How to Get the Most Out of Therapy - Justin Lioi, LCSW - Brooklyn, NY

The other night I was out with some friends eating briny food at Jacob’s Pickles and the subject, as it sometimes does, turned to therapy.

I was being asked how to get the most out of therapy—how to be successful at it. They were talking about their own experiences in therapy–when you have nothing to talk about, when you want something more, when you want it to end, why men don’t go to therapy–and that they like their therapist, but…they sometimes didn’t tell their therapist everything…they even lied sometimes.

We spoke about how therapy is a process and how it takes time to trust someone, and that’s a good thing.

It’s not a bad idea to wait to talk about certain personal events only when you’re ready to do so. When people do the opposite I often find myself helping them slow down. I’ve found that if someone “gives away” too much too soon they often end services early. They may leave that first session wondering why they told that stranger—because when we begin we are strangers—way too much.

I make it clear that I’m not reigning them in because I can’t handle their story, but I’m supporting them in seeing how healing is a process.

I’m using that word “process” a lot. I guess it’s just that to get the most out of your therapy there’s a certain amount of trust in your therapist that needs to develop and there is a certain amount of trust in the process that should occur. And that trust in the process comes and goes over the course of treatment. Trust being very important to us as humans.

My One Piece of Advice for How to Get the Most Out of Therapy

As I said, people outside of my clients often want to talk to me about their therapy.

I hear how, “My therapist:

  • is great”
  • falls asleep”
  • remembers everything”
  • ends sessions early”
  • is like a friend”

Some people want to know more about their therapist and some say their therapist shares too much.

Many people express anger or frustration about their therapist while others are afraid their therapist thinks they’re boring. Many wish they could just be buddies instead of the formality of an office and payment.

When I’m then asked how to get the most out of therapy, no one wants to listen to my one piece of advice:

Tell your therapist how <angry/happy/pissed off/excited/frustrated> you are with them.

Bring all of that stuff into the room and the process will become very different. It will be much more dynamic and you may find that the things you’ve wanted to work on really start getting worked on.

Working in the “Here & Now”

Anyone who is in therapy spends an enormous amount of time talking about their lives outside the office.

This makes perfect sense of course, you came to therapy for a specific reason and it’s usually to change something about that life. Why wouldn’t you think the most important thing to do is to let your therapist know as much about that as possible?

It is important to talk about all of that. It all can provide lots of helpful information for your therapist and allows them to get to know you better and better. Patterns begin to emerge in how you respond to situations and people, connections are made clear that you then have the chance and ability to shift now that they are known.

Still, the “gold” for me as a therapist—and as a client—is when we can talk about what is actually happening in the room. Working in the “here and now” as it’s called in therapy circles and the most effective work is done in these moments.

It’s when those patterns and those connections start emerging between the client and the therapist. That anger that comes up over something I may have said or the way I said it. Or maybe the moment I remind someone of someone else.

I remember a time a while back when I told my therapist how he reminded me of Brian Lehrer. We spoke for a while about what positive feelings I have to this voice on the radio and what that says about the authority I was giving to my therapist. A lot was discovered in how I deal with authority figures once I respect them. Was I hesitant to challenge them which could limit my own growth. We allowed that to play out together.

A Feeling Example: Anger in Therapy

Many people come to therapy because of their anger. Either it’s explosive and it’s led to consequences such as losing their job or it’s so hidden that they’d never admit they are angry at all. It gets internalized and comes out as physical symptoms or depression.

While making someone angry is not my intention, I’m sure that along the way something will bring up some negative feelings in a client while we’re in my office.

If I had been able to make the space safe enough for my clients to let me know they are pissed, or even just slightly irritated because, perhaps I forgot a detail of a story they told or wasn’t able to call them back as quickly as they felt I should have, we are now working with all the outside stuff in the here and now. We get to examine the real, raw feelings together. I get to see it, feel it, and then help you work through it.

But I can only do that if you’re willing to do it with me.

Finding Freedom through Truth Telling

During your therapy, especially if we’ve been working together for a while, your focus isn’t on taking care of me or on a worry that our work will end because you’re showing your feelings.

If you want to know how to get the most out of therapy then this is it: let your therapist in on your feelings toward your therapist.

  • If they are late, talk about it.
  • If they answer the phone or text, talk about it.
  • If they fall asleep (this is a hard one, but I’ve heard it more than once), talk about it.
  • If the slightest spark of anger or irritation arises because of something your therapist does, talk about it.

Maybe there’s a perception that you often bring to your relationships that isn’t getting worked on. God knows, I used to think people were always getting upset with me, but talking directly about it in therapy I realized how much it was my own perception of how I thought people felt. My reaction wasn’t based in fact, it was based in a defense of what I was afraid others’ reactions would be.

Wow, how freeing it was to move beyond that!

If you’ve been considering therapy, but are unsure about the process or uncomfortable about how it works feel free to get in touch and I will be happy to answer some questions.

Justin Lioi, LCSW is a men’s mental health and relationship expert based in Brooklyn, NY (and online throughout New York State and internationally.) He received his degree from New York University and has been providing counseling for men and their families for over 10 years. Justin is on the Board of the National Association of Social Workers and writes a weekly column for the Good Men Project called Unmasking Masculinity. He can be found on local and national podcasts talking about assertiveness, anger, self-compassion, all with the goal of becoming the man you want to be.