How does counselling work?

[aeroxwolf]

I'm attending counselling (talk therapy) in a couple of days and being totally honest, I don't know what to expect. I'll spare the details, but I haven't been feeling myself for a while and decided I need to seek some form of professional help to get back to feeling awesome again. How exactly does this work? I've read a few things online, but the descriptions are very brief and full of "this totally changed my life and way of thinking around" bullshit. 

 

If anyone has any information or advice, I'd really appreciate it. Thanks 

 

[Ayattar]

Basically, it's a waste of time. A substitute, designed for the people who don't have anyone to talk with, no confidant.

[Sidewalk Surfboard]

Basically, it's a waste of time. A substitute, designed for the people who don't have anyone to talk with, no confidant.

That's a pessimistic way to look at it.

[Kaedal]

Basically, it's a waste of time. A substitute, designed for the people who don't have anyone to talk with, no confidant.

Friends and family are not always able to properly help you, because they're biased and sometimes even unable to see anything wrong. 

[nurseeyeroll]

If the counselor is good they will challenge you to move and grow through stagnant thought processes that may be limiting or shunting your growth as an individual.  Sometimes it is working through old pain and sometimes it is having the person take responsibility for their current issues of dilemma.  You are there to be assessed.  Friends and family often have their own agenda.  Some want you just the way you are and do not want you to change out of fear of being left behind.  The counselor will help you to identify good and bad boundaries you may  have in your life that causing issues with relationships,work, or school. 

[Zeitzbach]

You know how sometime they say, "The best way to get rid of the stress is to talk about it."

Basically, you pay someone to listen and pretend to actually care so you can talk about all your issues.

[Ratmomma]

It can be helpful if they actually understand what's going on with you, but then again I've got a whole slew of shit going on and haven't had too much luck with garden variety counselors and instead have been upgraded to psychiatrist.

Make sure you feel comfortable with talking with whoever you get (obviously), and it's important to feel that you can talk about whatever without them judging you. I had a therapist tell me they felt like I was "making things up" just to fill up a session, which is absolute bullshit at its finest. They'll take notes on what you're talking about, and then the next week will go over what you both talked about and see if things are different or the same. They'll give you some exercises to work on to help you work thru things that are nagging at you.

[StrangerCoug]

If the counselor is good they will challenge you to move and grow through stagnant thought processes that may be limiting or shunting your growth as an individual.  Sometimes it is working through old pain and sometimes it is having the person take responsibility for their current issues of dilemma.  You are there to be assessed.  Friends and family often have their own agenda.  Some want you just the way you are and do not want you to change out of fear of being left behind.  The counselor will help you to identify good and bad boundaries you may  have in your life that causing issues with relationships,work, or school. 

To add onto this, patient confidentiality laws mean that you can discuss what's bothering you that you're afraid to tell anybody else. I had a couple incidents with people on this board on Skype that I've told some of my closer online friends about, but as far as people I've met in real life goes, only my counselor knows about them. For one of them, my counselor actually did a better job than my friend at helping me understand why what happened happened the way it did.

[Kaedal]

You know how sometime they say, "The best way to get rid of the stress is to talk about it."

Basically, you pay someone to listen and pretend to actually care so you can talk about all your issues.

"Pretend to actually care" is a wrong and cynical way of looking at it. A person doesn't become a psychiatrist or counselor because of the pay. There are better paying jobs with less stress and better hours than those. People that train to become counselors and the like tend to do so out of empathy and passion for people. Of course there'll always be a professional barrier there, but a certain degree of care and sympathy for the patient or person you're in charge of is required, too.

[Charrio]

I've been in therapy for a while now, it works but took me several months to even let my guard down.
I can't relax or stop my anxiety so it's been hard.

 

It has helped tho, being so introverted IRL makes it very hard to talk to anyone and this has helped.

[Skylar Husky]

I saw one for anger management issues. They talk to you, find out why you think you feel the way you do and make you introspect or look into yourself to tell them about it. They also tell you ways to cope with your issues and offer you ways that you can overcome it. It is partially them and mostly you who does the hard work. You have to want improvement in your life to make the improvements and they make you grow a bit too as an individual.

There is no need to be nervous about it. 

[#00Buck]

It goes like this...

The counsellor will give you excellent advice. 

You will choose to argue with them and not take their advice because you're the kind of person who needs counselling. 

[Conker]

From my understanding/research, the first session is usually a pretty laid-back q/a session so the counselor/therapist can learn a bit more about you.

[GarthTheWereWolf]

"Pretend to actually care" is a wrong and cynical way of looking at it. A person doesn't become a psychiatrist or counselor because of the pay. There are better paying jobs with less stress and better hours than those. People that train to become counselors and the like tend to do so out of empathy and passion for people. Of course there'll always be a professional barrier there, but a certain degree of care and sympathy for the patient or person you're in charge of is required, too.

I'd challenge that. There's a ton of contract psychiatrists/psychologists at the hospital I'm working at that make 300k a year. And theres a few that show up to work regularly in sweat pants. Psychiatry is actually a pretty lucrative business because there's so few of them.

They very much are in it for the money and sweet benefits.

[Kaedal]

I'd challenge that. There's a ton of contract psychiatrists/psychologists at the hospital I'm working at that make 300k a year. And theres a few that show up to work regularly in sweat pants. Psychiatry is actually a pretty lucrative business because there's so few of them.

They very much are in it for the money and sweet benefits.

I fail to follow the logic. They're paid a lot, so that means they're in it for the money? Healthcare employees are always paid a shit ton. They also have a lot more stress involved, thanks to the fact they're under government supervision in most of the west. It just takes one or two complaints from your patients before you get a few departments digging in your personal documents.

[GarthTheWereWolf]

I fail to follow the logic. They're paid a lot, so that means they're in it for the money? Healthcare employees are always paid a shit ton. They also have a lot more stress involved, thanks to the fact they're under government supervision in most of the west. It just takes one or two complaints from your patients before you get a few departments digging in your personal documents.

Its because its such a high stress job that the overwhelming majority of people in the field are in it for the money. Not for some great noble reason. Medical professionals of all sorts are the most cynical folk around. We have empathy for our patients so we better understand and treat you. Not sympathy. The best medical professionals are the ones that see you the way a mechanic sees a car. A problem to be fixed.

If you want to see the true people working for a noble purpose in medicine~ look at the CNAs. Those people are the ones that are truly doing it out of the goodness of their heart.. Because CNA work is the most exhausting, disgusting, and dangerous stuff of the medical field, and they get paid minimum wage. You could work at K-mart for the same pay for less stress and wear on your body. Yet they do it anyway.

[Onnes]

I'd challenge that. There's a ton of contract psychiatrists/psychologists at the hospital I'm working at that make 300k a year. And theres a few that show up to work regularly in sweat pants. Psychiatry is actually a pretty lucrative business because there's so few of them.

They very much are in it for the money and sweet benefits.

If we're talking about counselors, that often implies someone with an LMHC or LCSW or other such credential. Just looking at some brief median wage data, this means below $60k in much of the US. This shouldn't be that surprising given how little most insurance policies are willing to pay out for counseling and other mental health services.

[Kaedal]

Its because its such a high stress job that the overwhelming majority of people in the field are in it for the money. Not for some great noble reason. Medical professionals of all sorts are the most cynical folk around. We have empathy for our patients so we better understand and treat you. Not sympathy. The best medical professionals are the ones that see you the way a mechanic sees a car. A problem to be fixed.

If you want to see the true people working for a noble purpose in medicine~ look at the CNAs. Those people are the ones that are truly doing it out of the goodness of their heart.. Because CNA work is the most exhausting, disgusting, and dangerous stuff of the medical field, and they get paid minimum wage. You could work at K-mart for the same pay for less stress and wear on your body. Yet they do it anyway.

Which is pretty much what I said. Empathy. Someone who lacks in empathy would make a pisspoor counselor because they wouldn't give a shit about the person or their problems. But reducing it to "paying someone to listen to you bitch" is a gross simplification, akin to saying that an EMT is paid to drive a car.

[GarthTheWereWolf]

Which is pretty much what I said. Empathy. Someone who lacks in empathy would make a pisspoor counselor because they wouldn't give a shit about the person or their problems. But reducing it to "paying someone to listen to you bitch" is a gross simplification, akin to saying that an EMT is paid to drive a car.

I think you're mistaking empathy for sympathy. Empathy is being able to understand what the person is feeling while still staying detached. Sympathy would be taking on the feelings that the other person is feeling. Doctors would burn out extremely fast and be ineffective at helping people if they took on the feelings of their patients. Its why they take entire courses on "therapeutic speaking."

Things like: "You seem sad." or "I understand you're feeling ___ and that must be difficult. Would you like to talk about it?"

Yes, "Paying someone to listen to you bitch" is a simplification, but it isn't wrong either. They're trained to pull information out of people and analyze it with a sense of clinical detachment.

[Bloodshot_Eyes]

I think you're mistaking empathy for sympathy. Empathy is being able to understand what the person is feeling while still staying detached. Sympathy would be taking on the feelings that the other person is feeling.

Nope.

Empathy is feeling with them.

Sympathy is feeling for them. 

 

[Kaedal]

I think you're mistaking empathy for sympathy. Empathy is being able to understand what the person is feeling while still staying detached. Sympathy would be taking on the feelings that the other person is feeling. Doctors would burn out extremely fast and be ineffective at helping people if they took on the feelings of their patients. Its why they take entire courses on "therapeutic speaking."

Things like: "You seem sad." or "I understand you're feeling ___ and that must be difficult. Would you like to talk about it?"

Yes, "Paying someone to listen to you bitch" is a simplification, but it isn't wrong either. They're trained to pull information out of people and analyze it with a sense of clinical detachment.

I'm not intending to argue against empathy or for sympathy. I'm arguing against the simplification, because it causes more trouble than it's worth. Being told that someone is there to be paid to hear them bitch is just going to dissuade that person from actually talking to a professional. If I'm told that a doctor is being paid to cause me pain, it's not wrong. Pain is often a part of healing and medicine, but the phrasing makes it seem really damn negative. 

[GarthTheWereWolf]

Nope.

Empathy is feeling with them.

Sympathy is feeling for them. 

 

I'm referring to clinical empathy which is used in the medical field.

"Outside the field of medicine, empathy is an essentially affective mode of understanding. Empathy involves being moved by another's experiences. In contrast, a leading group from the Society for General Internal Medicine defines empathy as “the act of correctly acknowledging the emotional state of another without experiencing that state oneself."

I'm not intending to argue against empathy or for sympathy. I'm arguing against the simplification, because it causes more trouble than it's worth. Being told that someone is there to be paid to hear them bitch is just going to dissuade that person from actually talking to a professional. If I'm told that a doctor is being paid to cause me pain, it's not wrong. Pain is often a part of healing and medicine, but the phrasing makes it seem really damn negative. 

True, and I understand where you're coming from with this. It is discouraging to someone considering utilizing their services. However, they shouldn't go in with flowery expectations of it either. Since the blunt description isn't too far removed from whats actually going on.

[Luka]

I'll be honest with you, it made it worse for me. But that's when I was a kid, the one I had betrayed my trust back then and that lead to trouble.

So they helped enforce my trust issues, if anything :v

[Kinare]

Truly, it depends on how you react to it. If you come at it thinking "this will not work, what a waste of time" then it will be because you will combat everything they try to throw at you. They can't just snap their fingers and make it better, that would be an ignorant assumption. It will be hard work if you have an issue bigger than just needing someone to talk to. If you come into it with an open mind and actually give the person on the other end a chance to help you, then it might actually benefit you. Still not a guarantee, but I can say with 95% certainty that if you try your best you will at the very least learn a lot about yourself and maybe learn how you can help yourself or get better help elsewhere.

It would also benefit you to ask some questions if you haven't thought to do so already, and since this is your first go I would assume not. Some therapists specialize in different types of disorders/issues and use different methods to try to help, so ask who you're going to what they specialize in, how the generally approach wellness, and note it for the future if you don't feel like they're helping, then you can try to find someone who specializes in different things later. They may even refer you to someone else if they feel your issue is a special one that requires a specialist. There's websites that can actually match you up with a therapist who specializes in what might be wrong with you. If the current therapist doesn't work for you I would suggest getting her to give you a general summary of what he/she thinks might be wrong so far, then going off of that when looking for a new one. You can also get a copy of the records he/she keeps on you to pass onto the next one.

Edit: I see no one really answered the "how does this work" question, so I will. Basically what you should expect at first is for them to ask you some very basic questions about your life as a whole, which will probably take up the first session unless you specifically ask to discuss something. The next session you will see them start to want you to talk about what is actually going on with you, may even ask "is there anything in particular on your mind today" or some variance before diving into the questions they want to ask you. If you are very self aware you can jump right into what you feel is going on, what specifically you would like help with, and all the details of your issues and they will ask for any other information they need, then try to equip you with mental exercises to combat behaviors.

Edited October 11, 2015 by Kinare