Making the Most of Therapy
Written by Dr. Megha Pulianda for Psychology Today
We spend a lot of time talking about good therapists, but is it possible to also be a “good” client? I use the word “good” loosely, of course. The client invests in services, and the therapist is naturally responsible for the structure of sessions. Clients are, however, ultimately responsible for change. Our role is to cheer from the sidelines and offer support along the way, but the only person who can make the winning shot is the client.
Take Miranda, my made-up twenty-something client who represents the average client I see in my office. Miranda is attentive and active in our sessions, and she is willing to talk things through. She consistently brings important content to discuss, and she has opened-up to me more and more over time. I am honored to work with her and be invited into the most intimate parts of her psyche. When our hour together comes to an end, she predictably exits the safety and structure of the office (zen music, table top oil diffuser, and all) and re-enters her life, as all clients do.
At this point, Miranda has a choice to make. She can take what she has learned in therapy and apply it to her life. Change is always uncomfortable. She may be afraid to have a tough conversation with her boss or sign up for the community college courses she has been hesitant to try. Miranda can lean into this discomfort and begin to use the strategies she discussed with me. She can then come back to therapy to share what she tried or didn’t try, what worked or didn’t work. Perhaps we have discussed daily journaling as an option for her, and she decides that it just isn’t for her. From there the process can continue in an informed manner.
Miranda can also leave the office and continue to go about her day-to-day life as usual. She can use therapy as a place to decompress each week without really applying any changes to her life. During our hour together, she can utilize the space to share her thoughts and feelings and talk through some of the most pressing and significant issues she faces. She may not experience any major changes, but she enjoys the cathartic process of coming in.
As a therapist, my true, honest hope is that my clients will be willing to take the risk to make changes in their life as they see fit. I can appreciate the vulnerability involved in this process, so I also hope that this motivation for change will happen when the client is ready for it. I also understand the choice and autonomy my clients have in deciding what therapy means to them, and I want to respect those boundaries without imposing my own ideas.
Still, as Miranda’s therapist, I believe she may only benefit from the second scenario, decompressing weekly discussions, at a surface level. If she refrains from applying the tools to her life and if she hesitates to make significant changes, it is possible that she will not maximize her investment in our sessions.
Consider the difference between a week-long clean eating cleanse versus a major shift in our attitude toward food, fitness, and health. The cleanse has a real, tangible short-term benefit, it’s true. It can help jumpstart a comfort and familiarity with a new process. But the bigger change in our attitude and habits will have a longer-lasting effect. The second process is more daunting. It's tougher and more frustrating, but that’s why I am here to support my clients along the way. Real change comes from real work.
Dr. Pulianda & Associates in Southlake, Texas is committed to providing compassionate care to adults, teens, couples, and families in the Dallas-Fort Worth Area, as well as all of Texas via online telehealth therapy.
