During therapy

I want to discuss other things with my therapist

My therapist didn’t want to talk about my past but I felt I needed to tell someone what had happened to me so I could begin to process it all.

You might feel like you would like to discuss a wider range of topics experiences with your therapist than you are doing at the moment. This section aims to explain why your therapist might have a particular focus. 

Each type of therapy has a different understanding about what leads to the problems and situations for which people seek therapy and therefore focuses on different things with the use of different techniques. For example, some therapies will place a greater emphasis on talking about past events, whereas other therapies will look at the importance of personal relationships in more detail. These differences in theory and understanding lead to different methods or techniques of therapy, different ways of working in the therapy room, and what is considered relevant information for therapy. 

A therapy that has a greater focus on developing and understanding of key thoughts, images and memories will make greater use of questions and techniques that focus on this area. Similarly, a therapy that is more focused on understanding unconscious processes would use a series of techniques that seeks to bring them into focus. Therefore the conversation and activity in the therapy room would be expected to follow the areas thought to be relevant to your particular problem or situation from the perspective of the therapist, and the particular approach they are taking. 

It’s important to note, however, that just because a therapy has a greater focus on one set of experiences (such as thoughts), it does not mean that other areas are not important - it is just that some therapies are very clear in what needs to be addressed in order to help particular problems. Other areas might be less directly relevant immediately (e.g. behaviours), but might be expected to change as a consequence of focusing on the key area. 

Once your therapist has completed your assessment they will usually come up with a plan for therapy based on the theories and models that a) they have been trained in and use in clinical practice and b) that apply to your situation or problem (this is sometimes called the ‘formulation’).  Your therapist should explain their understanding of your problems and discuss the therapy methods that they believe will help to address, overcome or understand your difficulties.

It is important that your therapist takes time to ensure you understand the plan that has been developed, and that you agree to it. Therapy should not start without your informed consent. Therefore, the plan needs to make sense to you so you see it as a credible way of helping you with your difficulties. This will help set the scene for the ongoing work of therapy, and ensure you know why specific discussions are appropriate and others less so.

If you have any concerns There was a lot of things which I never got to tell her, I did want to but it’s like she didn’t allow me to about why your therapist is focussing on some areas, and not allowing you to discuss other things when you want to, a useful place to start would be Should my therapist be doing this?

It is always important that your experience is heard and you are able to raise issues that you consider important as they occur. At times, it may be appropriate for your therapist to suggest limiting the amount of discussion about a situation if the time spent in therapy could better spent on working on the areas that are keeping you stuck but this should be discussed with you. 

If you feel that the specifics, uniqueness and breadth of your situation have not been taken into account and that considering your experience in more detail would help you engage more fully in therapy then you may be able to agree allocating some time each session to these areas. 

If you feel that the emphasis and focus of the therapy and therapist isn’t right for you then it may be best to discuss alternative options with them, or your referrer (see related content – I don’t feel very involved in the process. Can I choose another therapist?)