How to Get the Most Out of Your Therapy or Counselling

Are you sure you get the most out of your therapy or counselling?

Perhaps you sometimes find yourself thinking that — well — therapy’s a bit of a pain?

It’s expensive, for one thing, and it’s also a chunk out of your week – a time when you could be getting other stuff done.

So it makes absolute sense to do what you can to make sure you really get maximum value for all that time, money and emotional energy you are putting in.

Here are seven simple tips to help you maximise the benefits so you get the most out of your therapy or counselling:

1. Use metaphors

2. Notice your body

3. Attend regularly

4. Remember that the therapist is not judging you

5. Allow the pauses

6. Talk about your feelings towards your therapist

7. Take risks

Read on, and I’ll explain more about what I mean, and how it can help you to get the most out of your therapy.

And if you get the most out of your therapy or counselling, you stand to get far more benefit for each hour, £ or $ that you invest.

Who wouldn’t want that?

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1. Use metaphors

Our minds grasp things much more quickly and in a fuller, deeper and more complex way, when we use metaphor.

Don’t worry — you don’t have to be a poet! In fact, we all use metaphors frequently (“she stabbed me in the back”; “I feel that I’m wading through treacle”). It really doesn’t matter if the metaphor is a well-known cliche, or sparklingly original. What does matter is that it ‘rings true’ for you.

When you use a metaphor, you open up so much. You give your therapist a short-cut to understanding what you’re trying to say, because so much information can be conveyed in a single image.

Tell her you’re ‘walking on a knife-edge’, and she can get a feeling of what you’re going through. She might even experience an inner shudder as she imagines how it must feel to be on that knife-edge.

And when your therapist feels something about you, rather than only knowing it on a cognitive level, she can help you in a much more profound way (I won’t go into the brain science  on this here, but neuroscientists are now proving what psychotherapists have sensed for decades).

How do you come up with a metaphor?

Well, there are two ways: either it comes to you, or you go hunting for it. Both ways are good!

Metaphors often appear in your mind without you even trying; you just need to notice them.

Deliberately hunting for a metaphor can also be productive. Ask yourself, ‘what does this situation feel like/ remind me of?’  Your answer may be very simple (‘It’s like there’s a massive rock in front of me’) or more complex, like a story (‘I feel like I’ve been pushing a massive rock up a long, long hill and just before I get to the top, people jump on top of it and it rolls on top of me and I get crushed’).

 2. Notice your body

Be interested in what happens in your body during a therapy session. It can be a very useful way of

• Getting in touch with your emotions
• Uncovering new layers of understanding about yourself
• Calming yourself
• Helping your therapist understand you better
• Helping you know what is the most important aspect of what you’re working with

It’s also very often a signal of anxiety. I’d like to explain a bit more about this, so that you can see why anxiety might come up in a session, and how anxiety can help you and your therapist guide the work so that you’re challenged enough but not too much (if therapy is not challenging enough, you won’t gain much; but if it’s too challenging, the dangers are that you’ll shut down, leave or get re-traumatised).

Why might anxiety come up in therapy?

Because in therapy we may need to feel, think and say things that we’ve always felt were ‘not okay’ — and we’re unconsciously expecting disaster to befall us because of this.

This anxiety shows up in the body in different ways. Joggling your leg, tapping your foot or fingers, clenching your jaw, tensing your muscles or making a fist, can all be clues that your anxiety is rising.

Here’s an example.

Marcus’ family were very much ‘keep your head down, grit your teeth and get on with it’ types. For them, expressing excitement, exuberance or joy was just ‘not done’. It wasn’t that anyone had ever actually told Marcus that he mustn’t allow himself to get excited; but the messages had been transmitted on a deep, implicit level. So when Marcus felt positive and lively feelings bubble up within him, he got anxious and squashed them before he even knew consciously that they were there!*

What leg-joggling, foot-tapping or jaw-clenching might mean - and how to make it work for you in therapy. Share on X

When Marcus learned to tolerate his excited feelings, he gradually lost the anxiety and sense of ‘wrongness’ about feeling them. He was widening his ‘affect array’ (the range of feelings that he could bear to feel without having to shut them down or necessarily act on them) so he could become a fuller, freer version of himself.

So when you notice your body getting jittery or tense, the best thing is to comment on it to your therapist.

Then you can talk and think together about what feelings might be rising up inside you. Often, simply naming the feelings out loud together will be enough to settle your anxiety down.

The aim is not to ignore the feelings, or push them away, but to allow yourself to feel them without needing to act on them.

This might feel very strange and in some way ‘forbidden’, but it can be an important part of your healing. Having your therapist with you, supporting you, while you learn to tolerate a range of feelings, is an important part of the healing process.

Sometimes the unconscious anxiety is so strong, though, that it bypasses your ‘striated muscles’ (the muscles that you can move voluntarily) and goes into your ‘smooth muscle’ system (such as your digestive tract). When this happens, you will appear calm, but you may notice your stomach churning or tightening, or a headache coming on.

Headache or stomach churning when you're in a therapy session? Here's what to do. Share on X

You can also use diaphragmatic breathing (slower, deeper breaths where you make sure that the air gets right down to your diaphragm, causing your belly to expand, and blowing through your mouth on the slow out-breath).

Standing up and jiggling or walking around in the room for a minute or two can also help.

If the unconscious anxiety is extremely strong, your senses and/or thinking can get disrupted. You may feel giddy, fuzzy-headed or disoriented. Your vision or hearing might change in some way (perhaps becoming blurry, or as if you’re in a tunnel); or you might dissociate and start thinking or daydreaming about something else entirely.

Do you get fuzzy-headed or daydreamy during your therapy sessions? Share on X

Again, talk with your therapist about what you’re experiencing. Your anxiety levels need to be brought down before you can continue with anything else. To help you ‘ground’ yourself and bring down your anxiety, your therapist might ask you to talk to her about what you can see, smell, touch or hear right now in the room.

3. Attend regularly

Show up for your therapy or counselling session every single week.

Why? Because it works!

Regular attendance is much more likely to lead to success. Your conscious mind needs to connect often enough that you don’t lose the thread of what you’ve been working on.

And your unconscious self also has needs.

On a very deep level, you need to feel that the therapy relationship is reliable and can be counted on, in order to feel safe enough to really open up and receive the help that is on offer. This may sound crazy, but I know from my own experience as a client that even when it was my decision to miss a session — even though it was usually for an unavoidable reason — it actually felt at some very deep level that it was my therapist who was abandoning me, rather than my own rational choice!

Not attending sessions is a signal, to your therapist and yourself, that something isn’t working.

It could be that you’re not with the right therapist, or that there genuinely is a practical difficulty (e.g. your transport options are pretty much unworkable/ you have a chronic health problem that makes it hard to get to sessions).

But it’s more likely to be that on some level you’re scared of going — maybe because you are feeling something towards your therapist, such as anger or longing, that you are anxious about bringing.

If you notice yourself allowing other things to intrude on your therapy time, such as dentist appointments, requests from friends or demands from work, gently ask yourself what makes it so hard to commit to your therapy. And bring these thoughts – even if they’re only half-formed – to your session to discuss with your therapist! A discussion like this can be incredibly productive and really move things to the next level so you can really get the most out of your therapy or counselling.

4. Remember that the therapist is not judging you

This is a really important one – and you’ll probably have to keep reminding yourself a lot.

The chances are, that you will experience a lot of criticism and judgement in therapy: but it will probably actually be coming from you, towards yourself. [Note: when you experience it as coming from the therapist, do discuss it, as it is fairly likely to be an example of something called ‘transference’ in which we unconsciously transfer our own feelings onto someone else.]

Therapists learn through their training that they are in no position to judge anyone else’s choices.

How do they learn this? Mainly through encountering their own inner demons/ mistakes/ imperfections in the course of their own therapy (note: this is one reason you should always choose a therapist who has had extensive personal therapy herself).

Therapists also learn through the repeated experience of hearing about (and understanding and empathising with) the struggles, mistakes and imperfections of many, many clients.

Why is it important to remember that the therapist isn’t judging you?

So that you can feel safe enough to admit to all the difficult, painful and/or embarrassing stuff that has contributed to making you seek therapy. And of course, that stuff won’t get a chance to heal until it’s been gently, respectfully and carefully worked through in your sessions.

5. Allow the pauses

Do you talk a lot in therapy? I remember the feeling of ‘I’ve got so much to say, and only 50 minutes to say it in!’  It probably feels absolutely necessary to pack in as much as you can, in the limited time you have.

And yes, part of the healing work of therapy is definitely in the telling of your story to someone who is trained to listen really, really well.

You need to be properly heard by someone who is interested in what you have to say, and who is actively thinking about it, and helping you to make sense of your confusing, varied and often painful experience.

But amongst, under and between the words, something else is going on at the same time. It’s hard for me to describe here what that is, because it’s so multi-layered and endlessly unique for each therapist-client pair.

If you allow yourself some pauses from time to time, you can help yourself (and your therapist) to drop down into that deep well of meaning and connection. At times, dipping into that well will feel like nothing’s happening, just a gap and an absence. But really, all sorts of things are happening, inside you, inside your therapist, and inside the living connection between the two of you.

Seven simple ways to enrich your therapy or counselling. Share on X

And then, having paused, you can enrich the therapy by talking about what’s happening. Believe it or not, it’s all worth talking about.

You can talk about whatever was going on in that pause.

• Maybe you zoned out and began planning your grocery list.
• Maybe you became conscious of a funny feeling in your gut that seemed somehow relevant to what you had just been talking about.
• Maybe you got in touch with deeper feelings of need, grief, anger or love.
• Maybe you got a deeper insight into the problems you’ve been wrestling with.
• Maybe you became filled with doubts about whether your therapist is any good.
• Maybe you became aware of feeling inexplicably scared.

All of these types of experiences make for highly valuable, enriched therapy work.

And you’ll find that instead of ‘talking about’ (which certainly has its place in therapy, but may not lead to actual change) you’re now ‘working in the here-and-now’ (as it’s sometimes called) and bringing your ‘now’ self (in all its many and varied parts) into active relationship with the therapist.

You and your therapist may also spot links between what’s happening for you ‘here-and-now’, and what happened for you in your past.

Which in turn can mean that you become able to feel differently towards your past experience, and help you feel truly ready and able to move on into a more choiceful sense of your future.

6. Talk about your feelings towards your therapist

Whaaaat? Okay, I know this one is likely to make you cringe and shudder.

‘TELL HER how I feel about her??? But I think she’s stupid [or insensitive/ sexy/ jealous/ god-like/ lazy/ boring/ cruel]! And I love her/ I loathe her! I can’t tell her that – she’ll throw me out!’

Well – yes you can tell her that stuff.

And it won’t kill her.

Or you.

Your therapist has (I would hope) done enough personal inner work to not be rocked too far off balance by your feelings towards her, whether they are loving or antagonistic. And she knows that it’s not that you are ‘bad’ or ‘too needy’.

She knows it’s normal, and expected, and something you can both learn useful stuff from.

In fact, this is a big part of the therapy. Ever heard of ‘transference’? It’s a very fundamental idea in counselling and psychotherapy, and it’s about the fact that we all tend to transfer feelings that are to do with our inner world and our history, into other relationships in our lives. When you have a strong feeling towards your therapist, it’s likely to be (at least in part) to do with something that he/she evokes in you that is connected to your own life experience. And working with this, making it as conscious as possible, is going to be a cornerstone of your healing.

This is not to say that there may not be objective things in him or her (that many other people would also perceive) that you are responding to. The cruelty/ insensitivity/ jealousy that you have spotted, may be absolutely an element of what’s going on. In which case – all the more reason to speak with her about it!

For more on this, you may like to read my article ‘Does Your Therapist Get it Wrong?’

7. Take risks

Talking to your therapist about your feelings about them can be a good example of risk-taking.

What else do I mean by ‘take risks’?

Taking the risk of being truthful. Of being vulnerable. Of sharing the feelings that you’ve always been so alone with: the shame, the grief, the loneliness, the rage – whatever it is that you’ve been bearing alone.

Why does it feel so risky?

Because there will have been a time (many times, perhaps) in the past, when you took the risk of sharing those feelings, and you were met with a response that felt like an emotional assault.

So you learned to keep those feelings locked away, hidden, and protected. Which at the time, was adaptive (helpful to you), but now keeps you small inside, frightened, and insecure.

This could be why it feels so risky to share your feelings... Share on X

 

It’s also useful to bear in mind that oft-repeated therapist’s saying, ‘There are limits to what you can do in the therapy room, but no limits to what you can talk about’.

(So, no, you can’t just throw something at your therapist, hit her, or smash her vase. Acting in these ways in therapy is definitely not okay. But maybe you can talk about any urges to do those things, as long as you are coming from a place of reflection).

How to 'get the most bang for your buck’ in therapy or counselling. Share on X

Give these tips a try!

I hope that I’ve given you some ideas for how to get the most out of your therapy or counselling.

Did any of them strike you as potentially useful for you? And did any of them make you want to recoil in horror? Both of those categories are the ones to think about.

No-one’s forcing you to use any of them, but if you do, I feel hopeful that you’ll be very glad you took the leap!

If you found this useful, or if you have any other ideas for good ways to get the most out of therapy, I’d love to hear them! Just add to the comments below.

Are you thinking that you might quite like to start training to become a counsellor or psychotherapist yourself? This article by psychotherapist Jodie Gale might give you some good ideas for what to look out for in choosing which training to go for.

*’Marcus’ is not a real client, but a fictional composite.