Fair question. With the disclaimer that I can only speak from my experience and that it may not be representative of everyone who is in therapy/counseling, etc. here’s a run-down of what my weekly therapy sessions are like:
First of all I’m in a therapy program through Upstate Medical University located at the Hutchings Psychiatric Center in Syracuse, NY. There are a number of different programs at Hutchings ranging from outpatient care to inpatient treatment, and frankly, it’s not the most welcoming building in the world. It’s a squat brick building surrounded by probably an eight foot black chain link fence. It has none of the aesthetic charm of the actual hospital facility located on the same campus. The two buildings are separated by a parking garage that usually requires me to park five floors up (though I almost never take the elevator because I figure the walking up/down is good for me).
In many ways it’s like any other doctors office, I check in with a receptionist and then head into the waiting room. The waiting room is a little different. You know how when you go to the doctor you try and guess what’s up with everyone? (“Ooh, I’ll be he’s here for that thing on his face!”) A mental health waiting room is kind of the same but there are usually not external symptoms on display. Other than crying. I don’t know that I’ve ever been in the waiting room there without someone crying. Which is a little unsettling at first but now it’s pretty much routine. Usually if someone’s crying depression plays some role in whatever they’re there for. Oh, and I’ve noticed they keep the lights really low. Like the overhead florescent lights are off and there are two small lamps that keep things just on this side of light. What’s up with that?
Anyway, when I go up and meet with my therapist (Jean) we sit in her office. There’s no couch, I don’t lay down (though one of her colleagues in an office down the hall does have a couch (or rather, chaise lounge)). I haven’t asked if that’s up to the individual therapist or if furniture is assigned on some sort of seniority or first-come basis. We sit in fairly typical office chairs facing each other for our weekly conversations.
About 2/3rds of the time I want to go in and talk about something specific, and sometimes there’s no set agenda or topic of conversation. Usually during our conversation we talk about these things within the context of identifying thought patterns, looking at them on a factual basis and assessing how I react/handle them based on that. We talk about skills and strategies to deal with my anxiety and my depression- for example, if I’m going to a social function, I like to drive myself there, that way I’m not dependent on a ride and I can leave whenever I want. It might seem silly, but I can get consumed by feeling “stuck’ some places and being in control of my transportation goes a long way to alleviate that. So we just discuss these things for about 50 minutes every week.
I don’t really talk about anything like repressed memories, childhood trauma, my relationship with my mother, etc. There are no Rorschach tests. Every fourth session or so I may get my prescription refilled and she’ll record my blood pressure. And that’s pretty much it.
I will say I find it enormously cathartic to be able to talk so openly to someone who, in many ways, is a total stranger. There’s no prior relationship with her or anybody I know (at least I don’t think there is…) so I can be honest with frustrations, disappointments and disagreements with people I know and love without fear of them getting back to those folks. To be able to talk frankly about stuff like drinking and sex, etc. It’s very freeing.
So that’s what therapy is like. I go once a week and engage in productive conversation. I don’t know when I’ll “terminate” or if I’ll eventually cut back to monthly or yearly appointments, etc. But for right now it’s working out well as is.
If you’re considering therapy, I’d encourage you to look at options in your area. If you’ve had other experiences, feel free to leave a comment!