“But what should I do?”
It doesn’t happen often, but once in awhile, I will meet with a client who asks me some variation of the above. The thing that is most challenging (to me) about clients who directly ask what they should do is that they are usually those who are experiencing the most pain and confusion. It makes sense that people who are struggling, hurting, or experiencing despair would want someone to tell them what to do to make it stop. And, often, I would like to help them make it stop too, so there is a strong pull to give an answer.
But giving advice is not psychotherapy. Therapy is a place to explore your feelings and learn about yourself. It’s a place of self-discovery. It’s a place to find out how you have become tangled up and a place to learn how to untangle yourself. It’s a place to gain a better understanding of your inner world and your relationships. This process is what people come into therapy to learn. It’s what mental health professionals go to school to learn how to provide. Sometimes it takes time and reflection to see the patterns and it isn’t a quick fix, as much as both therapist and client sometimes wish it were. Sometimes just acknowledging and sitting with that pain, confusion, and wish for an immediate answer is the best thing we can do.
This does not mean that I withhold information from clients when I think it might be helpful. If I notice a theme or have some concern that a client may not be acting in their best interest, I speak up. It also doesn’t mean that I am non-directive. There are times when I get very directive with clients. I integrate cognitive-behavioral interventions in my work and I tend to use them when people need symptomatic relief or when people are trying to break habits. At the most extreme that can happen when someone is in danger and I need to get them into the hospital or go over a safety plan with them. In these cases, we may make a list of people to call and things to do when they are feeling actively suicidal.
Less extreme versions of my being directive may include encouraging a client to make an appointment with a psychiatrist. Or I may develop a plan for a client to do breathing or relaxation exercises when she or he is anxious or call a friend to go to the gym when depressed. With my couples, I often prescribe “homework,” which includes communication exercises or plans to notice positive aspects of one another or the relationship. In my dissertation support group, I will sometimes make suggestions to counteract procrastination.
But these are specific treatment approaches to specific problems and not the same thing as telling a client what to do with major life decisions. If you want a therapist to tell you what to do, as opposed to helping you figure out what is right for you, it could be worth thinking twice about what you’re seeking. Some people want others to tell them what to do because it means not having to take responsibility if things don’t work out. Friends and counselors can give you advice. But if what you are looking for is just someone to give advice or tell you the things that have worked for them, it may not be psychotherapy that you’re looking for. Conversely, if you are going to therapy and you find that your therapist fills the time with advice, suggestions, or anecdotes about their life, it could indicate that they have some discomfort with allowing the therapeutic process to unfold. Be aware that you can find someone else who creates the space for your process of becoming conscious and finding the answers that are right for you.