How to talk to a therapist

MSer Kahn Johnson is a therapeutic counsellor who works at Jigsaw Therapy Norfolk. He was diagnosed with MS in 2006.

You might think that talking to a therapist is simple – you sit down, you talk about whatever is on your mind, you go home again. But experience has taught me that this is not always the case – or always what some people think.

You might also wonder how, and indeed, if talking therapies can help when living with MS. Again, experience has taught me it can. A lot of emotions can be stirred up post-diagnosis, both with the person given the diagnosis and those closest to them. I found therapy to be really helpful in navigating this new and unforeseen path my life had decided to go down.

So then, what are ‘the rules’? What can you talk about, and where do you even begin?

Well, take a seat!

The therapeutic relationship

Finding the right therapist for you is the most important step. In the same way that you don’t like everyone you meet, you don’t fancy everyone you meet, you won’t necessarily get on with every therapist you meet. They know this, and so won’t take it personally if you say things are not working out for you.

It’s important to remember that the relationship you will have with a therapist will be the most important, the closest, you will have outside of those closest to you. Over time you will almost certainly find yourself talking about things you wouldn’t even dream of bringing up over a coffee with your nearest and dearest. This is the beauty of talking to the right person.

It also underlines why the right one is so important. You need to feel comfortable, you need to feel that they get you, you need to feel safe, seen, and heard. And this doesn’t happen between every therapist and every client. I’ve had three amazing therapists over the years who helped me through some very difficult times.

I’ve also had sessions with ones who sadly didn’t. And that’s not their fault. It wasn’t my fault. It just wasn’t ‘right’.

And as the client, it’s important that you feel that connection – and if you don’t, that you feel able to say so. A good therapist will understand and want to support your choice.

And at the end of the day, if you’re paying you don’t want to be wasting your money.

Where do you even begin?

The thought of seeing someone can be overwhelming. What are you supposed to talk about? Won’t it all sound a bit stupid? It’s probably not that a big problem anyway…

And so, like just about everyone else before you, you will probably talk yourself out of the appointment several times before you even get to the allotted day and time. And that’s OK. We’ve all been there. Your therapist will have been there. It’s normal.

There is no set subject you have to talk about. There are no rules here. Modern therapy is nearly all ‘person-centred’, and what that means is that you the client sets the agenda. It’s your time, it’s your dime, you can talk about whatever you want.

You might think it’s nothing – that doesn’t mean you shouldn’t bring it up. There might be something you know you ‘need’ to talk about, but if you’re not ready then don’t be under any pressure to open that particular trap door.

Some of my favourite sessions with a therapist have involved me talking about what I watched on TV or a new album I’ve just discovered. Sometimes, that led me to actually talking about something that had been on my mind. Sometimes it was just nice to discuss people baking cakes. Both are valid. Both serve a purpose for you. And your therapist will know and respect that.

It’s your time so you can very much ask. Most therapists will welcome discussing the journey, the issues being raised, the topics being talked through.

The only way we, the therapist, know what’s going on is if you share it. We have a phrase – “bring it into the room”. What this means is, if there’s something you want to raise, raise it. Not saying things won’t help anyone, and you’re in the room because you’ve sought help. So, feel free to help the therapist to help you by talking about something sessions-related if it is on your mind.

Are all therapists the same?

Ahh, good question. No.

In private practice, the essential framework is the same – person-centred as mentioned above – and unless the therapist describes themselves as following a specific philosophy (psychodynamic, for example, meaning they will focus mainly on your past) they will pretty-much use a range of tools and techniques to help you.

The NHS, however, tends to favour one technique only – CBT, or cognitive behaviour therapy. Here, you will have a limited number of sessions, deal with one specific issue only and be given the tools to hopefully help you cope with that one issue after the sessions have finished.

CBT is a very good technique for this very specific purpose. It will help you cope. It will give you skills to overcome the one issue you took into the room. But, for me, it isn’t a long-term solution. It’s a sticking plaster, rather than dealing with what caused the injury (if that makes sense).

It’s a very good approach for a large organisation to use, because you can record outcomes, work in a time-limited way, and help a lot of people quickly. The NHS doesn’t, sadly, have the resources to offer long-term treatment.

As a client, I haven’t got on with CBT. Issues around attention and concentration mean doing homework or recording feelings can be very challenging.

But as a therapist, it’s a very handy tool to have in my toolbox (I don’t actually bring  a real toolbox into the room…) and has helped clients note how they are feeling as the work progresses.

The important thing to remember is that, at the end of the day, it’s just talking. And you’re in control of that.

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