What brings you here?

The therapeutic process starts with a question, “What brings you here?“, and an answer that is the real question, the complaint. A question that the psychologist can help interpret in a goal-oriented way, or simply deconstruct together to find what implications it holds.

In some cases this process happens before therapy, if the client’s awareness has reached a good enough level and she/he’s able to bring a more ‘raw’ version of their discomfort (“I am suffering because I keep behaving a certain way, or feeling down” rather than “I keep fighting with my partner, I want to understand who is right and who is wrong”).

Symptoms are frequently brought to therapy, and what is usually asked is “I want to get rid of them”, a reasonable goal for people who are suffering. If there is discomfort, I might want to see a professional who helps me solve that discomfort.

At this point the psychologist can answer in many different ways, based on her/his approach. 

Some might work on that symptom or complaint more directly. One example is to determine what kind of symptom it is (Is it anxiety? Is it insomnia? Is it somatic?) and draw on the psychologist’s knowledge to find which techniques are the most effective in these cases and guide the client in practicing them.

The psychologist might help the client see how some of her/his thoughts are irrational, by providing facts, and helping the client to consciously back up those thoughts and emotions with a rational response that reduces the discomfort they bring.

Another psychologist might foster the client’s acceptance towards her/his humanity and feelings, while helping them to focus on the present moment and recognise their emotional and physical states.

We could be invited to see ourselves as many different ‘selfs‘ and treat each part, especially the most vulnerable, with kindness, knowing why they are there in the first place.

Some other psychologist might work more in the long term, inviting the client to go back a little and contextualise the here-and-now with a broader image of her/his life and patterns. This can involve the client’s fantasies and desires, which lead to needs and often judgements, and these are all explored better to see where deeper issues lie (note: it’a often how we judge our feeling that creates discomfort, rather than the feeling itself).

It can also involve an exploration that is more based on family and relational dynamics in general, because any individual is placed in a social context and cannot be separated from it.

Other methods would use the therapeutic relationship itself to understand the client’s models of interaction in life, since another assumption is that we will tend to repeat our usual dynamics with our psychologist.

Mentioning all possible approaches would take a lot more than a month, but the take-home message here is that we don’t have to go blindly into therapy. Therapy is not something we treat like a black box, that we’ll only see the content once we open it. We can ask professionals how they work, which methods they use, what they believe when it comes to mental health.

This won’t grant us that we will immediately find the perfect match, but can help us make a more mindful choice based on our needs and goals.

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