When Counseling Fails
When I see a new client, one of first questions I ask is about their history with counseling. Sometimes the answer is heartbreaking. A bad experience can turn a person off to the whole field, and in turn limit healing opportunities and options. Whether in my personal life, in my office or through podcasts, oh, the stories I have heard...I recently heard a story on a podcast where the client had forgotten traumatic memories-her counselor insisted that she needed to relive the feelings to recreate the memory in order to heal. He then had her get on the floor and held her to recreate the panic sensation. Wait, what?! That sounds horrible! As you can well imagine, it was a long time before this person returned to therapy. And when they did, it was with some hostility toward the new therapist, even though the new therapist was completely unrelated to the weird "get on the floor" guy.
Certainly, sometimes counseling fails because the therapist has ideas that are ill informed, or they behave in an unethical way. My insurance premiums and ethical studies options reflect this reality! Sometimes therapy fails because the therapist and client are unable to create an alliance for treatment. Therapy is a personal endeavor. It is a journey through a person's difficulties. In order for this to happen effectively, the client and therapist must create a relationship within which the client is comfortable going into thoughts, memories, or feelings in a new way.
Therapy sometimes fails is because the heart of therapy is change, and a client is not ready for change. When a person decides to enter therapy it should be with the clear idea that you as the client are the one with the power to create. The therapist is there to facilitate, educate, support. But, we cannot create the change for a client. This means that a client must be ready for change. Look, there is no right or wrong here. Maybe a person comes to therapy because they are getting ready to be ready to change. That is not a terrible start. But a person who is deeply entrenched in a particular way of thinking stands a good chance of losing the opportunity for therapy success.
So, what is the success or failure that we look for in therapy? Another early question that I ask is, "what is your goal in coming here?" The answers vary from, "I don't know" to answers that reflect a specific learning goal. We will talk about expectations. Obviously, a childhood rife with trauma resulting in current relationship problems will not be completely resolved in eight sessions-regardless of what the latest counseling seminar marketing materials promise! Sometimes we work together for a few months, then take a break. Some clients have standing ongoing weekly sessions, other sessions are short term brief therapy, 3-4 sessions and done. Together, with your therapist, talk about what your arc of therapy will look like. What is the general overview? Your therapist should be able to chat with you about issues, directions, how they see your issues. Ask them! Your therapist works for you. So, how do we define "therapeutic success?" Well, I define therapeutic success as growth oriented change. I love it when I can reflect back to a client a positive change I see. My clients have defined their successes as, "I am just feeling better ". And, really, that's often the goal.