What happens in psychotherapy?

The first three to four introductory sessions concentrate on assessing your difficulties and what your wish to achieve in psychotherapy. Your past is also important and we will take a close look at it so that we better understand what lies behind your current difficulties and how your past experiences still influence and cause problems in the present.


You will be asked to fill out some forms at home, such as the Psychotherapy File and Schema therapy files. At the end of these four sessions, we will together make a collaborative working hypothesis (a joint understanding and creation of reformulation) of your difficulties and of what might be the origin behind them.


If we are going to start shot-term psychotherapy we will agree on a set number of sessions (usually 16 to 24 sessions plus follow-up after three months). If we are going to start a long-term therapy, we will set a rough approximate of how long we are going to work together.


Once you start psychotherapy, the appointments are weekly (sometimes twice a week), preferably on the same day and at the same time. Those times will then be set aside for you. Regularity and continuity are important in therapy, as they give structure to the process.


Each appointment lasts 45 minutes.


In therapy sessions different therapeutic methods can be combined to help you to recognize, challenge and revise old patterns that do not work well. The aim is to develop your ability to formulate and recognize faulty procedures so that they are more in your control and can be gradually replaced. You can make changes by developing other more functional procedures and by adopting an active problem-solving stance, so that events and emotions that seemed to be out of control and unpredictable start to be understood and to become more controllable. Monitoring yourself and the sequences in your daily life (outside therapy sessions) is important. Then you can notice how gradual changes in your beliefs and repetitive patterns affect you and your relationships. You can test these out in the real world. Homework assignments (diary keeping, rating scales etc.) may also be part of the therapy.


Last, there is an old joke that goes like this:

QUESTION: How many psychologists does it take to change a light bulb?

ANSWER: Only one, but the bulb must really want to be changed.This old joke reflects a fundamental point about psychotherapy in general.


Any change that happens must come from you and your own efforts. I can guide, but I cannot do the work for you.


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