Recently I have been thinking about the blessing that therapy has been in my life and how I didn’t always feel that way. When I was first diagnosed with bipolar disorder I was willing to take any medication the doctor prescribed because I believed them when they said that would help me get better. Therapy, on the other hand, I was adamantly opposed to because I didn’t understand what it was.
Growing up one of my grandmothers frequently referred to things her therapist had told her. I remember thinking it was weird to have someone else tell you what or how to think. Because of this I never wanted to go to therapy. It didn’t help that a common taunt growing up among peers was “you need therapy.”
This was reinforced by many of the representations of therapy in the media–on television and in movies. The people seeking therapy were often portrayed as messes who never got better, therapists were often portrayed as weird caricatures who were out of touch and condescending towards their clients. None of it instilled any confidence in the institution and created in my mind intense resistance to the idea.
Over the years I have had many conversations with people who have had similar aversions to therapy. They have varying degrees of understanding and belief in therapy and it has caused me to reflect on what changed my perspective on therapy and what helped me to get the most out of this tool on my path to wellness with bipolar disorder.
One of the things that I have spoken to people about before is that I wish there was an orientation class for therapy to help people understand the purpose of therapy and how to get the most out of it. One of the big mistakes that people often make is focusing on the therapist as the expert and expecting them to guide the therapy.
Therapy really is only as effective as both parties make it. You need a great therapist who is able to provide professional guidance within the ethical boundaries of their profession. Equally as important is your participation. This is where the class would come in–helping you to know how to do your part to make sure your therapy is productive and beneficial.
Here are my top six tips for getting the most out of therapy. This list is definitely not exhaustive, I’m confident there are other tips that would also improve your therapy experience. These are the top six from my personal experience. I would love to hear your tips in the comments.
First, Find the RIGHT therapist for YOU
Although therapists go through specialized education and training they are also people–not all therapists are good and not all therapists are a good fit for you. When you go to therapy you put yourself into a very vulnerable position. It is essential to have a therapist that you can trust and that you feel comfortable opening up to so that therapy will be effective.
If you start seeing a therapist and you don’t feel that it is a good match, change therapists. It may seem like a hassle, however therapy will only be effective if you can work openly and honestly with your therapist. Be proactive and make sure that your therapist is a good match for you.
There are also a number of different therapeutic approaches and techniques–EMDR, cognitive behavioral therapy, etc.–and not all therapists are trained in or specialize all of the different modalities. There may be a specific type of therapy that will be most beneficial to you that your current therapist is not trained in. In that case it is best to seek a therapist that specializes in the type of therapy that you need, similar to seeking a medical professional that specializes in the type of physical ailment or injury that you have.
Second, Give Your Therapist Something to Work With
Therapists are not mind readers or magicians. One of the things that is challenging in therapy is that the only information that the therapist has to work with is what you give them. Sometimes this can be difficult because you don’t always know what to talk about. I remember the initial intake session with my first therapist. I was severely depressed and I didn’t want to be there–I was there because my parents had been urging me to go for years.
I didn’t know what to say. I struggled with thinking clearly and I didn’t know what to talk about. It took a few visits to figure out what I was doing. Over the years I have started to understand the process of therapy better. One of the things I have found extremely helpful is using a mood tracking app and journaling. These tools help to identify triggers, unhealthy thought and behavior patterns and unhealed trauma that your therapist can help you work through and heal.
It is also important to not withhold information from your therapist because you are afraid of what he or she will think of you. This goes back to making sure you have a therapist you can trust. A good therapist is able to hold the information you provide without judgment. The focus of the therapist is to help you work through things in order to come to a place of mental health and healing. The more complete the picture you provide, the better he or she will be able to help you.
Third, Therapy should be used proactively, not just reactively
One of the mistakes I made for years was only going to therapy when I was in crisis, and then when the crisis was over I would stop. This is counterproductive for many reasons. First, the process of establishing yourself with a new therapist can be exhausting and sometimes intimidating.
It often takes multiple sessions with a new therapist for them to get enough information to start effectively working with you. It can also give a skewed picture to the therapist if their only experience with you is when you are in crisis. The longer you see a therapist the better they understand you, the more comfortable you become with your therapist and the more effective the relationship. Starting only when you are in crisis and then ending therapy when the crisis has passed can make it hard to get real, lasting benefit from therapy as a tool.
The other problem this creates, especially with bipolar disorder, is that there isn’t real progress made in identifying unhealthy thought and behavior patterns, unhealed trauma and unhealthy boundaries. As long as these issues go untreated there will continue to be mood cycles that are caused by these unhealed and unprocessed triggers, even if you are on the right medications or micronutrients for your brain balance.
Therapy as a tool is most effective when you use it proactively to learn to process and reduce crises in your life and not just reactively manage crises when they occur.
Fourth, Focus on Healing in Therapy, Not Blaming
In therapy the focus needs to be on healing, not blaming–choosing to be a victim impedes your progress towards healing. Something that I have found to be a challenge in therapy, and I have heard others talk about in their experience, too, is that sometimes it is easy when you are in therapy to get focused on a person or persons that have caused you harm.
The problem this presents is that if you become focused on the other person and what they have done it can prevent you from healing. You have no control over what someone else says or does and it can turn you into a victim who continues to be traumatized by another if your focus is on the choices of someone else. This can also prevent you from actually healing because it takes the power to choose away from you.
Something that really helped me understand this better was thinking about emotional or mental injury the way I would think about a physical injury. If I broke my leg I would go to the hospital for help. While I would need to explain to the doctor what happened in order for her to assess the injury properly the focus would then turn to the injury itself and what treatment was necessary to heal the injury.
The more serious the injury the more serious the intervention. The only other discussion about the way the injury occured would be if it was likely to occur again, what boundaries would need to be implemented to prevent further injury.
This helped me so much in learning how to process trauma. When I am working through trauma the most important thing is to focus on the injury itself and utilize the necessary treatment to process and heal the trauma. Learning to implement healthy boundaries to prevent further injury is critical too. This approach is empowering and will help the healing process so much more than if you spend all of your time focused on the person who caused your injuries. You can’t control their choices, but you can choose to heal from them and protect yourself from further injury.
Fifth, You get out of therapy what you put into it
When you are seeing a therapist you need to actively participate not just in the session but in doing the “homework” between sessions. Sometimes we want things to be simple and easy–take a pill and you’ll feel better. But the reality is that therapy is not easy. It takes effort to first discover the unhealthy thoughts and behaviors, unhealed trauma and unhealthy boundaries, and then work to process them or replace them with healthy alternatives.
If you are not willing to put in the effort during sessions and between sessions therapy will not be productive or helpful. As you work with your therapist, prioritize the work between sessions in your day to day life. Make sure that you are setting alarms to remind yourself and following through on what you committed to do so that you will be able to make real change and progress in improving your mental health.
Sixth, Therapy takes time
There is a saying that therapy is like peeling back layers of an onion. I have learned from first hand experience that this is true. When you begin therapy there may be pressing issues that first feel like they are the only issues. You set therapy goals and work towards them. Over time as you work to heal the initial problem you will likely discover additional issues that need your attention. Do not be impatient with the process.
It takes time to uncover the mental, emotional and psychological issues that are contributing to or possibly even causing your mental illness. It takes time and effort but as you work to heal you will begin to live in a more balanced and healthy way.
When I first started therapy I had an end date in my mind. I still struggled with some stigmas in my mind about what it meant to see a therapist. Over time I have started to understand that this is an important tool to live well with bipolar and my view and opinion of therapy has changed.
I don’t know if I will ever stop going to therapy. I continue to see my therapist once a month. I do this for a number of reasons. First, it takes so much effort–emotional and mental–to begin with a therapist and that can be a barrier to starting with a new therapist. I have a productive relationship with my current therapist and don’t want to start over with someone new so I continue to maintain the therapeutic relationship in case I need her.
Second, I have found that at least a few times a year something new will come up that I need help resolving, processing or healing and I am able to add sessions when necessary. Finally, I know that I will never be “cured” from having bipolar disorder and therefore find value in maintaining a relationship with a professional to give me someone I can check in with periodically to make sure I am stable and healthy.
Therapy can be a powerful tool for healing emotionally and mentally. The more you understand this tool and how to use it well the more effective it will be in helping you learn how to live a healthy, balanced, productive life with bipolar.