What is Therapy Anyway?

I’ve created an in-depth guide for you here which includes shortened versions of the first sections of my Informed Consent document, plus some extra information to peruse when you’re confused or have questions. You can always reach out to me if and when you do, but reading material like this makes all the information I might share easier to reference. Brew your tea! I’ve held no bars in thoroughly explaining some things that people are typically confused about.

General Information

The therapeutic relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This document will provide a clear framework for our work together.
The Therapeutic Process
You have taken a very positive step by deciding to seek therapy. The outcome of your treatment depends largely on your willingness to engage in this process, which may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. There are no miracle cures. I cannot promise that your behavior or circumstance will change. I can promise to support you and do my very best to understand you and repeating patterns, as well as to help you clarify what it is that you want for yourself.

I like to acknowledge the potential difficulty of therapy ahead of time so that whenever it is starting to feel like “work,” or whenever it is bringing up some “stuff” that is difficult for you to be with, we can hopefully find a way to work through those tougher times in a way that is enriching, and ultimately really valuable to you in all of your relationships and in your overall well-being. I like to encourage a culture of transparency in our relationship about these times that may come up in therapy, so that I can support you through those times in the most caring and attuned way possible, and so that we can move all the way through the hard stuff, attain each of your goals for therapy, and give you the very most value for your investment.

There may be times when it feels like there has been an “empathic break” in one of our sessions, i.e., times when I failed to see you in the way you needed to be seen, or to hear you or be with you in the way you needed. I may have even offended you or made you mad. I highly encourage talking about this together, even if it is difficult. This can be great practice for doing this in other relationships in your life if this is an area of difficulty for you in general. I want you to always advocate directly for your needs, though I don’t expect you to always know how to do it perfectly, and I am here to help out with that whenever you need. My promise to you is that I will hear any feedback or any thoughts or feelings you may have about any instance of ‘empathic break’ in our relationship with equanimity, compassion and professionalism. Though I will not always be as perfectly empathic as humanly possible, I do try, and I am committed to constant improvement, in general, and with regards to relating to each individual client. Whatever an empathic break brings up for you is actually really rich and valuable clinical data, for both of us, and it can be so rewarding to process it together. There can be significant relational healing in an event like this alone for someone who, for example, has a difficult time with conflict or with leaning in, moving through it and doing repair in a way that feels positive and supportive.

At some point, you will begin to feel done with therapy. That’s wonderful! That’s the goal. I always encourage a “goodbye”/graduation/termination session so that we can process our work together, reflect on your progress, plan for future obstacles to maintaining that progress, and also so that I can reflect to you genuinely all of the wonderful gifts and charisms that I see in you. Many people have a hard time with goodbyes, or the ending of any kind of relationship. Therapy, at its best, should be a corrective experience, allowing you to have the experience of a positive “goodbye,” or a positive shifting of the frame of a relationship in a way that promotes the highest good of all.
On the other hand, you may begin to feel done because we are not jibing, or for other reasons, such as financial reasons. I also encourage transparency around this, so that no subject is taboo. I am committed to doing whatever I can to connect anyone who ever reaches out to me or comes into my office to support/therapeutic services that make the most sense for them, on a personal and financial level. I am well-versed in sliding scale clinics and options in the Bay Area, and I know a lot of great therapists in San Francisco as well, and I am always happy to provide referrals, whatever the reason is that therapy with me is not feeling right for you or matching your needs (on any level) anymore. Additionally, we could always discuss going down to a temporary sliding scale fee for you within my practice if I have a sliding scale spot available and you would like to stay, but are going through a financial hardship. If, during or after our first session, you felt some kind of empathic break, or you felt we weren’t jibing as people, I always encourage giving it four sessions before making a definite decision, just to feel it out, and especially to see how it feels after processing the empathic break with me. Though your participation in therapy is always 100% voluntary, it is my responsibility to you to do my best to see us through these times when your commitment to your therapeutic goals is flagging, for any number of reasons. It is also my ethical responsibility to ensure I have done everything possible to connect you to whatever support is most appropriate or financially doable for you at any given time if your therapeutic goals are still not met, and especially if you are in crisis or showing up with acute symptoms or difficulties. This is an ethical responsibility that I take very seriously.

More Info About What Therapy Is, What to Expect, and How it Works:

  • Therapy is a process that takes place during and in between weekly sessions, some of which will feel “eventful” and some of which might not. You may not feel noticeably “better” during or at the end of any given therapy session. ear, you may look in the mirror and notice that there is a significant difference.
  • There is no way for me to tell you exactly how long you will need or want to be in therapy. Generally six months to one year is a good amount of time to receive a thorough course of therapy though there are no rules about that and of course, your participation in therapy is always voluntary. You can choose to transition out or transfer to another therapist at any time. My strong encouragement would be that we talk about that openly so that I can help out with any needed or appropriate transition and so that we can have a goodbye session.
  • There is no magic wand with therapy. Ultimately you are doing the work by showing up and doing your best to dig deep and understand yourself at a deeper level. I will, of course, offer support, reflections and guidance. Unless we are doing EMDR or another curriculum based therapy, there is no strict curriculum for the way that I do this. In fact, it’s actually very intuitive, integrative, and individually tailored.
  • The relationship and the weekly rhythm is an important part of the healing factor of therapy. In my approach I take very seriously the fact that the research clearly shows that it doesn’t even matter what type or form of therapy is being used if there is no relationship. It is a relationship of unconditional positive regard, and totally confidential (except for a few exceptions we’ll go over), so it is probably unlike any other relationship you’ve ever had in your life. You can literally tell me anything and it will not be judged and it will stay here.
  • You might come to therapy one day at the bottom of the well of sadness, despair or grief, or even in a state of rage about something or other. There are a couple of things to know about this: The first is that I encourage this. There is no emotional state that renders one “emotionally incapable of participating in therapy”. The second is that you may come to a therapy session one day feeling utterly depressed, and you might not feel much different at the end of the session. Again, there is no magic wand with therapy, and I certainly do not engage in toxic positivity strategies with people who are feeling depressed. One of the most important healing factors of therapy is that you have a place where you can feel some of those huge feelings all the way out and all the way through with a compassionate, non-judgmental witness, and there is some evidence that the nervous system and the body might actually be doing some important purging and releasing when you allow that while in a safe container with a compassionate witness.
  • At some points, therapy may result in some discomfort for you, which is totally normal. My hope would be that we’ve created a relationship that feels safe and comfortable enough that we can push through those moments of discomfort together. (I’m happy to answer any questions about what I am referring to here, but in general, within a good course of psychotherapy, defenses or unconscious material may become more clear to you, which almost always results in some discomfort because the defenses developed as survival adaptations in early life, so of course a part of you is very invested in keeping them, and unconscious material has been shoved into the unconscious precisely because you or someone around you finds or found it unacceptable! The hope is that this aspect of therapy promotes greater self-awareness, a more integrated, authentic and whole sense of self, and all around healthier relating.) These moments certainly should not last long or be the defining feature of therapy. For the most part, therapy should (and does) feel like a comfortable, safe, open, honest and easygoing relationship, and it should feel like a time of replenishment, self-care, ease and flow.
  • Traditional psychotherapy, depth therapy, talk therapy and even EMDR are based on the idea that the psyche has its own healing process and healing ability and we are merely creating a container, guidance, support, and maybe sometimes points of reference for that process. But we trust that whatever you bring to session on a given day is what needs to come in at this time. In other words, we trust the process. And methods of therapy that do trust this process are highly evidence-based not only in terms of short term results, but also in terms of long-term results, unlike some curriculum-based therapies like CBT which only produce short-term results that, according to the research, don’t tend to hold up in the long-term.
    What to expect: Usually after about one year of traditional talk therapy, looking back at where you were when you started will feel like looking at a “before” picture from the day you decided to grow your hair out, for example. The changes may be very gradual, but the cumulative effect may actually be significant or even drastic, depending on how much integrating you have to do, how much you have to become aware of, and based on that awareness, how much you’ll put into action in your life.

How I Work

My approach is intuitive, integrative, eclectic, humanist and individually tailored. What that means is that I have received training in a number of evidence-based therapy modalities, as well as in Jungian dream work techniques, and the integration of oracle cards, astrology, deep imagination, energy work and hypnotherapy in clinical practice. Since I am devoted to lifelong learning, I am continually adding to my toolkit, and I pull from it with each client in an intuitive, deeply present, and individually tailored way. I bring a feminist, social justice lens to the work as well, and I am constantly considering the ways that political and ecological realities are impinging on the mental and emotional wellbeing of the people I work with.

EMDR (currently considered the gold-standard evidence-based therapy for treating trauma, as well as anxiety, depression, and even phobias) often structures the meat-and-potatoes of the deeper work I do with clients, although it doesn’t necessarily always need to. It’s not uncommon for me to weave guided deep imagination processes into the structure of EMDR based on parts work, and getting to know each of the internal parts that we are meeting, or that may be throwing up roadblocks, as we move into deeper work together. I approach each member of your internal community with deep kindness, compassion and acceptance, and I will encourage you to bring the same attitude of kindness, compassion and love to your own internal community. Self-compassion and self-love are highly emphasized in my approach. And as I dive into deeper work you (where all the good stuff is!), whether we are using EMDR or not, my approach is ultimately alchemical in the sense that I hold the firm belief that your shame, self-doubt, old anger and even trauma, can be transmuted into the most precious gold of your being.

EMDR and other deep work approaches (throughout history and cultures) share this alchemical thread. Ultimately, I conceive of the work we do as finding, mapping, even seeing visually the energetic and emotional tangles in the physical, energetic, and emotional body, and then allowing those tangles to open up and release the tremendous energy currently eddying and getting stuck in them. Once that energy is freed up, it can be used in activism, art, or stepping into the life of your dreams with more moxy, vitality, courage and gumption than you thought you had.

Lastly, I don’t do the blank canvas, chat-bot therapist thing. I bring my whole self to the work. Even though I never talk at length about myself or make the session about me (it’s your time!), you will know the real me. There is no act, no performance of anything other than my human self, helping to facilitate and contain your healing. And I hold that healing space with the purest heart of compassion and acceptance of which I am capable. And in my approach, I am transpersonal enough to believe that sometimes, when we least expect it, we enter divine ground. It descends as a grace and can’t be called on at will.

I hope to speak to you if you’re curious or want to know more! Send me an email 🙂

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45 Franklin St. Suite 214
San Francisco, CA 94102

annalise@deeperwelltherapy.com
(949) 533-4651

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