Why counseling does not take.


By David Joel Miller.

4 Reasons counseling does not work for you.

Counseling and Therapy

Counseling and Therapy

You go for counseling and while you are there in the counseling room everything seems better. You know what you need to do. You are ready for a change. Only over the next few days the vision of recovery you had in that counseling room fades and the things you thought you understood all get lost.

Why can’t you hold onto what happened in the counseling room when you get back to that real life?

Personally I am skeptical of counseling that goes on for years with nothing changing. How long the process of change will take you depends on where you started your journey and how far you need to go to reach your recovery.

If you are not making the progress you think you should be making, discuss this with your counselor. I learned early on that it is not exclusively what happens in the therapy hour that helps clients but what they are doing to practice these new life skills in the other 167 hours each week that they are not in therapy.

As a cognitively oriented therapist I like to suggest practice sessions, a form of homework, which clients need to do each week between sessions so that when we meet again we can talk about how to improve their recovery not just go over the same ideas again.

Here are some reasons that your work in the therapy session may not be transferring to the out of therapy world.

1. You can’t learn to swim in the classroom.

A long time ago the preferred method of teaching swimming and scuba diving was to show lots of classroom movies and have slide shows and demonstrations of how to swim and how to put on your scuba gear under water.

What the trainers quickly discovered was that what people learned in the class room did not translate well into the water.

The best way to learn is under real life conditions. So if you get your instruction on swimming in the pool each thing you do is quickly reinforced.

Lots of cognitive therapy is about learning life skills and perfecting those skills takes practice. I encourage clients to come to the session and talk about the times they tried to use their new skills outside my office and how that worked out for them.

In some situations therapists have needed to go out into the field and help the client walk through the new life skill under real conditions.

So whatever you are trying to change about yourself practice between therapy sessions and then discuss the results the next time. Do not leave the lesson in the office.

2. Insight does not change you.

Many people come to counseling wanting to know why they are doing things. I can’t fault you for wanting to learn all you can about yourself. Getting to know you is a lifelong adventure.

The fallacy in this approach is that having once come to understand your inner workings you may still keep doing the things the same way you always did.

Several stories about this topic come from the realm of substance abuse. More than one alcoholic has gone for psychoanalysis, sometimes or a long period of time and at a great cost, when their therapy concluded the client was sure that now, understanding their inner workings, they would never drink again. Within days that person was drinking to intoxication again.

Overheard in a bar; one patron was telling the other that they were an alcoholic, the second patron replied me to. So they sat for a while and discussed why they both were alcoholics.

The conversation concluded, they both ordered another round.

Insight by itself does not result in change. Change takes more than insight. It takes motivation. It takes practice and once those changes have been made change takes maintenance.

3. Venting does not help if you keep filling up the negative emotions.

People like to think that getting it all out will rid them of negative emotions. We used to try this with couples who were having excessive arguments. The couple would yell and scream at each other in session. Some therapists even had the couple hit each other with foam rubber bats.

The result of this venting was not a reduction in anger. The “venting session” resulted in couples who went home and then hit each other with real bats.

Venting can function like rehearsal. The more you vent the more you become quickly triggered to anger, depression or cravings for drugs and alcohol.

4. You never talk about what is really bothering you.

The best predictor of successful therapy is your belief that this person you are talking to can help you. If you do not feel comfortable and really open up then the big stuff that you are holding back will never get taken care of.

One recovery saying is that you are only as sick as your secrets. This is especially true in therapy if you do not feel safe to open up and talk about what is ailing you. If you are not sure what secrets your therapist will tell and what they will keep secret, look back at some of the past posts on this topic or ask your therapist to explain confidentiality to you.

If you are in therapy now or have been to therapy and you did not feel it was helpful these are some of the reasons it may not have “taken” there may be other very personal reasons also. Make sure you tell your current counselor about those past efforts and especially tell them any reasons you felt it was not helpful to you.

An informed therapy client gets more benefit out of counseling.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended books.

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