The first thing my therapist ever said to me was that 90% of the work of therapy would happen outside of these sessions.
My first reaction was outrage: I'm paying you to help me, and you're only going to do 10% of the helping?! Now I look back at such a thought as yet another sign that past-me needed therapy.
I went to therapy wanting to be fixed, and wanting my therapist to do all of the fixing. I thought the world owed me something. I felt low, and believed (perhaps subconsciously) that painting myself as a victim would make things easier. I couldn't have been more wrong.
Over the next month, my therapist refused to give me clear-cut answers or solutions. She refused to take pity on me. Instead, she listened more intently than anyone had ever listened to me before. She held a space for me to sit with my own feelings and inadequacies.
And then she gave me four tasks to focus on between our sessions. Here's what happened.
1. Say 'no' three times and write about how it feels
I have a tendency for people-pleasing, so I knew right away that this would be difficult. Conflict doesn't come naturally to me, and in general I prefer to maintain the harmony of a group than to speak out if something doesn't feel right. It's not a trait I'm particularly proud of.
My therapist assured me that the best way forward was to experiment with having firmer boundaries. My task was to go away and say 'no' three times the next week, and then report back on how it felt.
I said 'no' at work when I already had a lot on my plate. It actually felt quite liberating, although I noticed myself following the 'no' with slightly too much justification. Like when a classmate in school would give three different excuses for why they hadn't done their homework. Then I said 'no' to a weekend trip I didn't want to go on, which initially felt like a wave of relief, until the fear of missing out crept in.
And I said 'no' to meeting a friend after work, which I’d usually do unthinkingly. This 'no' was the hardest. I looked back through my journal from that time, and the aftermath was a series of fraught rhetorical questions: What if they don't want to meet up with me again? Will I become more distant from them? Will they not come to my birthday in a few months? Will anyone come?
When I showed these to my therapist, her eyes lit up. This was a prime case of hypothetical reasoning, she told me, a common cognitive bias, and one we could look at taming in the future.
2. Have a difficult relationship conversation using JADE
Another challenge I had was communication in my relationships. I struggled to clearly and confidently get my point across, and often left a conversation feeling annoyed at myself for skirting around an issue, conditionalizing it, or—even worse—having promised something I didn't mean.
In our second session, my therapist and I explored some of the patterns I was falling into during relationship conversations. She told me about the JADE approach to clear communication. When going into a particularly tricky conversation, she said, I should try to avoid these things: justifying, arguing, defending, and explaining (JADE). The aim of the conversation is to state how you're feeling, ask how the other person is feeling, listen actively, and then try to reach consensus. Falling for the common JADE traps derails this aim.
In my next difficult relationship conversation, I still slipped into JADE. I softened my points by saying 'but' afterwards (defending), along with a few mentions of 'because' (justifying). I ended up in a full-blown argument, one that became quite personal and had strayed from the original issue we began discussing.
When I went back to therapy to share this news, tail in between legs, my therapist reassured me that the main aim wasn't to succeed, but to try. And by doing so, I began to develop a better understanding of my personal boundaries.
3. Look out for slipping into a 'parent' or 'child' ego state
The task in week three came after delving deeper into my communication style when having conversations—especially difficult ones—with people close to me.
We looked at ego states, which are related thoughts, feelings, and behaviors that make up our personality at any given time. The psychiatrists who came up with this model, my therapist explained, proposed that there are three primary states: parent, child, and adult.
The parent state is when you exhibit thoughts, feelings, and behaviors similar to people who played a parental role in your early life. In our parent state, we often have thoughts like “you should do this”, “never forget”, or “under no circumstances.” The child state is when you tend towards behaviors you exhibited as a child, like looking at the floor in silence instead of engaging in conversation, or folding your arms. The adult state is the ideal, as your thoughts and feelings are purely based in the here and now.
The task for this week was to spot instances of the parent or child ego state—either in myself or others—and try to move things to the adult state.
The child state was the easiest to spot, like when I’d promised to finish a presentation, but ended up prioritizing other work. I noticed my body language folding inwards when admitting the presentation wasn't done. I heard myself speaking in short and dismissive phrases like "I don't know what happened" and "I couldn't do it." The irony here is that acting in a child state encourages the other person to inhabit the parent state. Understandably, my colleague began to sound frustrated and impatient.
Moving into an adult state requires voicing your thoughts in a measured way and not jumping to conclusions. Easier said than done. It was like trying to change my technique in tennis: no matter how much my cognitive self wanted it to happen, the behavior just didn't follow.
4. Make big decisions based on enlargement not happiness
The focus of my fourth therapy session soared up from the micro level to the macro—from interactions with another person to life choices and meaning. Basically, I was uncertain where to find meaning in my life, and what I wanted my life to look like in five or ten years' time.
What would genuinely make me happy? Did I want a long-term, monogamous partner? Did I want one career in something I could become deeply accomplished at, or did I want to live a breadth of different working lives?
My therapist put forward a new way to think about big life questions: through the lens of "will this enlarge me or diminish me?" rather than "will this make me happy?"
While happiness feels to me like a slippery and often undefinable term, I felt I could get a much more solid grasp on what enlargement meant. It moved my internal dialogue away from short-term worries. For example, as I debated whether to live abroad for a few months, I thought less about the everyday elements of happiness—my current apartment, my partner and friends, my tennis group—and more about whether the decision would be good for my soul in the long term.
Do you know someone who's struggling with mental health? Read more about how to support a friend who's struggling.
Perhaps the biggest thing I learned, though, was that therapy wouldn't give me the answers. That it wouldn't fix me. Maybe more importantly, being fixed wasn't the point. The point of therapy was to give me a set of tools that I could use on my own, to help navigate to my own answers. Or at least to better questions.
Will is a Partner at mental health startup Spill, and has recently been researching and writing a guide to preventing burnout in startups.