What Even Is Therapy?

You might be wondering, "Okay, you guys are therapists, but what would you say you do here? What even is therapy?" In this transcribed episode of The Shrink Think Podcast, Aaron and Nathan explore that question and chat about what to expect in therapy sessions.

Nathan Hawkins:

Just drop the mic. Yeah, therapy's a place where you go and get help. That's the bottom line. It's just real simple, straightforward.

Aaron Potratz:

Thanks for listening. Just kidding. Keep going.

Nathan Hawkins:

I think out there in this day and age, there's a lot of people that maybe are your friends that are going to therapy and it seems like everybody's doing it. It used to be one of those things where when I first started, I think Jesus was a baby and they had just chiseled out Mount Rushmore. So it feels like back then it was like people would regularly come in and there was a regular nervousness of like, "Oh no, they're going to think I'm crazy." Well, I'm already here, so I guess we know that I'm not. I have one guy said that, "I guess we know that I'm not so." And I'm like, "What?"

Anyway, it was more of the people that were known for going to therapy 20 years ago were people that needed a lot more help. In other words, if you could see somebody and go like, "Wow, they probably need a mental health person to help them out." And that's what was in the mind's eye of everybody that would come in and then that nobody wanted to be labeled like that. Well, over the course of the years, now here we are and a therapist are almost similar to dentists, right? Everybody's got one. "I'm going to check back in with my therapist.”

Aaron Potratz:

And people take mental health days from work and from school all the time.

Nathan Hawkins:

Right. COVID slung shot that a catapult, like everybody's here now. But that also puts this weird pressure out there, I think, in the culture of like when somebody goes, "Oh, my therapist," or "Oh, blah, blah, blah," and you're sitting there thinking, "I don't have a therapist. I don't even know why I would. I don't know what the point of doing that. I feel pretty normal and I thought you were normal until you just said that you go to a therapist," right?

Aaron Potratz:

Right. Yeah. And I think too the other thing that I wanted to speak to in this episode was a lot of people, maybe you've gotten over that hurdle and you're about to go in. It's kind of some of the practical like, "What even happened. What do you do when you're in therapy?" You walk in, you talk to somebody, you walk out and some money was exchanged somewhere. Somehow you're different. You're better. What the heck are you doing in there? And how does talking about your problems or how does just talking with another person even help? And why can't you just talk to a friend or whatever? The question is getting broader as I talk, so maybe I should shut up. But I'll keep it practical in relation to what even happens and why is that even magical for the healing or the transformation process?

Nathan Hawkins:

I mean, the simple thing is is that you picture there's a couch and there's a chair typically, but let's get into that a little bit from a practical standpoint. This might feel like the weeds, but people can be curious, right? So in some rooms you're going to have therapists that are more child therapists, you're going to see a bunch of toys. It will look like a full on playroom. I mean, these therapists, I feel like on their break time, they're in their playing dinosaurs, right?

Aaron Potratz:

Right. It's like I'm paying for babysitting, right?

Nathan Hawkins:

Right. And those guys are doing a lot of work and are usually very underappreciated in the sense that their kid leaves and then they know that this kid's going to go and tell their mom or dad like, "Yeah, we just played.

Aaron Potratz:

Right.

Nathan Hawkins:

"Nothing else happened. I paid that therapist for what?" There's that. Then you've got the setup for some therapists really know that they're only going to see individual clients. They have no intention of ever seeing more than one person. So there's two chairs across from each other, maybe a little coffee table. And then you've got folks that are like, maybe they see couples more often and they've intentionally got a little bit of a larger space. And they also see individuals, but there could be families. So now they've got a chair and a large couch, maybe a three cushion couch. That's for two reasons actually. One could be that couples that they work with oftentimes are contentious and they want to be able to have these people sit next to each other but have space in between. Or two, because they do see more families and they need the room to be able to have these folks in the room.

So actually the room is pretty intentional. There's other situations where you might go in and only be in the room for a little while and then end up going on a walk because you need the outside. Some therapists will use that dealing with anxieties because there is a calming effect to be in nature. And if they happen to have an office that's near a nice forested walk and it's private enough to be okay and you've agreed that that's a fine thing to do and that that's helpful for you, you end up doing a walk. But the idea is that you're putting people in a context that's a safe human to human connection that where you can have some conversation.

Aaron Potratz:

So that's the context. When you walk in, you see this set up, you sit down. I think a lot of people are like, "Okay, so what next? How do we get started? It's a little bit awkward because you're a stranger. We both know I'm going to spill my guts with you. I'm going to share all the most private things with you." And you're expecting that, and then somehow we're going to leave, and then now you know this. For me, and I know for a lot of therapists, it also depends on your personality. I'll ask some questions up front. Usually when in the first session, yeah, we're kind of digging into it. We're getting into some of the details that are going over an intake, asking a lot of questions about what's been going on so that in some sense that's a little bit more intentional.

I found that that structure is pretty helpful to people because when you have something that you're walking through or questions that you're answering, it helps to, I think, bring a little bit more safety to that first session. But beyond that, when you walk in, then it's like, "Okay, you know what my issue is. Now what?" That's where a lot of therapists to do a little bit of chit-chat. It's like get to know you. It's not a waste of time. It can be if it goes on too long or just becomes a little too pointless, but it's a bit of like, "I actually want to get to know you as a person. What are some of the things that we can talk about and connect over that are sort of light, but feel like, 'Ah, okay, this isn't so bad. Let's take the next step from here'." Or at the end of a session, this is the kind of thing that a therapist might circle back around to like, "Oh, well, what does the rest of your week look like?" Or, "Oh, do you have piano lessons next week as well or whatever?"

It gives us something that sort of anchors us together, anchors the session from week to week that we can go back to. Back in the day it would be like, "Did you see that sky today? Talk about blue.”

Nathan Hawkins:

Oh my gosh.

Aaron Potratz:

"Yeah, the weather. It's amazing." Or, "Well, it's been pretty crappy, hasn't it?" Those kinds of things, they're small, but they're also really connecting and they make things feel really safe. And I know this is part of your personality because I know there are some people that really hate the chit-chat. They do not want to do this small talk. And that's totally fine if you want to just sit down and say, "Okay, so here's the deal. I yelled at my mother yesterday and we had a gigantic argument. I don't want to apologize, but I probably should. What do I do?" Okay, if you want to just jump in, that's totally fine as well.

Nathan Hawkins:

Yeah, I had that first when you said that literally say like... I think this was the first time I ever met him. You got to keep in mind, your therapist, me in this case, is also a human trying to understand and also experience the fit of therapy, right?

Aaron Potratz:

Between you and the person?

Nathan Hawkins:

Right.

Aaron Potratz:

Yeah.

Nathan Hawkins:

Right. Like how it's going to feel.

Aaron Potratz:

Right.

Nathan Hawkins:

And I am kind of like, "Hey, so how was the drive? Did you get here? Was it hard to find the place or whatever?" This is a person who in the Portland, Oregon area, there's a lot of folks that are engineers around here, so there's a kind of mindset with those folks, and he goes, "Yeah, I'm not paying you for chit-chat, so can we just get to it?" I was like, "Wow." I didn't say wow. I was like, I said, "Okay." What I did was, and as I looked at his intake and saw that there were several things that were pretty pressing, and he had mentioned how much alcohol he was drinking or something like that, and I said, "Well, can we start with your alcohol problem?" Because in my mind, if you want to be that straightforward, then let's just go, right? Because I've learned that if that's the way that you are, then I'm going to try to meet you where you're at. And if it doesn't work, either one of two things have happened, right?

So he goes, "Yes, that's a great place to start." And I'm like, "Okay, this guy really is legit. This is genuine. We're really doing this.”

Aaron Potratz:

Right. And then that's when you patted your forehead with a towel like…

Nathan Hawkins:

Right.

Aaron Potratz:

Sweating to see if it's paid off, right? No, but I like that you told that story because in those early sessions, you really are as a therapist trying to feel somebody out. You're trying to... Not in the way you might think.

Yeah. You're trying to socially feel somebody out for what kind of person are you? Do you want the chit-chat? Do you want to ease into the problem or do you want to just get right down to it? Because for some folks out there, you might feel like you need to share a little bit about the entire story, the entire context. You need to put everything on the table before you jump in. Or maybe you need to slowly unpack things as time goes on. Or you're like this guy where you want to open your briefcase and just dump it on the table, like, "Here it is," right?

But we as therapists are trying to adjust how we do things and how we navigate the relationship with you. And there's a small variety. It's not like we change our colors and we become a different person, but depending on the person, we can be more talkative or ask more questions and do more listening, be more directive, or let you be more directive. So we're trying to feel that stuff out in terms of how is this going to fit together and is this going to work together.

Nathan Hawkins:

Yeah. That does speak to the fact that there is flexibility with the therapist, right? There is. We can be all things to all people in some circumstances, but there are limits to that. So that's part of getting to know your therapist in the beginning to know like, "Oh, maybe this isn't a good fit because you guys get together" and it just doesn't feel right. That happens. You start therapy and then you think, "Okay, this is not going to work." I've had that happen. I'm thinking how often of... "What do I want to say here?" Almost everybody does that, right? Just kidding.

Aaron Potratz:

Yeah. I think that happened to me once, but tell your story. Pick one of your stories.

Nathan Hawkins:

Yeah, pick one.

Aaron Potratz:

Which one?

Nathan Hawkins:

Yeah. I think it happens when you kind of know yourself and know that this is not going to be a thing. You may not realize this yet as a client, but you're kind of counting on your therapist to do that. You're counting on them to be able to say like, "I can't help you with that.”

Aaron Potratz:

Yeah. It's kind of like you bring your car to the mechanic and maybe the mechanic specializes in brakes, but they might know something about some other part of your car.

Nathan Hawkins:

Aaron just drives his car.

Aaron Potratz:

I just drive the car so don't come to me with your car problems. But it's like if a mechanic says, "Well, I actually work on this part of the engine, not on that part. I know a little bit about it, so I can help over there, but this is going to be really my main focus." That's helpful. That's helpful for you to know, "Okay, well, I'm not going to waste my time talking about this engine noise or if it does this because that's not your specialty.”

Nathan Hawkins:

So in another example, or not an example but circling back to my engineer guy, I can do that. There's other therapists that that would not be a fit. They would immediately be potentially even offended. I mean, it's just a human thing. And the dude did come off harsh. I got to admit, at first I felt trying to tell myself, "Don't be aggressive. Don't be passive-aggressive.”

Aaron Potratz:

Right. Don't take it personally, basically.

Nathan Hawkins:

Yeah, "Don't be defensive. And then light him up." But then I thought, "Well, if he's really like this, I would needed to test it out to see if he was going to get offended" because one of two things were going to happen. Either that's our last therapy session and it was over in 15 minutes.

Aaron Potratz:

Right. Before it ever started.

Nathan Hawkins:

Right. Exactly. Or this is how he is. My personality is not like that at all, but I've learned that it's helpful for me to be in those situations because oftentimes those folks' spouses or partners are not, are more like me because they have a tendency to couple with folks that are more emotionally flexible than they are.

Aaron Potratz:

Like sort of opposite of how they might be.

Nathan Hawkins:

So I'm kind of in that way, for me, bridging a gap. I know that about myself. And so I was like, "Well, take the risk. I don't know how this is going to go." But there's other situations as therapists that we know we don't do some of that stuff. Now, when you're doing your research to find someone and let's say you feel like you found someone, there are a bunch of different kinds of interventions out there that therapists do. It may be that you get in there thinking, "Oh, I heard that I need to do this EMDR thing because my friend told me it was amazing." And then you find somebody that does EMDR, and so you're cool doing that. And you get in there and start talking and you start understanding more of what EMDR is. And then you're not sure how you feel about the therapist, and so then you're like, "Oh, no. It took me this long to find a therapist that does this technique. What am I going to do? This feels super weird."

But you can also just ask that question to say like, "Okay, well, I kind of did come in to see you because I was told EMDR is really cool and I want to do that. How do we do that?" Just asking those types of questions are very helpful.

Aaron Potratz:

Yeah, I love it when people can be that, I guess, aware or direct or honest. That doesn't mean that everybody always knows that that's what they're looking for. I think you had said in the beginning that sometimes people come in and they don't really know what it is exactly they are looking for. They've just got a bunch of things and they're like, "Well, so-and-so goes to therapy. Should I be going to therapy? I've got some issues, but maybe not as much." Or, "Wow, I'm not as bad as so-and-so over there. But I do think it could be helpful." So just being able to bring that stuff to the table and put it out there is incredibly helpful.

One of the questions that I will ask, I'm going to keep moving us along here in what happens in a therapy session. In each session, I will usually start out by letting people talk about their week because life has happened. Sometimes it's like, "Oh, I want to give you some of the context for what's been going on." Some people don't want to do that. Some people just want to say, "Here's something that happened. Let's deal with that. This one specific thing." And I don't know what else happened the rest of that week.

Other people are sort of like, "Okay, this happened and that happened." It might seem innocuous, it might seem like they're just sort of shooting the breeze. But as a therapist, I'm looking for that thread that's running through it. Like, "Why are you telling me this? Why is this significant to you in relation to why you came to therapy in the beginning?" Because usually people are tuned in to whatever that thread is. They just don't know that that is the thread. And so they're saying, "This happened and that happened," but it's very much related to the reason why you came to therapy. And so I'll give people a chance to share about that, and then I will speak to what is that issue or maybe even ask some questions that can highlight, "Is it this issue?" to bring some clarity to it.

In addition to that though, I will usually sometimes instead of just asking that, or maybe even after they've shared a bit about what's going on, I'll ask the question, "What do you need from me today? What do you need from this session? Or what do you need this week?" I like that question because it helps you as a client to think about what's going on in your life and what's going on with this issue, but also to ask yourself, "What is it that I need?" I'm not going to just tell you this and say, "Fix it or tell me what to do." Maybe you don't even need to know what to do. Maybe you don't need guidance or affix. Maybe you just need understanding. You need somebody to look at this and be like, "Isn't this crazy? This is terrible. Can you believe that my brother-in-law did this?" or whatever. Maybe you just need somebody else to see and validate some of the things that you're thinking and feeling.

Sometimes you do need some of that guidance, but asking that question helps you as a client to better know yourself and bring those needs directly to the table so that you can say like this guy, "Yes, let's start with my alcohol problem.”

Nathan Hawkins:

Yeah. One of the other things that I add in to that would be like, "Why now? Why are we doing this? Why is this happening now? Is there any significance to right now?" As therapists, we are really looking, as you were saying, Aaron, to try to tie in that thread. That's not just the thread overall of why, but deeper into how you operate as a human. So we might say something like, "It's true. So right now what you're realizing is you need validation. It's really important for you to just be heard," right? And then we hear that out and then we realize as therapist like you've really never been heard. And then we're able to circle back and kind of help you out. And then that can be a big realization for you to realize like, "Holy mackerel, I have actually never really have." And it can be really kind of a grounding and an epiphany of like, "I really do need this." And that's an okay thing to need.

Aaron Potratz:

Yeah. It's not just like in the moment, like, "Hey, I need you to give me this thing." But like you said, when it can connect to something deeper that has been going on for someone or a deeper rooted issue in their life, it's not just a, "Oh, I need this right now." It's like, "Oh, I really need this," or "I really do need this. Wow. I didn't know how significant that was to me.”

Nathan Hawkins:

The reality is we've talked about in another episode that we can't observe ourselves. We just can't do it. So what's happening in therapy is you are experiencing honest observation because you're experiencing your therapist is going to be try to relate back to you in a safe way that's okay for you to hear what they're experiencing, which probably means there're other people that you're around are experiencing that too.

Aaron Potratz:

Right. And just know that that can be very uncomfortable. We know that. We're trying to give you that feedback as gently, but as directly as possible. But just know that if you are experiencing that, yeah, your therapist is making observations and wanting to reflect things back to you, kind of like a mirror so that you can see yourself not, again, to make you feel bad about yourself so that you can see what's really going on so that you can actually make some progress.

Nathan Hawkins:

It really is one of those things as therapist we really want to be productive and honor what's going on. I mean, there's a lot of times, I don't know how much you've heard this, but especially in the beginning of sessions, meaning early on in the process, like the first two or three, I'll get comments like, "How many sessions do I have to go before you get a new car?”

Aaron Potratz:

Right.

Nathan Hawkins:

Yep. Because that's all I'm doing. Actually, to be honest, in the beginning it was kind of jokey, but after a while I can remember being a little offended by it because it was like, "I'm trying to help you. I'm not doing this. I mean, yes, I need money to live, but that's not what I'm sitting here doing." We really do care about what it is that we're trying to do and it really is actual work. I think that's one thing that maybe you as a person considering this don't totally realize, but maybe your friends have said because it's kind of like a quick kitchy little thing to say like, "In my work, I need to understand more about this, about myself or whatever." But if you think about it, it really is actual work to confront stuff in your life that have become habits that you're realizing at heart and that you are working to not do them simply because you know they're not great. And that's it as far as you know.

So we really appreciate you listening and taking the time to be with us. Have a great day.

Aaron Potratz:

Thanks for listening to our show. Don't forget to head over to Apple Podcasts, Spotify, Stitcher, or wherever you get your podcast to leave us a review and subscribe to our podcast so you never miss an episode.