First Posted on November 21, 2010 by alisonball

I have now been working as a psychotherapist for many years- since 1986. In all that time I have had hundreds of people find their way to my door thinking that what I have to offer may be what they need. Many have gone away after the interview and have never come back again; for whatever reason, I have not made the sort of connection with them that enabled them to stay. Sometimes it may be that I personally am not a good fit for them, perhaps the way I present what I do does not seem right for them, maybe my fees are too high, maybe it is just not the right time in their lives for the sort of work it seems to them that I do. Mostly we never know why someone leaves and does not come back. With some of course, we decide together, on the spot, that someone else may be a better fit for them or for the sort of therapy they are looking for- others we never know.

Why me, why now- is a common question that needs to be asked when someone arrives; and for psychotherapy, the fit is everything. I may not be the right person for them at this time in their lives but I may be down the track- or it can be the other way round. Sometimes we can do some work together but they cannot stay with me to go further. And it may well be that they need something that is just not in my personality to give them. And sometimes it takes a few sessions or a few months or even a year or two before someone feels safe enough to stay and deal with the deepest issues that trouble them. And all the time the issue of whether or not I am right for them may be a subject for discussion between us- or we hope that it is- for this relationship will mirror and reflect relationships in the world.

So over the years I have seen many people for single interviews, a couple of sessions, or for a few weeks or for a few months. Then there are many who I have seen for a year, or two or three- usually weekly- sometimes more often. Hopefully most of them have got what they needed for that time in their lives and for that part of their journey. It may be all the therapy they ever do in their lives or they may sooner or later move onto another therapist- just as many come to me having been with other therapists in the past. There may also be those who have left after that amount of time and have been disappointed with me- they have not got from our work together what they wanted or needed. Some can stay and speak about all that negativity and sometimes we can move forward again together- but sometimes not- feeling so negative can be too much for some so they leave rather than speak about how they feel. Sometimes they are repeating past patterns of behaviour but for whatever reason the time they have spent in therapy with me is finished.

And for a small number- where the fit is right- the work can go on for many years. The deepest work for those who have suffered long term relational trauma, can only be done in the context of a long term, on-going, reliable, robust and often intense relationship. It is easy for outsiders to be cynical about this sort of therapy- equating it to the Woody Allen scenario and scoffing about dependency. It is true that we, as psychotherapists work with dependency. Far better perhaps to be dependent on a psychotherapist for many years and gradually work toward individuation and independence than to have ruined your health with a dependency on alcohol, cigarettes or drugs; or to got through life feeling totally at odds with yourself.

And it is a fact that the issues that some people have to or want to or need to deal with in order to just cope in life- let alone lead a fulfilling life- takes time- often a long time. Some need the sort of relationship they did not have as a child and we have to sort of “re- grow” them through those stages of development that somehow became distorted or damaged for them. Some have never before allowed themselves to be dependent on anyone- their way of coping has been to be super independent so trusting another at all is something they have to learn.

And after all these years of working I live in awe of the few people who have been able to do this sort of work. Perhaps they were so desperate that they felt they had no choice but they did do it. Maybe it was because I myself had to do that level of therapeutic work myself that I appreciate so much the courage of those who do take that path. They have often done so without the help of medication because of early bad experiences when medication was offered as their only alternative. I admire their fighting spirit on behalf of themselves- to find eventually a life of internal freedom- the hard way.