10 things you always wanted to know about psychotherapy but were afraid to ask

My name is Sarah Lee and I'm a psychotherapist working in Manchester city centre in the Uk and onLINE.

Explore Your Mind: white man, visible from the shoulders down, sitting on sofa with tattoos on his hands

Who are you?

I'm Sarah Lee, a UKCP registered psychotherapist. I work in Manchester City Centre helping people suffering from depression, anxiety and low self esteem.

I have a special interest in working with clients with depression and survivors of long term abuse. 

If you're further afield you can work with me online. If you have any questions, you can call me on 0161 694 7259 or send me a message.

Psychotherapy can seem a bit mysterious. What exactly happens? How does it work? In fact, does it even work at all? 

Below I'll try to answer a few frequently asked questions about psychotherapy. If you have more questions please feel free to leave a comment and I'll try and help.

1. Will I have to lie on a couch? 

If you don't have much experience of psychotherapy, you might be reliant on what you've seen on TV or read in a book.

Freud, who is widely known as the forefather of psychotherapy, was originally practicing hypnotherapy, hence the couch. Whilst some psychoanalysts still use a couch, many psychotherapists do not. 

I work from a chair so you won't need to lie on a couch. Clients sit in a chair opposite me so that we can talk easily.

2. Will it be like on TV?

If you've ever seen 'Good Will Hunting' you might recall the lighting speed that Sean Maguire (played by Robin Williams) works at. There's also a scene where the therapist shouts at his client.

No therapist should be shouting at their client and whilst I want you to improve, change is not always as fast as it looks on TV. As my trainer was fond of saying 'it's a slow cooker, not a microwave'.

It's also worth pointing out that any responsible therapist is bound by a code of ethics. This is set out to ensure that clients are not exploited by therapists. This means no therapist should ever be in a romantic relationship with their client (as you frequently see on TV). 

I adhere to the UKCP code of ethics which ensures I work ethically and respectfully with clients. The UKCP is a professional body which voluntarily regulates psychotherapists in the UK and holds their work to high professional standards. 

I've yet to see a TV programme or film that realistically portrays psychotherapy. On the odd chance I do catch something, I find myself muttering 'we're not allowed to do that' repeatedly before I eventually switch over!

3. How long will it take?

Whilst some therapies are strictly time limited e.g. 6 sessions, some people need more time. If you have an issue you would like to explore, then this might work for a 6 session time limit. In fact I've even worked with one client for only 2 sessions and even this was reported as 'very helpful'.

Because I work privately, you have the option to continue therapy if you are finding it useful and have the financial means to continue. I recommend that clients commit to 6 sessions so that we have a chance to work effectively.

Thereafter some clients choose to leave, some will stay for couple of months until they feel better able to understand themselves and get support and some  may continue in therapy for several years. You are welcome to stay in therapy for as long as you find it helpful.

4. Does therapy actually work?

It does. Now of course you'd expect a psychotherapist to tell you that therapy worked. But I trained after having therapy because it helped me and met many colleagues and clients along the way who also found great benefit in therapy.

It can be difficult to measure outcomes in therapy, so it's useful to set goals that we can work towards. If you're not sure what goals are realistic or how to set them I can help with this too. 

5. How does therapy work?

One of the most important things in therapy is to feel a good connection with your therapist.

This is because the 'therapeutic relationship' (what happens in therapy) is important to healing. If you haven't felt heard in other relationships or you've been told you overreact or are overemotional, therapy is a good place to have a different experience.

I'm used to people feeling that their feelings are 'wrong'; in fact there is no such thing as feeling the wrong thing because it's a subjective experience.

Previous clients report feeling the benefit of being able to offload things they might not tell anyone else without being judged and many feel safe enough to tell me things they have never told someone else. 

6. How can I know if my therapist and I are a good fit?

Since research has demonstrated that the fit between client and therapist is one of the most important factors in therapy effectiveness it's important to find someone who is a good fit. If you find your therapist likeable when you first speak to them, this is a good start.

You should feel that they pay attention to you and give you room to think and speak. If you feel uncomfortable or unable to talk then this might be a sign to look for a different therapist.

You likely won't feel able to trust them fully straightaway, but you should feel that there is potential for you to trust them. 

7. Do therapist know lots of secret tricks to solve all my problems?

Some clients are disappointed to know that I do not have 'the answer' for them.

I've also been known to say 'I don't know' when a client asks me what they should do. Therapy is not about me telling you how to live your life and what you should do. It's more about helping you to see which parts of your story are relevant and where to look for answers.

Think of it like sorting through your wardrobe; a therapist doesn't wave a magic wand and magically reorganise your wardrobe, rather they help you to decide which pieces suit you and which don't, whether you need something new or whether you can repurpose what you already own if you look at it differently. Perhaps it can be mended.

The client also needs to be prepared to try new things they might not previously have considered (which may feel strange at first until they get used to them). 

8. Are therapists perfectly in control of their own lives?

I don't know anyone that feels perfectly in control of their own life!

That said, a good therapist has had a lot of their own therapy. I had therapy throughout my training, so when I do things I wish I hadn't, or feel overwhelmed I normally have a good idea why or what it's about.

The aim of therapy is to help you to adjust to ups and downs and get support from others when you need it. It doesn't mean that there won't be any ups and downs. It's normal to experience good days and bad days.

9. Is a therapist like a paid friend?

A friendship is different to therapy. I trained for 4 years to become a therapist, and had to demonstrate understanding of theoretical ideas and how to practice therapy.

I also had a lot of therapy so that I don't bring my own issues into your therapy and can set them aside. Therapy is for the benefit of the client; it isn't a two way thing like a friendship. There is no need for you to look after me so you are free to take time to focus on yourself. 

10. Do therapists really care about their clients?

I do care about my clients. I've been on the other side of therapy and needed help myself so I know what it's like to want to change without knowing how to do it.

Therapy is a professional caring, in that there are certain boundaries which should not be broken. I can't be friends with my clients for example and I don't meet socially with them. 


To Arrange a free 20 minute phone consultation to find out how I can help, please call 0161 694 7259 or Contact me here

Image credit: Tanja Heffner, Unsplash


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