Dr. Kris Boksman, C.Psych
I Want to Come Every Other Week to Make Therapy Last Longer. Why Don't You Do That?
OK sure, I get it! I think I see what you’re thinking — “If I get therapy, I will feel better because I am meeting with a therapist. I’m working on my _____ (depression, anxiety, PTSD, crazymaking family, mom guilt, etc.), so, I will feel better if I stretch out my meetings out to last as long as possible and keep within my budget.”
What Do We Want? TO FEEL BETTER!
To start, I’d just like to give you some kudos. Good for you for being thoughtful about what you need, and coming up with ideas to help you feel good as possible for as long as possible. YOU are our kind of psychotherapy client! We want you to feel better, too.
I can tell already that we’ll make a good team because we are thinkers with the same goal in mind - feel as BETTER as possible for as LONG as possible - Team BETTER for the win! Amiright?
When Do We Want it? RIGHT NOW!
So we want to feel better for as long as possible. Sure we do. But will staying in therapy longer do that? Well... yes and no.
The thing that I’m online to tell you about today is that it's not your therapy meetings that make you feel better, it is what happens that changes you in the therapy meetings that is responsible for helping you start to feel better.
And so, with this in mind, and assuming you’re seeing the best therapists in Kingston, Ontario - because if you’re going for therapy you should see the best psychotherapist you can who really knows how to help someone with anxiety or depression, for instance, change how they feel for the better (ahem, I’m just going to say that you should be going to the psychotherapists at Limestone Clinic, ahem) - what will make you feel better, faster, is actually more frequent therapy over a shorter period of time, not less therapy, or therapy that is more drawn out. Do you see what I did there?
I get the idea that counselling with a psychotherapist is a good thing, and so then it feels like it follows that the longer it lasts, the better you will feel, for longer; however, when it comes to psychotherapy, don’t you actually want therapy that is as transformative as possible, as quickly as possible? Like, if 6-8 ‘doses’ of counselling is usually what helps people really start to see a difference in their emotional states for depression and anxiety, would you like to have 1 session each week (typical, usually recommended schedule) and start feeling better in 6-8 weeks (1.5 to 2 months), OR, have 1 session every other week (or “biweekly” therapy), and start to feel better in 12-16 weeks (3 to 4 months)?? I don’t know about you, but feeling better faster is on my personal agenda. I’m not into unnecessary suffering. No thanks.
It's Not the Therapist, It's What the Therapist Teaches You
I really want you to think about what feeling like you need to prolong your therapy is suggesting. This may be a fine point but I think it's really important. This suggests that you need to stay in therapy to stay feeling good. But at Limestone Clinic our therapists would suggest to you that we think you have better things to do than feel shitty and feel dependent on a therapist. We want you to give your bad moods a serious ass-kicking, learn some cool new Emotional Ninja Badass moves, and transform your life. As fun as I'm sure you are to talk to, our therapists would rather see you kick bad-mood-butt and fire us because you're feeling better, instead of keep going in watered-down therapy every other week for years.
"Evergreen" Psychotherapy Services
Bleech! That lousy type of therapy that goes too slow or doesn't really change much but gives you company month after month, year after year? That's what those in the business call having an "Evergreen" model. And I don't think you want that. Evergreen psychological services are services that go on forever and ever, without anything really changing. These kinds of therapy models fool the clients into thinking that without the regular company of the psychologist or social worker, they will spiral back to feeling alone and hopeless, and this makes the therapist their recurring "green," but leaves you, the client who wants to feel better, stuck with a therapist who isn't skilled enough to really help you change things. In an Evergreen model, you're the un-ninja.
BE THE NINJA
It is not having a therapist which makes you feel better (though having emotional support and a neutral person who cares for you is quite lovely). But that won't fix your problems. If you have depression, anxiety, or trauma (the three problems for which people most commonly seek professional mental health services with us at Limestone Clinic), what is going to help you the most is what you and your therapist change together in your therapy sessions. And change is what you want, right? Not the usual ho-hum of emotional stink that you've got going on right now.
Think of it this way - transformational therapy is therapy that helps you learn about what you've been missing to help you move to a state of more emotional balance. It's not a friendship or companionship thing, because therapy that is strictly supportive in nature isn't really changing you, it's just making you feel a little better while you're still doing things wrong and treading water. If you are looking for companionship, maybe you are seeking a therapist to help you feel less alone in the world, but then I'd still argue that it isn't a therapist companion that you are needing, you are seeking a fix for feeling alone and what this sense of aloneness or isolation means to you.
Another way to put this is, if you are feeling like you are treading water over and over in your life, do you want a therapist who will jump in the lake with you and keep you feeling supported while you swim and swim, or do you want a therapist who will guide you about how to get out of the damn lake, get a decent little hibachi heated up, and hand you the marshmallows to make some s'mores to celebrate your personal growth accomplishment. (I am Team Better, but also, unapologetically, Team "Get-the-Fuck-Outta-the-Lake-and-Let's-Have-S'mores!"). Mmmm. S'mores.
Ok - sorry - back to the subject at hand - Or, maybe, when you were at another phase in your life, you felt safer when you had supports around you. Maybe earlier in your life when you were anxious, or when you were sad, these were the times that you learned that people really showed up for you, and you felt less alone or most supported. Maybe you think that to feel best in your life, you just need a therapist in your corner, and you can feel safest and most secure by knowing that the therapist will be there in case you need them. If you are looking for a therapist to help you feel safe and protected, then I'd argue that it isn't a therapist companion that you are seeking, but that instead you could really use a deep sense of knowing that when the shit hits the fan, you can handle it. Does that make sense?
Trust me, this is different. Transformative therapy is different.Because transformative therapists want you to be different in your world so that you can show up in your own life and be your own fucking hero, whenever you need it.
Therapy Frequency is Like Vitamin Dosing
Therapy - It's kind of like taking a vitamin to cure a vitamin deficiency.
You know you'll need a certain number of doses before you really feel better. Once you get the doses in you, in a format your body can absorb, you'll feel great. Take too much too soon, and you'll feel a different kind of sick. Take too little, or water down the dose, and you'll feel sick for longer.
You could rationalize that if you are deficient of a particular nutrient, MORE of the nutrient is better, sooner, instead of less, over a longer period of time. In some instances, and for certain deficiencies, taking the supplement your doctor suggests you need is something you can do in a hurry. This is like doing a therapy intensive, where you take a deep dive on something specific and really target it over several hours in one week to get a significant change in that issue. Or, more commonly, you work at the usual pace, which is 1 session per week, until you get the results you desire. Either dosage is good because we're not giving you more than you can handle, and we're meeting the need for the system to change as soon as possible so you feel better.
Now for the slightly shitty news - biweekly therapy, in our experience, just doesn't work as well as weekly therapy. It's like taking your vitamin supplement half as often. What's worse, it's also weakening how much of the vitamin you can absorb. So, for example, instead of the vitamin giving you 100% of what it's supposed to contain, it's now at something like 60% potency. The supplement is weaker! This means you'll need MORE of your supplement, not even just the same amount, to get the same effect.
Really? Yes, really!
Our psychotherapists have found that when we do therapy every other week, or heaven forbid, less often than that, they spend more time "catching up" in the client's life and less time doing the actual transformative work of therapy. This means less "dose" of the helpful parts of therapy, and less effectiveness of the work, overall. Why on Earth would you want to pay the same amount for a less effective dose of treatment, and have to stay in treatment longer? When you put it this way, many people have their "a-ha" moment and understand that a more frequent therapy model gives the most reasonable chance of feeling better and staying that way.