beginning with a new patient, my first goal is always to assess the situation. 

I begin the assessment phase by looking at family history, medical history, and life narrative, while measuring the person’s capacity for self-observation and expression of thoughts and emotions. We then begin to explore the current stressors bringing them into treatment. The purpose of this approach is to get enough information to gain context for the situation at hand. Without context, a therapist would be working in the dark.

For patients working through psychological conflict, my goal is to move beyond the simplicity of symptom reduction and to help them gain insight into personality structure, perceptual blindspots, and expressive blocks. A guiding question for much of this work is, “What problem are these symptoms the solution to?” 

William Symes a master therapist and supervisor writes in his book, Mastering the Art of Psychotherapy:

“the fear of negative consequences derails simple psychological health. If it were not for the fears associated with childhood, which produced one’s personality structure, the psyche would naturally self-express on a moment-to-moment basis; instead, the psyche self-corrects by transferring energy from a blocked emotional expression into and through a symptomatic expression.” 

When we begin to move into the working phase of therapy, one of the major goals becomes to create a space for fuller, freer, and more courageous expression. By engaging in this way, my patient’s fears, anxieties, relationship styles, and symptoms become activated in the therapy, allowing us to begin to work in the here and now of the relationship, processing the conflicts as they arise, connecting them to the past to gain insight and understanding. In this approach, therapy is an encounter, however, one that is couched in the safety and support of a caring relationship.