Is "In Treatment" Really What Happens in Therapy?

People have asked me this often in the past few weeks. If you've been watching HBO's new series, "In Treatment," you would see a therapist go through the following:

Reciprocating romantic feelings for a client.
Having a client fall in love with another client.
Get into a physical altercation with another client.
Have a teenager attempt suicide in the office.
Go to their own supervisor for personal therapy.

Plus so much more!

In truth, therapists do have struggles and difficult clients, but since 1999, when I began working with clients, I have never experienced most of these issues, as well as practically all the therapists I personally know and affiliate with.

Do clients form romantic feelings for therapists? It can happen, and does happen to most therapists at one time or another. It's a process clients go through when the therapist has proved a safe, nurturing environment for the client to be able to work through their pain and begin to heal. That process is so strong, that a client's feelings may be misconstrued as romantic feelings. A competent therapist recognizes these feelings and uses this interaction to further process the healing.

In general, therapists don't fall in love with their clients (although it has been known to happen), therapists don't push their clients into bookcases, and don't have client attempt suicide in their office. This television show has some wonderful acting and some great moments that draw the viewer in, but remember, it's ultimately a TV show!

If you have seen it and have concerns, please post them! We can address them here!

Is My Problem Therapy-Appropriate?

I hear this question a lot. New clients will call and start off our conversation with, "I know you probably have more important clients with more critical issues, but I don't know where else to turn." It always amazes me how people don't believe their issue is important enough to seek help themselves.

Well, here is some reassurance. People cope differently in reaction to situations. Something that may stress one person out may easily roll off of your back. In turn, you may find yourself having difficulty dealing with a particular situation, but you see others sail through the stress with ease.

Regardless, if you're finding you're having difficulty dealing with a particular issue or relationship, and the inability to cope with the problem is impacting your ability to carry out your normal daily routine, then it's time to do something about it. You have a right to be happy within your life, whatever that means or looks like to you.

Reaching out for help is not a weakness, but in fact a strength. It's the strength of knowing your limitations and recognizing getting help will allow you to heal faster, rather than trying to work through the problem on your own, only to realize that you're sinking fast.

So, if you are doubting as to whether or not your issue is important enough for therapy, ask yourself this:

Am I succeeding at overcoming the problem myself?
What will it take for me to recognize I need help to get my life back in order?

Remember: Only strength allows you to take one step at a time.

What If I Feel My Therapy Isn't Working?

Do you go to therapy wondering what you're going to talk about? Do you feel like you're spinning your wheels and getting nowhere? Feeling discouraged that you're constantly taking one step forward but 3 steps back in therapy?

Therapy requires time, patience and work, but you probably don't want to feel like you will be in therapy forever. If you're feeling discouraged, it's real easy to call your therapist, cancel the appointment and never reschedule. But is it really the best decision for you? Could be....maybe not.

Therapy is a complicated art. There are many factors which contribute to the success or failure of therapy, the main factor is the rapport between the therapist and yourself. Other factors include: your commitment to therapy and yourself, the therapist's competence and confidence in their own skills, the issues you bring to the table and the length of time you've been dealing with the problems, just to name a few.

Dropping out may prevent you from facing the problems that brought you to therapy in the first place. So what do you do?

First, talk to your therapist as soon as you start to feel discouraged. Let your therapist know how you're feeling, what you are seeing is happening with the therapy, and what your expectations are. Opening this channel of communication helps the therapist understand what you are wanting and an open discussion of your needs and expectations can be laid out on the table.

After having such a discussion, you and your therapist can lay out a new treatment plan addressing your concerns, which may include additional resources in addition to therapy such as support groups, medical evaluations, etc. After processing all your options, you may agree transferring to another therapist may be needed. If this is the case, your therapist should be able to provide you with appropriate referrals so you can continue your journey.

Disclosing to the Counselor -- How much is too much?

Counseling is an interesting phenomenon. You pay a complete stranger to open up to them, become vulnerable and place some level of expectation they will be able to help you through your problems and come up with better solutions. This can feel weird, overwhelming, even downright scary. But, how much should you disclose?

Your counselor can only help you if you're upfront and honest with them. This may not mean you have to unlock every skeleton in your closet, but if you're holding back, they may not be able to help you move forward. For example, if you are actively engaging in the use of alcohol or marijuana and you emphatically deny this to your therapist, they may attribute your symptomology to more severe mental disorders. They cannot assess, and thus intervene, appropriately.

Communicating with your counselor can also be beneficial if you find you are having difficulties with the direction your therapy is going. Sometimes, I find clients may experience difficulty bringing up problems to the counselor when it has to do with the counselor; however, counselors are people too. We make mistakes and misinterpret client signals, which could inadvertently derail your therapy.

If you find yourself uncomfortable with your counseling experience, I recommend you bring it up with your counselor. Let them know how you're feeling and what your concerns are. Again, the counselor can't read your mind and will want to know how they can best help you.