The key to successful therapy

No one is embarrassed when they need to consult a doctor for an illness. However, seeking psychotherapy seems to fall into a different category – with many people avoiding it, delaying it, or feeling guilty about it when they seek help for emotional and other non-physical problems.

These may be anxiety, depression, panic attacks, anger, loneliness – all mental problems that can benefit from the help available from therapists. Especially now, in this time of war, tragedy, and ongoing loss, it is understandable that often we are overwhelmed and feel we just can’t face another day.

According to an Israeli psychologist, there are three issues you need to settle before you choose a therapist. Do you agree on his/her methods? Even if you agree with his/her goals, you may not have the same idea about how to achieve them.

Therapists base their methods on what they believe is most effective. But if you believe, for example, that hypnosis will work better for you than biofeedback for your tension headaches, then look for someone who practices hypnosis.

Do you feel you’ll be a partner with your therapist? Most today feel that their patients have the right to be closely involved in every phase, from setting goals to agreeing on the type and length of treatment. However, if the therapist objects to the shared approach, consider trying someone else.

Do you know the difference between evaluation and therapy? If you want a professional opinion in a dispute over, say, child custody, or whether your aged relative is competent to manage his/her finances, you are asking for an evaluation. If you want treatment for a personal problem, you need to seek therapy. You can usually speak to the psychologist on the phone before a formal interview, and in that way understand what you will be meeting about, what you want done, and whether this person is the one who can help you.

Usually, personal pain is the first order of business when you go for therapy. Your distress needs to be relieved as quickly as possible. However, this alone won’t produce lasting results. It requires goal-setting, with early, short-term objectives followed later by long-term goals.

The therapist usually starts with a working hypothesis: Why now? What has tipped the scales? What brought this man or woman to my office at this time?

The first interview is a diagnosis, which can then suggest a specific treatment. The answer to “Why now?” defines what the patient needs from the therapist.

If the answer is simple, the goals can usually be simple, too. If the client says, “Teach me to be strong enough to ask my boss for a raise... or to stand up to my husband... or to avoid always being exploited, etc.,” the therapist can say he/she can or can’t do it.

However, clients rarely go to their first appointment with such specific goals. Most are unsure about what they hope to accomplish beyond getting relief. But unless goals are set as soon as possible, clients may waste time and money looking for help that doesn’t exist, with the therapists working on problems that the patients don’t consider problems.

Set early goals

Before you consult anyone, jot down what you think is causing your distress. Events such as the aftermath of Oct. 7 and the horror we all faced, relationships, stresses can be better understood and clarified when you write them down. Take the list with you, as your insight reveals a lot about you and will lead the therapist in the right direction.

After the first visit, consider whether you were comfortable. Can you work with this professional week after week? You should feel a level of trust and understanding early on. But if you felt patronized or hopeless, look for someone else. Compatibility is the best predictor of how well the therapy will go.

Try to make your goals measurable in some way. It’s not always easy, but it will tell you whether you are making progress.

For example, if you and your father have a terrible relationship, one goal might be to carry on a telephone conversation without getting angry or upset. If you can do this a few times, you’ll know you’ve made progress.

Sleeping well without nightmares, losing weight, stopping smoking are all goals that can be measured. Part of the therapist’s job is to clarify exactly what you want to change and to help you achieve it.

Long-term goals, in Freud’s words, are the ability “to love and work.” Determining what you want to do with the rest of your life involves your personality, beliefs, values, dreams, ambitions, and imagination, so it is not easy.

A client may want to survive a divorce, move to a new city, and change a job. It may take 20 sessions to help him/her. The job of the therapist is to help people grow, not to tell them how. Excessive dependency on anyone can be destructive. Taking charge of your own life can be scary but at the same time fulfilling.

It is important to know that whatever pain you are feeling for whatever reason can be relieved with help from a competent therapist, and you should feel no stigma in seeking that help. The peace and inner tranquility you will discover when the pain is gone will be well worth whatever it has cost you financially and emotionally to achieve it.

If the pain involves the loss of a loved one, no one can assuage your grief, but a good therapist can help you come to terms with it and give you coping skills.

May peace soon come to all Israel, may Hamas and Hezbollah terrorists be vanquished, and may our hostages be returned to their loved ones! 

The writer is the author of 14 books. Her personal favorite is Esther – A Jerusalem Love Story, which has recently been republished by Chaim.Mazo@gmail.com. Contact her at dwaysman@gmail.com