When does it end?

It’s a good question, and there are a few reasons why this is raised:

• If you’ve never been in therapy before (i.e. you are starting from scratch and overwhelmed by all of the information you discover) it may be a source of comfort to look for structure; to see if there is a beginning, middle, and end to the process.

• Some modes of therapy advertise a pre-set number of sessions. After, say, nine sessions, they will isolate your issue and you will have been handed rational strategies for dealing with it. A problem with this approach is: what if that issue isn’t “it”? What if there’s more to it than the “it” someone told you you suffered from? Not least, what if you are suffering from something that doesn’t lend itself to rational strategies (grief for the loss of a loved one, for example)?

• You may think that seeing a therapist creates an addiction or crutch which you will not be able to shake, thus endangering your independence.

Whether you are experienced in therapy or not, not many people look forward to the unknown. If you are concerned about “how many sessions”, then this is a conversation you should have with your therapist at the outset (along with standard questions about rates, cancellation fees, and directions to their office).

I can’t tell you from the outset how many sessions you and I will have. It would be foolish of me to do so because each individual is different and each individual has a unique spectrum of concerns they may wish to discuss. However, I do make it clear to my clients that they are in charge of stopping and starting therapy – what good would this process be if that choice were taken away from you?

If you want to see a therapist but are scared of how long it may take, why not find a therapist you think you’d like to see and book an initial session, with no commitment for a follow-up?

Concerned about a therapist’s qualifications? Perhaps you should ask whether they belong to a professional association, such as CAPT, which ensures that its members practice within clear, established ethical guidelines (among which, respectful termination of therapy would fall within).

Remember: if it’s important to you, then it deserves to be raised. If a prospective therapist can’t answer your questions to your satisfaction then it’s probably best that you consider someone else.

Short answer: yes.

Long answer…

…it’s sort of like martial arts. There’s karate and kung-fu, and aikido, and tae kwon do (to name a few). And yet there are streams of karate which may incorporate, say, judo. There are streams of kung-fu which also focus on tai chi chuan.

Similarly, with psychotherapy – whether the practitioner is a psychotherapist, psychologist, or psychiatrist – there are disciplines, called modalities. Here are a few, to give you an idea:

Freudian/Jungian: Freudian psychoanalysis is a scientifically-leaning attempt to understand the human mind using the idea of drives as a motivating factor in human psychological development. The Jungian approach is a split-off from Freudian psychoanalysis, much more accepting of the spiritual (and sometimes mystical) facets of human belief and how they inform our psychological development.

The traditional Freudian and Jungian approaches are known as one-person psychology: there may be two people in the therapeutic space, but only the analyst (as opposed to the client) is in control. The client associates, the analyst interprets. The analyst is the sole expert.

Cognitive Behavioural Therapy: Cognitive Behavioural Therapy (aka CBT) is a rational approach. It tends to focus on very specific problems with the client, as opposed to allowing for deeper (less clear) problems to come to the surface. A CBT practitioner will typically structure a fixed number of sessions with a client, with the idea being that by the last session, whatever is ailing with the client will be worked out, not unlike a muscle. This may be handy for isolated problems, such as helping to quit smoking, or perhaps some forms of anger management.

Relational Psychotherapy: Relational Psychotherapy is a newer, dynamic form of therapy. Unlike Freudian/Jungian approaches, it is a two-person psychology: there is mutuality between the therapist and the client, and the structure is such that the therapist is not positioned as an all-knowing expert who controls the kite strings. This leads to greater, fuller communication between therapist and client.

The general idea behind Relational Psychotherapy is that interpersonal relationships are a foundation of how we are raised, how we develop, and how we see ourselves at the end of the day. The focus is on the present, the here-and-now with the understanding that, while relevant events of the past are welcomed into the therapeutic space, it’s how the client feels now which is what’s ultimately important. Unlike CBT, Relational Psychotherapy is not hyper-focused on fixing isolated problems, since some problems which may seem isolated may have deeper roots in our behaviour.