Common themes in therapy – a psychologist’s reflection

Working as a psychologist means that I get to meet so many people every day – each with their unique stories, personalities, needs, and challenges. One of the greatest privileges of my work is to get to know each individual and sit with them as they navigate their lives.

Despite the vast differences between everyone, being in hundreds of sessions also highlights just how unifying the human experience is. In their own ways, my clients often find themselves facing similar barriers and difficulties, and as a therapist I sometimes find myself helping them understand these similar patterns.
Below are just some themes that commonly pop up in therapy, and how I like to help clients understand and link it to their lives:

Core psychological needs
When first presented with the idea, many clients have a knee-jerk reaction to resist talking about how their childhood impacts their current lives. I get it – it can seem irrelevant, a bit Freudian and blame-your-mother, or even too vulnerable. Yet, looking to these formative years are integral for at least one main reason – to understand the story of how our internal processing and coping systems have developed.

As humans we have three core psychological needs – safety,  connectedness, and control/mastery. We are wired, from the moment we are born, to figure out how to have these needs met. Depending on our early environments, the responses and capacity of our caregivers, and the consequences of our own responses, we start to develop frameworks of operating that give us the best chance to feel safe, connected and in control.

When you look back at your life, what do you notice about these needs?
How were they met/not met? What did you learn about how to get them
met?

In all likelihood, these systems that you learnt early on are still at play. Through building insight about the past, we can come to learn how you respond to the world in the present, and possibly the ways in which these are no longer sustainable or effective for you.

Emotional avoidance vs acceptance
Of all the terms that come up in my sessions, “avoidance” is probably one that I repeat the most in a day. Being in distress sucks, and the human brain can be very creative in coming up with ways to get around needing to feel those most vulnerable feelings. It can deem certain feelings, sensations or situations as unacceptable/threatening and form elaborate mechanisms of never having to be faced with those feelings.
However, this results in life becoming smaller and smaller. There is less we can do without being confronted with the very things we seek to avoid – it seems that despite all the effort the anxiety is just getting worse! This is because through avoidance we inadvertently give more power to those feelings in our lives – our decisions are no longer driven by what we truly want and value, but by how we can get around sitting with these vulnerable emotions/thoughts.

On the other hand, hard as it may be, making space for these feelings is integral to taking away their power. I will not pretend this is easy or quick to do, and the truth is we all need to come back to this skill multiple times in our life, but the more we practice it I PROMISE the easier it gets.

Acceptance of feelings/thoughts that we wish weren’t there – maybe because they are uncomfortable or bring up pain and shame – is an active process that takes effort. It is confronting to allow ourselves to feel things we think we shouldn’t feel. Learning acceptance can be draining, but this means it is working.

Self-compassion and the authentic self
When my clients start to exhibit compassion for themselves and begin living life as authentically as they can, it is important to draw attention to these wins and celebrate them! Unfortunately, we don’t all get taught how to be compassionate to ourselves. The first time clients hear about it, they often think it means showering ourselves with false praise and indulgence. This is far from what true self-compassion looks like. Rather, I introduce self-compassion as drawing on the authentic self – the one that can hold, listen to, and navigate the various parts of ourselves. Self-compassion allows us to acknowledge what is TRULY going on for us, make space for this, and eventually give ourselves the permission to do what will meet our needs
at the time.
It is not always easy or comfortable to be self-compassionate, especially if we have relied on the critical bully inside us to always get us where we want to go. Like acceptance, this is something we can learn and re-learn across a lifetime, but it is worth it to keep trying as it brings us closer to living as the people we authentically are.