Psychodynamic therapy offers deeper opportunities for self-exploration. Here, MTA Therapist Dr Shalini Masih shares fascinating insights into what her clients can learn in those first few sessions.
It might sound surprising but I think that starting psychotherapy can be a little like a blind date — and not just a blind date with your therapist but with your Self too. In other words, those unknown and unexplored parts of the Self that Psychodynamic therapy seeks to unearth.
In other words, before your first appointment, neither you nor the therapist will know quite what to expect. But that initial first meeting (and the ones that follow) is very valuable, as they offer you both a chance to reflect on the following…
As I mentioned, before your first session you might experience a sweet and sour concoction of feelings similar to the lead up to a blind date. In other words, there is an excitement mixed with a very palpable tension.
This sense of tension is, curiously, tinged with hope and finds home in the question, Will this relationship with the therapist be any different from other relationships in my life? And also, How will my vulnerability be met? Will my distress find a witness? In other words, you might feel both a fear of being judged and a hope of being accepted.
Our reactions to being vulnerable and seeking help take form in the early years of our life. Significant experiences with trusted others lay a template for us, defining our response each time we reach out to another. As a psychodynamic psychotherapist, I am very interested in the ‘emotional matrix’ that you grew up in and the emotional language it shaped. And I am also interested in how you feel about exploring this with me.
So your first psychotherapy session can be a valuable opportunity for you and the therapist to learn if there is any curiosity or anxiety around learning about the deeper parts of you.
When we begin therapy, we decide how we wish to be known by the therapist. And as an introduction, we might begin by sharing how we make sense of our psychological distress. So I pay close attention to the ‘frames’ that people use for explaining their experience, for example, diagnostic labels such as ‘clinical depression’.
It can also be useful to explore the following questions with the therapist: ‘What is my fantasy about “help”?’ ‘Am I expecting the therapist to be an all-knowing person?’ ‘Am I expecting a magical transformative experience like the one I have seen in multiple films on therapy?’
Raising these questions can help you both to work out if the therapist’s approach fits the therapeutic experience that you are seeking (and also, if what you are seeking is even realistic).
Your first session is an opportunity to think aloud and reflect on how you make sense of your psychological life. What are your own theories about the origins of your distress? Does it seem like an alien experience — one that escapes all thinking and intelligibility? In some respects, our own theories on our distress can determine how distressing the distress feels. It also shapes the expectations that we bring to the therapist for a ‘cure’ or healing. That first session then becomes a fertile space to talk about these theories and the expectations for healing that they shape.
Some clients may pinpoint a key life event as a cause of their distress. Others may feel as if they have been ‘this way’ for as long as they can remember. Difficulties in relating to people, a pervasive sense of emptiness, or a deep despair or anxiety that cannot be pinned to any concrete life event are some common themes that the work might then revolve around. To sum it up, the first session is an opportunity to reflect on your Self from the outside, perhaps for the very first time.
Psychoanalyst Thomas Ogden suggests that the therapist ‘must allow themselves to be freshly surprised by the ideas and phenomena that they take most for granted’. This is why things that you might think of as irrelevant could hold a special significance for a therapist, including every single word that you say. In other words, within therapy, you become special. And for some, this can be strange and unsettling.
In fact, each of us responds differently to being treated as special and significant in the therapy space. For some of us, it can be a deeply moving experience that we receive with gratitude. Yet for others, being in such an emotionally intimate space with a therapist can provoke discomfort or even dread. Again, discussing these reactions with your therapist can reveal a lot about your internal world.
After your first appointment, you and your therapist will probably fall into a routine of seeing each other regularly. But how do you feel about those spaces in time between your conversations?
Your reactions to these gaps can allow both you and the therapist to get a sense of how you deal with discontinuity in your life. Between appointments, some of us may carry anticipation tinged with hope while for others, gaps may be experienced as frustrating. This rhythm between sessions has the potential to also reveal how we experience the rhythm of reunion-separation in our lives overall. You may find that you are able to hold the tension of waiting along with the hope of a possible reunion. Or you may find that you struggle with this and that it becomes a goal for you to cultivate ways to manage it in collaboration with your therapist. Either way, you and your therapist can learn a lot from how you deal with separation.
One last point I’d like to make is that therapists are not omniscient. They are not seers holding answers to all the mysteries of internal and external life. It’s true that a therapist has acquired wisdom about how the mind works, yet they also rely on a collaborative relationship with you in order to explore whether this wisdom fits your experience.
A therapist, amongst other things, bears witness to the struggles you have been through in the past and are going through in the present. They can help you to experience deeper interpersonal connection and repattern internal beliefs that might no longer be serving you. Yet recovery is not directed by your therapist alone. What leads to recovery is the relationship that you share with them, its richness and its intimacy.
Psychodynamic therapy uses various techniques to help bring the unconscious into the conscious. Book a session with Dr Shalini Masih today or take our quick assessment to find the right kind of therapy for you.
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