Psychotherapy Perspectives

Thursday, September 17, 2009

When Symptom Relief Happens, Counseling has Only Just Begun!!

By Garth Mintun, LCSW, ACSW,CSW-G

You and/or your spouse have been engaged in counseling for a few sessions. It is your first time in psychotherapy and you have expressed yourself, you have been heard, you begin to have a fresh look at yourself and your lifeā€¦ and you are starting to feel hopeful; things can be great. Your anxiety is decreased, your relationship with your spouse has improved, and/or your child is remarkably better. Perhaps you are experiencing work to be less stressful now. Maybe you have some relief from depression. You are not in the midst of a crisis anymore, so you think about quitting the counseling. After all counseling is expensive and you feel better now, so why not quit?

This belief is often attached to the notion that it is time to quit because you feel better. Weeks or months go by, however, and the problems not only come back, but seem to get worse. What happened? Was therapy not effective?

As a new client (especially as a new client who is in psychotherapy for the first time), it is important to understand the following:

1. When you start counseling, often you feel better quickly because you feel symptom relief.
2. Symptom relief is good because it often means that there is awareness of old patterns of problems and therapy begins to solve the surface problems.
3. Symptom relief does not heal the underlying deeper problem/patterns; that process takes a longer time.
4. If you quit too soon when you experience the first symptom relief, you will not undo the fundamental patterns, therefore new symptoms or old symptoms often return more forcefully. This is because you have not yet changed the deeper systemic nature of the problem.
5. It is best to stay long enough to work on the deeper pattern, so you will substantially decrease the likelihood that the old problem will reemerge in other aspects of your life. It may take a little longer, but in the long run it saves money and creates a higher degree of success.

When the initial symptom relief occurs, it probably means that you have just started therapy and feel good about your work, but your work is not yet done. Now the real work starts, which often involves grappling with the underlying issues, such as old fears and traumas. At first this next step may create a little angst; you might feel a bit uncomfortable accepting that is part of the healing. Yes, the painful process starts after the initial symptom relief. Therapy helps you uncover fears, sadness, grief, and trauma that you may have previously ignored. Furthermore, therapy helps you make the connections between patterns and problems, so that you can get to the root or source of the problem and explore new behaviors and beliefs. This has the potential to enrich your experiences.

So, roll up you sleeves, take a deep breath, and know that you are in a safe and supportive environment which will help you address the issues that keep you stuck in old familiar and destructive patterns. You can now begin to make lasting changes that will create a healthier sense of yourself and help your relationships to thrive and be more resilient.

Keep up the good work, because you are not in crisis mode! Continued counseling pertaining to underlying patterns will enable you to avoid continued years of emotional pain. This may be hard work in the short term, but it will be beneficial for many years to come.

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