What is your therapist doing in your therapy sessions?

Ever wonder what your therapist is doing in your therapy sessions? Are they simply listening, are they doodling on their notepad, are they silently judging you?

Self-awareness and regulation

As a therapist, I have found it necessary to be self-aware, not just in the general sense, but also within sessions when therapy is provided. From the beginning through the end of our appointment, I am both actively listening to you, and checking in with myself. This is so I can remain objective and nonjudgmental.

This can involve internally asking myself why I'm asking the questions I'm asking or responding with my responses. I am also bringing awareness of and regulating my own nervous system and emotions. This is all in service of being more open and connected with what you are sharing and what you want for yourself with therapy. And most importantly, providing a therapeutic space where you are more focused and connected with your own internal experiences.

Recalling clinical information

Working in the same field for several years, you tend to accumulate a lot of information. At times during our appointment, something you share can remind me of this clinical information and knowledge. I do my best to only share this when it is useful for you and does not take away from the actual process in therapy. I may make note of it and share it at a later time after reviewing the literature on this information between sessions.

Note-taking

With my notepad, I will jot a few words or sentences that I find notable about what you shared so far to support our exploration in the session. This can be something we are curious about, something that relates to something you have shared before, something different or even contradicting to what you have shared, something that fits into what brings you into therapy and your goals in therapy, or reminders for our next appointment. If I find it relevant for our ongoing work, I transpose information from my handwritten notes into a progress note after our appointment.

Maintaining and building relationship

Lastly, the therapeutic relationship is an important part of the healing process. It affects client level of engagement and participation, and ultimately, progress. The effect of this is even greater with those with complex trauma which is the majority of who I see. Complex trauma usually involves deep, repeated relationship wounding. Relationship wounding can be rejection, neglect, or aggression from important caregivers or support. It's important that I do what I can to help you feel safe and secure in the room such as being mindful of my behaviors and how I carry myself.

So this gives you an idea of what therapists are doing during a therapy appointment. Through time and practice, it can look and feel like just listening.

---