"Once in treatment, those who formed a real partnership with their therapist-by being open, even with painful subjects and by working on issues between sessions-were more likely to progress."
--Consumer Reports.  11/95



What actually happens in the day-to-day process of psychotherapy? What are the client's responsibilities in therapy, and what might he or she actually do? What are the therapist's responsibilities, and what does he or she do-and not do?


Once you decide that a particular therapist is likely to be a useful guide through unexplored territory in your life, the work can begin. What do you do next?

Your primary responsibility in psychotherapy is to work toward becoming more aware of your experiences, thoughts, feelings, and memories, and to talk about them during the therapy session. The awareness may be about any aspect of your present or past life. It may be about the therapy or the therapist, about night dreams, daydreams and fantasies. It may be about hopes, joys, sorrows, fears, and relationships-anything that may come to mind during the session. Although people new to psychotherapy often try to "prepare" for therapy sessions by creating an agenda or deciding in advance what to talk about, they end up trusting that the process itself will bring to mind highly useful material. Sometimes it is the sequence of topics that are mentioned or the recall of events that appear to have been "forgotten" that provide important clues to what is going on for you below the surface. It may take time for you to feel convinced that your therapist is vitally interested in hearing about your ordinary as well as unusual experiences, and that she or he will not be judgmental or shaming no matter what you reveal or talk about.

It is sometimes particularly useful to report and talk about dreams, uncomfortable feelings such as anger and disappointment, and feelings of warmth or longing. Dreams can provide a useful window to that part of your inner life that is harder to access directly. Feelings that arise in a psychotherapy session may also have been an important part of relationships with important people in your past and can be linked to important memories. The therapist will therefore encourage you to talk freely about-rather than act on-feelings that may come up about him or her.

The process of revealing thoughts and experiences that are uncomfortable, painful, or laden with shame or guilt is important in the course of therapy. Indeed, simply talking at length about the details of such experiences in the presence of someone who is interested and empathic tends to be helpful, since it reduces the degree to which you feel alone in the experience or ashamed of some aspect of it. Revealing joyful experiences or points of pride and delight is also important.

Mental health is not just the absence of "symptoms" it is full, flexible and creative human functioning.

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