Sometimes, the fear of judgment shows up when you’ve been attending therapy for a while. Which might surprise you, because you have a great relationship with your therapist. According to Saidipour, this might mean that you’re close to discussing a difficult topic, a topic you’ve felt shame over. This is a good thing, too. “Understanding this can help you and your therapist become more aware of the significance of that issue in your life, and help guide you on how to proceed.”
Challenge: You’re mad at your therapist.
You feel like your therapist wasn’t listening to you. You think they brushed right over an issue that’s significant and distressing to you. Maybe they interrupted you. Maybe they seemed distracted. Maybe they said something that didn’t sit well with you. Maybe they asked a question that irritated you. And you find yourself getting mad at them. You also find yourself getting mad that you’re mad, because maybe you came to therapy to work on your anger—and clearly it’s not working.
Actually, this is normal and, when you talk about it together, presents another key opportunity.
It’s an opportunity to work on an interaction right away and strengthen your relationship with your therapist, Saidipour said. This is critical because regardless of the type of psychotherapy you’re in—cognitive-behavioral therapy, dialectical behavior therapy, psychodynamic therapy—therapy is about the relationship between you and your therapist, she said. “Research consistently shows that the quality of the therapist-client relationship is the main predictor of positive outcome of psychotherapy, regardless of what theoretical approach the therapist uses.” (See here and here for some research.)
“If [therapy] were just about learning skills, you’d read a self-help book. So many wounds happen in the context of a relationship, and they are also healed in relationships.”
Similarly, it’s an opportunity to uncover the relationship themes and patterns that exist outside of therapy for you: These themes might revolve around feeling disappointed or misunderstood by others, feeling isolated and disconnected from others, or feeling angry and critical of others, she said.
For instance, when your therapist responds with very little enthusiasm about your upcoming job interview, you feel deflated, and the all-too familiar wave of frustration washes over you. When you mention this to your therapist, you realize that you also feel hurt—and utterly rejected. Together you both trace these feelings back to a significant moment when you felt the same way.
“Having this conflict in therapy lets you work on it in real time, with someone who’s careful and sensitive to you, and gives you an opportunity to rework old relationship patterns in new ways.”
Challenge: You have nothing to talk about in session.
Maybe you came to therapy during a crisis. You were experiencing difficult, almost unmanageable emotions. Or you were going through a complex conflict, which shook the foundation of a close relationship. Or you were in the middle of major depression or daily panic attacks.
Now after doing the work, thankfully, things are in a healthier, more stable and settled place. And you find yourself with nothing to talk about in session.
According to Saidipour, particularly in psychodynamic or psychoanalytic therapy, where the intention is to gain a deeper understanding of yourself, this provides a prime opportunity to excavate.
In fact, some of the most “fruitful sessions” Saidipour has had with clients have begun with the words: “I have nothing to talk about.” She encourages clients to say whatever comes to mind—whether it feels relevant or not. “Following those thoughts [typically] naturally leads us into deeper work, what’s underneath the day-to-day occurrences. Often clients will end those same sessions surprised: ‘I had no idea that would come up!’”
In some cases, you don’t have anything to talk about, because you’re actually afraid to bring up a difficult topic. This fear may not even be a conscious one. Which is why doing deeper work in therapy is so powerful: You can unearth what’s outside your awareness.
“What seems like an issue can actually be an opportunity to understand yourself better,” Saidipour said. “The more you understand about your relationship to yourself and others, the freer you’ll be to move forward in your life.”