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A Year in Therapy: A Client and Therapist Reflect Together

A Year in Therapy: A Client and Therapist Reflect Together

Have you ever wondered what goes on in therapy? Leigh Matthews and one of her clients: Micheal*, reflect on his past year in treatment. Leigh is the Founder and Director of Therapy in Barcelona and an Australian Registered Psychologist with almost two decades of experience as a therapist.

Let us start, as we do in therapy, with the client experience. Below you will find the therapist’s reflections.


The Client’s Reflections

Micheal’s Past: Social Anxiety, Depression and Low Self-Worth on the Road to Therapy

I’ve struggled with social anxiety since I was a teenager. Whenever I found myself in a social situation, a shot of adrenaline would race through my stomach like an electric current. My heart rate would increase, my palms would become sweaty and I’d become incredibly rigid—often to the point where I couldn’t speak. I felt socially awkward and experienced myself as a burden on the rest of the group, making me feel depressed. I started to make excuses to avoid socializing, and whenever I did mix, my go-to solution was alcohol, loads of alcohol. For the few hours in which its effects lasted, I’d become talkative and disinhibited. However, the next day I’d be bombarded by flashbacks of the night before and something I’d said or done would cause me even greater anxiety.

On occasions when alcohol wasn’t an option, I made excuses to leave the room—use the bathroom, make an important call, get some fresh air—anything to avoid social interaction and the accompanying anxiety.

When I couldn’t leave the room, I had no choice but to use brute force to push my anxiety down in the depths of my stomach and hold it there like sitting on a giant jack-in-the-box. I’d then do my best to put on a brave face and contribute to the conversation as best I could.

All of these techniques had one thing in common: I employed them to avoid feeling the discomfort of anxiety. After years of practice, I became so adept at avoidance that those around me never suspected I had social anxiety. But it eventually became clear to me that avoidance was not the solution.

I didn’t know at the time that my anxiety stemmed from a lack of self-worth and an endless stream of critical thoughts that played like a radio in my mind 24 hours a day. I call it Critical FM. “You’re not good enough,” it would tell me. “Nobody likes you. You’re not interesting. Why can’t you be more like them? You’re not funny. You’re doing it wrong. You’re so stupid. You’re …”

You get the point.

The lockdown exacerbated my anxiety, and I became very depressed. I found myself tuned in to Critical FM day in and day out. Then I decided to give meditation a try. Initially very sceptical, I was pleasantly surprised to find my general anxiety had reduced within a couple of weeks.

I booked myself in for my first therapy session soon after.

Starting therapy was something I’d wanted to do for a long time and although there is a stigma associated with it, this didn’t bother me. My fear was that my therapist may judge me so my main concern was finding a therapist who would understand me. After my first session, I felt accepted and safe enough to reveal things I had never revealed to anyone before. Doing this in a non-judgemental environment was a relief in itself.

Micheal’s Present: The Therapy Journey and Doing the Work

Starting my therapy journey is one of the best life decisions I’ve ever made and if you’re struggling with mental health I would definitely recommend it. You will learn that you don’t have to struggle alone and the tools you acquire will serve you for the rest of your life.

My therapist helped me identify the unhelpful thoughts and stories my mind was telling me. I remember being shocked to discover just how harsh a critic my mind is. It was also a revelation to find out I didn’t have to pay attention to it anymore.

My therapist taught me some tools to help me in my daily life. In particular, I started to use defusion, which helped me create some distance between me and my thoughts. I also learned a technique called expansion, in which one deals with uncomfortable feelings and emotions by simply sitting with, accepting and making space for them. After years of avoiding and fighting my feelings, this seemed counterintuitive and took a lot of practice.

I’ve been doing therapy for just over a year now, and I’m making good progress. But I still have a long way to go, and my progress has not been linear. I have good days and bad days, but the general trend is positive. My social anxiety is significantly reduced, and I have the tools to address it when it shows up. I am now more authentic with friends, acquaintances and colleagues, who respond with greater openness. I care slightly less about the judgement of others, although this still informs many of my thoughts and actions.

A crucial part of my progress has been taking ownership of my therapy journey. Having a good therapist has been invaluable, but just as important is the work I do outside our sessions and implementing the techniques I discuss with my therapist in the real world. I experiment with them throughout the week and see which ones help me most. Here are a few things I have done on my journey so far:

  • Meditation
  • Defusion
  • Expansion
  • Identifying and challenging unhelpful thoughts
  • Positive affirmations
  • Journaling
  • Exposing myself to uncomfortable situations
  • Trying to be present and aware during the day
  • Reading books and watching self-help videos
  • Practising mindful self-compassion
  • Spotting when my mind is being harsh