How Do You Prepare For Productive Therapy Session

[falling_wave]

Ive been thinking about this a lot and have researched a bit as well. It is easy to just walk into therapy and deal with whatever comes up or comes out. Sometimes during a crisis that is the best way to do it and it all does come out in just the right way to help the situation. However, when there is not an immediate crisis it feels like preparing might help. I generally drive to the area where my therapist's office is a half hour to an hour early and park nearby so that I can take a little while to separate from my day and think before going in. I hate rushing to get there. I get incredibly anxious at the thought of even being a minute late. The thing is I can think all I want and I don't seem to get much good topic to talk about even though I am completely comfortable with her and my emotions during the week tell me I really need to process some things in therapy. Right now I have one major thing going on in my life that takes up a lot of y energy and where all of my emotions seem to go to. Right after it started I had what I call a crisis session where a lot was processed because I was crying non-stop through therapy and a mess. Since then Im still having a tough time coping but I feel more at peace with what it going on. The thing is thats all I can think of to talk about and all we do talk about even though I know there is more. My therapist is good at bringing up dynamics that she observes in our interaction so that helps. It sometimes feels like she is calling me out on stuff but Im glad because I am getting more insight. I just feel like I should be providing more material to work with. What do you all think?

Are there particular questions you ask yourself before therapy?
How do you recognize what you need to talk about?
Is there anything else that helps to set up a productive open therapy session?

Thanks in advance for your insights and experiences!

 

[ButterflyBean]

I only do this when I have a lot to cover, but I see my therapist weekly. When a lot has happened over the week, I make a list of things I want to talk about, briefly describe each, and email her. This way, she has an idea of what is going on and can prepare for a productive session. I will often schedule double sessions at least once a month for times like these, but if that is not possible, the email allows for communication even if I am struggling to talk. What I mean is, she can ask questions if I am struggling to find the words since she are already has a general idea from my email.

Example:

"Hi Dr. G,

I wanted to give you an update before we meet because a lot happened while you were away. Of course we will discuss everything, but at least you will have some idea of what's going on.

To make things easier to follow, I'm going to make a list and briefly describe each.

1.
2.
3.

I know there is a lot here, but I'm sure the session will go where it needs to. I am struggling but doing the best I can with what I have. I hope my outline is helpful, and I will see you (insert day/time).

(insert name)"

 

[jaccat]

I do a lot of journalling, here and on paper. I look back each week to see what things have been bothering me. It doesn't always work: sometimes I have no clue what I'm going to say, other times we end up talking about something completely different, but at least it helps with the worry that I'm going to be sitting in silence for an hour.

 

[Suzetig]

It is easy to just walk into therapy and deal with whatever comes up or comes out. !

It's funny how different we all are, this is a hardest thing for me. I had a habit of over preparing, knowing what I wanted to talk about and having an idea of how I would feel or might respond helped me feel in control of myself and my therapy. My therapist has worked hard for me to go in and just deal with whatever is on my mind in the moment - if I'm honest it feels like the hardest thing to do but is the most productive. If I'm in crisis, I deal with that because its at the forefront of my mind. If I'm not in crisis my mind has a way of picking up the things I need to and my therapist will unpick what's going on, sometimes making links back to previous stuff. I find this approach lets me feel whatever is bubbling under the surface and address it at the time, if I feel prepared beforehand I usually end up feeling frustrated because while I've covered what I prepared, it's not generally been what I've needed to talk about, if that makes sense.

I guess it's a long way of saying I trust the process of therapy will bring up what I need to look at in the moment.

 

[falling_wave]

@Suzetig your post made sense and I was trying to figure out what is behind my need to be prepared. I think it's that subconsciously I feel like if I'm not making quick progress my T will think less of me or if im not bringing in new material that I will lose her. She has given me no reason to think these things but they are constant underlying fears. I guess I just need to trust a lot more. It's weird though bc I trust her completely with talking about tough stuff but just not as much the relationship.

 

[Suzetig]

@falling_wave I think those fears are so natural in therapy. It's an odd relationship to say the least and I think it takes time to build confidence in the idea that your therapist doesn't have expectations of you - it must be the only area of my life where I don't feel there are expectations placed on me and that proves challenging for me to accept. I still struggle sometimes with the idea that I need to get therapy "right" in some way when actually all that's needed of me is to turn up on time and pay at the end (and sometimes I don't even manage the payment part).

What would it be like to push back against those fears that you need to "come up with the goods" so to speak, and just let what happens happen?

 

[shell]

I think sometimes those sessions where I don't go in with anything are the best sessions, I think I was using my weekly crisis to avoid the hard stuff that really needed to be faced. Now I try to work on the distructive patterns that I learnt from living for 18 years in an abusive family, it's only then I change myself in a permanent way rather than putting out fires, and running around with no direction.

I can really relate to that need to feel like I need to get therapy "right" that somehow I am doing things wrong, I think it relates to my fears of doing things wrong, because I was attacked so much for being bad and wrong, that I have a fear of making a mistake and being rejected. I am working on my fears of making a mistake, because it really makes it difficult to participate 100%, because I am too busy judging myself and perhaps her. I am scared I will look stupid so I hold back.

It's also really helpful to work on the themes that I find from re-reading my journals, they really show me how disfunctional I think when I am triggered.

Last week I followed her suggestions on what we would work on after talking about how my week had been, and I got so much out of it.

 

[PTSDbegone]

This is something I always struggle with. I worry if I go into a session and don't have something in mind to talk about. Then again when I do have something I want to talk about I find I can't get it out in the session, and I walk away frustrated myself. I don't want to waste my therapist's time, but often feel like I do. I even tried writing stuff down beforehand, and then I wasn't able to give it to her, or couldn't bring any of it up. I know this is pressure I bring on myself. I am starting to hope that in time when I am ready I'll be able to just talk, and not have these worries.

 

[barefoot]

Like some others have said, I definitely had a habit of over-preparing for therapy sessions, which I think was because I wanted to 'do it right' and which ultimately meant it was a huge pressure I put on myself every week. I think some of it was also because I had a real fear of the therapy ending so felt like I had to do everything quickly and not 'waste' a moment of therapy time. When this came up in a session, my therapist reassured me that she's not going anywhere and she'll continue to see me even if circumstances changed (eg financial) and this made a huge difference and felt like a weight had been lifted. This enabled me to let go of these pressures a little and to try to trust in the process more. She's told me repeatedly that there's no 'right' way to do therapy and that she has no expectations - I just need to show up and be how I need to be right there and then. It took a while for this to really 'click' with me but now it has it's pretty liberating.

I do have a habit of dancing around what I know I really want/need to talk about in sessions and also still go mute quite a lot in sessions and I dissociate - so I do sometimes come away kicking myself for not having brought something up that I really wanted to talk about. But if there are important things like that now, because I know that I have these unhelpful habits, I'll text her in the morning of our session to give her a heads up that there's something I want to talk about. This works well for me - because of the accountability, I think. I usually just say something like 'There's something I really want to talk to you about today so if I look like I've got nothing to say when I see you later, can you please remind me of this?!' I don't do this often at all - just when I know there's something I really need to say and I'll be really furious/anxious if I don't say it and have to wait another week to try again. Otherwise, I try to be more relaxed and see what comes up in the moment.

I do think about therapy a lot between sessions though. Sometimes I wonder if I think about it too much - like if it's become a bit of an obsession or something?! So it's all still on my mind a lot, but I don't now over-prepare what I'm going to say, how I'm going to say it and then pretty much role-play a whole speculative therapy session in my head day after day!

 

[falling_wave]

@barefoot I think about therapy a lot in between sessions too. I sometimes worry my attachment to her is too strong since I get abandonment fears but I really do believe it's just part of good therapy and I'd much rather be over attached than not attached at all. It enables me to do work that matter with her and it helps her know me to help me.

@Suzetig I don't know what it would be like for more than a session. I worry that I would start slacking off and not doing the work I need to for change and my mind could keep catastrophizing from there that we would lose a good connection and then there wouldn't be any need to see her and I would loss someone else important to me. This is probably especially strong right now because I have lost someone extremely close recently and have been processing that with her. I will try though to work hard on what comes up in therapy even if I don't already know what that will be. I will see today.

 

[barefoot]

@falling_wave - thanks for the reassurance. I don't think of myself as a needy or clingy person at all, so the fact that I think of her and the therapy work itself quite a lot feels strange to me. But I think I agree with you - that I need that level of attachment to have a good relationship with her and therefore to achieve good therapeutic outcomes.

Sorry to hear of your recent loss. I hope working that through with your therapist is helping at this sad and difficult time.

 

[falling_wave]

Thank you! Im having a hard time but working through it with my therapist truly is my lifesaver and I'm feeling a bit stronger each week.