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How Long Will Therapy Take?

It’s not infrequent that when I talk with people new to therapy they ask “How long will therapy take?”  Not an unreasonable question, but almost always an unanswerable one.  

Pete Pearson of the Couples Institute gets credit for one of the best analogies I’ve heard, which is that the question “How long will therapy take?” is a little like asking “How long will it take for me to get wealthy?”  No analogy is perfect (and the answer about therapy is actually much harder!) but consider some of the factors in the wealth question and think about what the parallels might be with therapy:

  • First off, how would you define “wealthy.”  There are some general standards, but each person might have their own idea of what that is for them.
  • How much money do you have to start with?
  • How motivated are you to become wealthy, and what are you willing to contribute in terms of time, effort and discomfort?  (If you hadn’t noticed, this is a big one!)
  • How much knowledge, talent and/or skill do you have in managing or making money?
  • How good are you at saving money?
  • Why would you want to be wealthy – what would that do for you?
  • And so on…

You can see there are lots of variables that feed into answering the question for wealth.  For psychotherapy, there are many more variables (and for couples therapy even more, since there are two people and then the interactions between them).  In therapy, most of the variables are also more fluid, and harder to define than the relatively easy quantification of money.

With all that in mind though, I thought I’d offer a few more analogies to give a feel for some of the other aspects of being in counseling that newcomers might be curious about.  Again, none of these fully captures the therapy experience (not to mention that there are many therapist-client combinations that can produce lots of different kinds of experiences), but hopefully they’ll shed light on some common aspects.

  • Therapy is like a class in that it works best with…
    • regular attendance
    • openness to learning new things
    • study and practice between sessions
  • Like talking with a supportive friend, colleague, or relative, in that…
    • your therapist cares about you and wants the best for you
    • you’ll likely get some different perspectives or suggestions that could be helpful
  • Like exercise, in that…
    • some pain is often required for gain
    • you’ll probably be asked to exercise muscles (skills) you don’t use that often, or in ways you don’t usually use them (going out of your comfort zone)
    • as before, the more you practice/exercise new skills, the better and easier things will get
  • Like meditation, in that…
    • you’re observing your own process (though with the help of the therapist)
    • you can gain perspective or distance from your normal experience
    • it can be frustrating when you drift back into old habits
  • Like making art, in that…
    • searching for understanding can be creative and insights can come “out of the blue”
    • there is often a weaving back and forth between feeling in-control (or having perspective), and feeling less in-control (“stuck in the woods”)
    • sometimes it flows nicely, sometimes it’s a bit of a mess, and sometimes it’s a delightful surprise
  • Like a magic show, in that things aren’t always as they appear, and sometimes a rabbit comes out of a hat!

Perhaps the best analogy is that therapy is a parallel side-road to a self-examined life.  Therapy is a journey, a quest, but not as simple as an itinerary since there are many possible branches and many paths to Rome.  It is certainly understandable that a client would want to know what he or she is getting into, but except for certain types of therapy targeting very specific and circumscribed problems, it would be unrealistic to quote a timeline, especially on the basis of an introductory phone call.  I usually tell people that I can give them a better idea after five or six sessions, though even then it must be a general and provisional.  

It’s also a little like remodeling a house or cooking a meal.  It’s good to have an overall plan, or recipe. The foundation must be sturdy, and the ingredients of good quality.  Sometimes you discover things as you go along that require changes in the plan or the timeline.  And rushing ahead without attention to detail and a full understanding of what you are doing in the moment can result in a shaky structure or an unpalatable meal.   But well thought through and put together it can be a lovely, nourishing project that elevates your life to a more fulfilling level.

Robert Solley

Robert Solley

Robert Solley earned his Ph.D. in 1988 and has been licensed over 20 years. He specializes in couples therapy, has been an associate with the Couples Institute in Menlo Park for over five years, and has an active practice in Noe Valley in San Francisco. He is also part of the Psyched in San Francisco staff of therapists.

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