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What happens in psychotherapy?

The First Meeting

When you meet with your psychotherapist the first time you may have some idea of what change you hope to accomplish in psychotherapy. Perhaps you do not know how to put this idea into words. It may be helpful to you to write about it before your first visit. In any case there is no right or wrong way to attend your first meeting. This is an opportunity for you to think about whether the psychotherapist you are meeting with for the first time will likely be a person you will feel safe with and able to communicate with for several weeks or months. Your psychotherapist will also be thinking about whether you are a good fit for one another. It is important that you know that you will always have the choice of whether to be in therapy or not. If you choose not to participate in therapy after this initial meeting, you may ask for a referral to someone else or simply decide not to meet again. Or you may want to try a session or two before deciding. 

 

Before the end of the first visit some people will want to have a clearly defined set of goals, a diagnosis from the DSM-5, and a plan for how to get better or manage symptoms. Others may wish to take longer to gather information, understand, and develop greater clarity about what they are experiencing before agreeing on a treatment plan. Still others may wish to think about therapy as a personal journey of self discovery. Whatever your hopes are for psychotherapy, it will be  important that you and your therapist begin the process of building a relationship in which you can feel safe, explore  and recognize what is true for you, and discover the inner wisdom that will allow you to live in the world in new ways. During your first meeting you can ask questions and explore options. 

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What can I expect if I decide on psychotherapy?
 

Psychotherapy has potential risks and rewards. You may find that your symptoms get worse or that they fluctuate. You may find that by increasing your awareness your life begins to change in unexpected ways that are uncomfortable or lead to difficult choices about personal relationships, work, or even how you think about yourself. But over time you should notice  an increasing sense of wholeness and authenticity. You may experience greater self compassion and tolerance for change and uncertainty. You may find that life has a more meaningful quality. You may experience a deeper sense of purpose and effectiveness in the world. It is also possible that you will feel that you have reached a plateau or are getting nothing out of psychotherapy. 

 

Each of these possible outcomes is  likely to occur at some point during long term psychotherapy. Discovering the reasons for the ways you individually respond to the psychotherapeutic relationship is a normal and often therapeutic part of psychodynamic counseling and therapy. This exploration can lead to clarity about how your personal boundaries affect your relationships. It can also help you learn the patterns of the symptoms you're experiencing and how to both manage them and learn from them. It can help you see how your life narrative, with its tragedies and triumphs, is both an influence on and influenced by your life experience, spiritual and cultural beliefs, health, and intergenerational family history.  

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