What is My Therapist Thinking About in Session?
People may wonder - what goes on inside a therapist’s head during a session with their client? The answer will always be, “a lot more than meets the eye”, and a good therapist wants it to be this way. Sitting with another human through their pain is incredibly profound and multifaceted - a true honor. It involves checking one’s own biases, believing in what you are doing, modeling boundaries and honest communication, and being a genuinely empathetic soul. As a therapist, you are the instrument used to help heal, and how you show up in the room is incredibly important. Moreover, it will change based on the client in front of you and what their particular needs are at a given moment.
Facilitating group therapy takes all of this even a step further. Typically, a therapist’s “client” is categorized as an individual, but in this setting, the group as a whole becomes the client. Each member is unique, and how they interact with one another is a micro of the macro - a mirroring of each person’s life and experiences. The therapist must have a presence and agenda, yet remain flexible to shifting priorities. They read the room and stay aware of nonverbal communication, give feedback at appropriate times, and acknowledge conflict as it comes up - knowing when to interject or when to let dynamics play out, and when unfinished business from previous sessions must be addressed. All of this provides members with real-time opportunities to work through old patterns of behavior and develop new relationships. Therapists also help set guidelines and goals for the group, such as learning to express one’s emotions more efficiently or highlighting the importance of confidentiality. As with individual psychotherapy, anything disclosed in the group must stay there, and all members have the right to confidentiality. Without this promise of safety, there can be no trust built, and without trust how can members open up and talk about what is going on for them? It is not only on the therapist to make this commitment, and must be a collaborative effort consistently maintained by all members of the group.
A fellow passenger on your journey, the therapist is right beside you, but cannot do the work for you.
As with therapy in general, group facilitators are not in the business of “advice-giving”. Instead, they work with “relationships” - holding the energy of a room, providing compassion for a person’s struggle, and guiding members to their own answers. To do so, they will actively listen, restate, clarify, question, encourage, validate, reflect, empathize and problem solve if action steps are needed. They often focus on the here and now, and may disclose their own reactions when carefully determined it would be helpful to provide feedback. They guide members as they learn that their relationships in the group reflect their relationships in the real world and that only within relationships can true change be cultivated.
Therapists themselves are human, and will undoubtedly be impacted by the work that they do. In an effort to best show up for their clients, it is important that they take good care of themselves in their personal time, as well as engage in consultation with other clinicians. Many therapists are in therapy themselves, demonstrating to clients that they too can benefit from therapeutic services and an empathetic space to share. Knowing what it’s like to sit in the client seat themselves helps therapists remain aware of the importance of openness and fluidity in molding treatment around client goals. In the case of a group, this includes not only individual member needs, but also those of the ever-shifting environment as a whole.
Each therapist is different, just like every client.
No session will look the same, and what one gets out of the experience is directly correlated to the effort they put in.