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(Continued) Questions Dr. Waters is commonly asked about how she approaches therapy:

How do you approach therapy?

I am a depth-oriented therapist who is grounded in an object relations approach to therapy, but integrates other approaches such as cognitive behavioral techniques and Gestalt techniques into my work. I very much believe that we are influenced by our past, in particular by the relationships we imprinted on growing up with our primary caregivers. We are neurobiologically wired to learn about relationships, and who we are, in the context of those first relationships. In these early relationships, we form a blueprint of how to be in relationships, how we feel in relationships, and how to behave in relationships. This early learning influences how we feel about our friends, our bosses, our employees, our romantic partners, our children, and of course, ourselves. This, in turn, profoundly impacts how we are functioning and how good we feel in work, school, and in our private lives. In therapy, I help my clients become aware of their blueprint and change it in the ways that will make them happier and more effective in life. 

What is the therapeutic relationship like?

In therapy, we form a unique relationship that is different than those “outside” of therapy. From the outset, it is created to be a very safe and boundaried relationship so that over time it becomes a very close and trusting one. Your therapist is not your friend, parent, or romantic partner, but they can occupy a very caring and special place in your life. It is a relationship that you ‘internalize’ and take with you between sessions, and after you have completed therapy. The therapeutic relationship should be a safe relationship where you can practice healthier ways of being in relationship, and where we can openly talk about how it is going. 

What is the point of therapy? You can’t change the past.

While you can’t change the past, you can re contextualize it by what you learn in therapy; this does change it in a sense. An analogy would be that when you reframe a picture, it can completely change how the picture appears to you. However, in therapy, it goes one step further because the composition of the picture also changes as it is reframed. In addition, the therapeutic relationship should be an impactful and positive one which creates a healthier relationship imprint over the ones you might have grown up with. This also changes how you understand the past. How we see ourselves is not, in fact, static-with or without therapy. Therapy should help you see your ‘Self’ (your internal sense of who you are) more accurately and realistically, which will be a result of seeing yourself from a less fearful perspective, and instead, a more compassionate, complex, and integrated perspective.

Why should I be in therapy? It is a luxury and there are so many people ‘out there’ who are worse than me?

It is true that your pain might be lesser than, or greater than, someone else’s. And yet, using a physical comparison, a broken arm is still a broken arm. People who struggle with getting help with ‘the broken arm’ usually have trouble with self-care, and that affects them negatively in a variety of ways. It is important to have compassion for others, and self-compassion really is the first step towards doing so. We really are responsible for being the stewards of our own health and well-being. After we ‘mind the store’, and take care of our own well-being, happiness, and efficacy in the world, we have more to offer others.

How can I tell if therapy is working?

This is an important thing to talk about in therapy. You are investing time and money into this process, and you want to know that it will work. Therapy is not an instant fix for the problems you are presenting but if we are working together, it is very likely we will be able to change your life in significant and enduring ways.

You should feel, quickly, a sense of initial compatibility and comfort with your therapist. You should also feel supported and a sense of relief that you are not struggling alone with the pain you are experiencing, or the desire for growth or healing with which you are coming to therapy. After that, some of the problems you are bringing to therapy might resolve fairly quickly, and others are likely to take time to resolve. I tell clients to think about how long a problem has been building up, and how far back the roots of the problem go, and then to calculate a reasonable time frame for resolving this problem. My clients and I establish meaningful goals for our work together and, if my client is willing, we rate them at the beginning of our work, during the work, and at the end of our work. It is very exciting and rewarding, at the end of therapy, to look at my clients’ progress with them.

How often will I come to therapy?

I recommend weekly therapy at first and for as long as this frequency is helpful. After a time (the amount of time varies with the individual), it is time to move into meeting every other week. One of the things which is most helpful about weekly therapy is that during the therapy session, you prepare for and plan for change, then you move back into your life and practice these changes, and then return to therapy for support and an analysis of what worked and what didn’t. I tell clients that life becomes the place to practice (the lab) and therapy becomes the place to prepare for practicing (the collaborative classroom in a sense). Change is very doable and very difficult at the same time. Weekly therapy supports a realistic model of change. 

What can I expect in therapy at first?

I will at first concentrate on building trust and building the therapeutic relationship. Also, I will conduct an in-depth Intake, over the course of several sessions, in which I try to deeply understand you, your strengths, and how your problems developed. No two clients are the same and my goal is to ‘get’ you and your ‘blueprint’ so that I can help you understand it, retain and build on what is working, and change the parts of the ‘blueprint’ which are not working. These first few sessions in which I ask many depth oriented questions provides me with a strong start to understanding who you are, helps me begin to be immediately helpful, and provides the groundwork for me to be very helpful moving forward in our work together.

How is couples therapy different than your work with Individuals?

I conduct the in-depth Intake with the couple so that I can get the information I need while I start to help the couple understand each other differently and build empathy for each other. I believe the members of my couples learned how to be in relationship, and who they are in relationship, growing up with their primary caregivers. My job is to help the couple understand their own ‘blueprint’ as well as each other’s ‘blueprint’. Much pain and conflict arises in a relationship when members of the couple behave in ways that are consistent with their ‘blueprint’ but aren’t working. Conflict also occurs when members of the couple are misunderstanding the other member because they interpret each other’s behavior through the lens of the ‘blueprint’ they grew up with. Being a part of a couple can be very painful, or it can be wonderful and healing. Most couples have an initial honeymoon period, after which they need to continue to have fun but also do the work of developing their relationship into a mature, growthful one. Couples therapy helps the couple understand each other differently, resolve conflict more effectively, enjoy and appreciate each other, and to grow together. 

Why should I do pre-marital therapy?

In my experience, my pre-marital couples are always initially startled that I suggest a twenty session commitment. I point out that, if they aren’t finding the work really productive, they can leave earlier. However, my pre-marital couples almost always stay in therapy for the twenty session course, and feel very glad that they did. Investing in in-depth, pre-marital therapy helps couples identify, and more deeply appreciate, all of their strengths, head off potential conflict, and learn how to productively approach conflict so that, when it occurs, it moves the relationship forward. I really love the idea of helping married couples make a strong start so that they head off problems before they can become deeply rooted. As a result, I feel deeply invested in and satisfied by this work.

What about talking about all of this in person?

I most often begin by doing a paid consultation. We are able to just talk during the consultation rather than doing all of the paperwork necessary to starting therapy. During the consultation, I learn about what you need help with, and I can talk with you about how I approach therapy. Since therapy is a significant investment of time, money, and emotional capital, it is important that we make sure we are a good fit. You feeling a sense of ‘fit’ and feeling comfortable with and confident in your therapist, is a big predictor of therapy being successful for you. If I am not ‘your person’ (or best fit), I will work to help you find the therapist who is. I really believe that therapy transforms people’s lives and I feel dedicated to doing this work with you.

Copyright © 2014 Dr. Julie Waters

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