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Information about psychotherapy

Psychotherapy is a form of treatment for mental and emotional development.

Although it helps individuals to gain insight into their problems, you don’t necessarily need to experience difficulties to be in therapy. Sometimes, people just want to progress in their journey and enjoy their life and overall well-being.

When used to overcome mental health concerns, it can be used for various sort of difficulties, including anxiety, depression, grief, relationship difficulties, eating disorders, obesity, lack of emotional control, and anything else that is stopping you from feeling happy.

There are different kinds of psychotherapy (like psychoanalytical, Cognitive, behavioural, cognitive-behavioural, family, systemic, person centred, humanistic, existential, and many more).

We can broadly divide all the different kinds of psychotherapy, in two main categories:

1: Working on the unconscious;

2: Working on the behaviour (linked to cognition).

 

Therapies working on cognition and/or behaviour, aim to help the individual in difficult circumstances of life. They are based on the idea that, by understanding how and why things happen, someone might learn and improve their skills to overcome those difficulties.

These techniques are particularly useful when someone needs sudden support, for example to go through a medical procedure, or to keep their anxiety under control to pass an examination or a job interview.

The benefits of these techniques are that they are very fast to be effective and therefore less expensive in terms of finance and time.

These results don’t generally last for very long, and research shows that problems tend to present again over time.

Therapies that work on the unconscious, tend to be a more general help for people, because they do not only work on the specificity of a difficulty that the individual encounters in life, but more broadly on the entire personality. Therefore, the effect of this group of therapies, is on the general wellbeing and happiness.  This is because, by working on the unconscious, the individual might be able to get to the roots of their difficulties and to overcome these. Sometimes, this will require an understanding of the problem. However, it is important that the person in question does not get confused between the ‘understanding’ of the issue and their wellbeing. In fact, many times, they get better without even realising what changed, or how it changed. Sometimes the understanding of how things changed, arrive after the ending of the treatment. The person does not get better by ‘controlling’ their anxiety. The person is more likely to get better by ‘mastering’ their anxiety at a different level, which is, exactly, unconscious.

Therapies that work at an unconscious level are:

Psychodynamic psychotherapy, psychoanalytic psychotherapy, psychoanalysis, Analytic psychology, brief psychodynamic psychotherapy.

Psychotherapists using those modalities of intervention, will need to have received psychotherapy themselves as part of their training.

 

What are the differences between the therapies working on the unconscious?

  1. Psychodynamic psychotherapy is usually offered on a once weekly base, and it generally starts showing some effects after 18 months from the start of the treatment.

  2. Psychoanalytic psychotherapy is usually offered 2 or 3 times a week.

  3. Psychoanalysis is generally offered 4 or 5 times a week.

  4. Analytic psychology is usually offered 1 or 2 times a week and tends to last many more years.

  5. Brief psychodynamic psychotherapy Is offered once a week, and it lasts generally for 16/30 sessions, and it’s the only one that focuses on one or a few problems.

 

 

The number of weekly sessions does not change the length of the treatment, but it changes the level of the treatment. The more intensive it is, the deeper you get inside your unconscious.

 

To work on your unconscious, you will need to attend your sessions in person. A minimal number of online sessions might be allowed, depending on your therapist. However, this will usually extend the length of the treatment.

 

 

What to expect from a session.

Your trained psychotherapist uses a particular type of technique, which constitute the ‘setting’.

Psychodynamic approaches usually use 2 chairs, and you will sit in front of your therapist. It’s a vis-à-vis therapy (Face to face).

The more intensive the treatment, the more your therapist will ask you to lie down the couch, to be able to reach deeper level inside your psyche.

The main tool of these therapies is the ‘association technique’. This means that you will be asked to talk about anything that comes up to your mind. This can be a thought, a feeling/emotion, a memory, a wish, or a dream. You don’t need to prepare or to present a topic. You will only need to speak as if you were thinking out loud.

Sometimes people think that they only need to speak about their ‘problems’. Actually, no! You need to speak about anything that is taking a space in your mind. 

Some therapists will adopt this technique from session 1, which means that they will just wait for you to speak, asking no questions at all. Some therapists might ask you a few questions during the preliminary sessions, where they will assess your capability to receive this type of  therapy. They might not feel that you are the best candidate for it, and they might suggest you ask another therapist for a different kind of therapy. This is not a rejection but advise for your wellbeing, if this therapy is not going to be beneficial to you.

Your therapist does not answer your questions. Your therapist will give you interpretations. This means that your therapist will tell you things that you might not be aware of, exactly because they are unconscious. Therapist do not give explanations of what happens inside of you, but they are there to help you to understand and see it.

 

What are the rules?

Rules for psychotherapy are part of the analytical setting. It is important that, when you start your therapy, you understand that you are not receiving a series of consultations. It doesn’t start and ends within a session. Therapy is a process, and it’s like when you go to your gym to exercise, or when you learn to meditate. Things start moving time after time, if you work on your psyche regularly. Missing sessions and cancellations might delay results for your therapy.

When you start your therapy, you buy a slot. That slot is yours until the end of the therapy. If you don’t attend a session, the slot is still yours, and you will need to pay for it.

Breaks and annual leaves are discussed at the start of the therapy, and your therapist will tell you generally when the breaks are. Breaks are very important to be respected, and they are generally relatively long, to give you the possibility to experience your ‘life’ out of therapy, and more practically to help you arrange your holidays during your therapist’s breaks.

Generally, all psychotherapists take breaks around Christmas, Easter, and summertime. However, each one might have their own rules.

If you take any breaks during other times of the year (which you are free to take anyway), you will need to pay for the sessions that you are going to cancel.

Most psychotherapists do not work during bank holidays. But, again, this is very up to the therapist. I don’t work during bank holidays.

Psychotherapists can sometimes take some extra days off to be able to do those normal things that any persons would need to do in their lives. Your psychotherapist might need to attend a conference, a seminar, a medical appointment, or have any emergency to attend.

I personally don’t charge patients that end up in a hospital for a physical illness which requires an admission. This is not because their slot is not theirs anymore, but because I want to avoid the patient feeling anxious while having an operation (!). However, most psychotherapists will charge you during hospital times.

 

Payments

The best way to pay for your therapy, is in cash, because it protects your confidentiality. However, you can arrange with your psychotherapist in case you have a preference for checks or online payments. You can pay per session or at the end of the month.

If you are using your private health insurance, you will need to give your therapist details of your policy, including: Full name, address, policy number and pre-authorization number, DoB. Some policies will have a basic number of sessions that they will allow you to use, like 10, 12,16. Some policies will allow you to receive more, after a written request from your psychotherapist. I am happy to help you with this report. I will give you the report when ready, so that you can read it. If the report is too explicit for you, you can inform me, and we can delete the information that you want to be shared. When the report is ready, you will send it to your insurance. I want you to do it. This is for me to feel confident that you are happy with the information sharing.

Some health insurances plans allow long term therapies.

Please, make sure that your sessions are covered by insurance, if you don’t wish to self-fund.

 

Conclusion

I hope that this summary helped you to have clearer an idea of what psychotherapy is like, and what to expect. I also hope that you will enjoy your journey.

One last thing to say is that psychotherapy is anxiety provoking. If you feel anxious at the beginning of your therapy, it means that it’s working. Sometimes people might feel stressed talking about their problems, sometimes they might feel sad and cry. There is nothing to worry about when you feel that way. It means that you are getting in touch with your feelings.

The best way to proceed when having those feelings, is to talk about that to your therapist in therapy.

Your therapist will need to know what you feel. However, it’s always your choice to open up in your own time.

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