Awareness, Acceptance, and Action: A Map for Therapy

So You've Decided To Start (Or Restart) Therapy...

The process of starting or restarting therapy can feel daunting. Connecting with a therapist may have been on your mind for weeks or months, but you felt unsure how to begin. If you've made it far enough to be reading this post, you're to be commended. You've recognized that there's an issue you want support around addressing. That might have required overcoming denial, minimizing the extent of the problem, or believing that you can "handle it" or "figure it out" on your own. 

Once you've surmounted those hurdles, you're still faced with finding the humility to ask for help and acknowledging that you deserve it. This part of the journey is reflected well by the saying, "You alone can do it, but you cannot do it alone". We're the only one responsible for the actions we take and yet we all need and deserve support. Only when the initial decision to allow yourself to be supported is made can the resources for change be accessed. Even if you enter into therapy for someone else - a partner, your child, an employer - unless your motivation becomes intrinsic and centered on your own desire for change, it will be difficult for the support to create lasting impacts. 

Often the recognition of the need for support precedes the realization that you deserve it - we all do. It is not a reflection of a failing or an inadequacy on your part - it is an acknowledgement of your humanity. One of the most common reasons people seek out therapy is that they feel inadequate in some way. While the ways this shows up in a person's life may vary, the commonality is striking as it reflects the challenges of navigating the complexities of life and all it evokes.

Now What?

You've become aware of the issues you're facing. You've accepted the need for help. Now, the action phase begins. You start the process of looking for support. This often takes the form of a Google search of the issues you're facing, like "anxiety", "addiction", "depression", "grief", "relationship conflict", or a broader search of "therapists in my area". It can feel like trying to find a needle in a haystack. Many questions may come to mind: "what type of therapy should I get?", "how do I know if a therapist is any good?", and "can I afford this?"

If you're lucky, you may know someone who can recommend a good therapist that they've gone to themselves or that they know secondhand. While this helps you to narrow it down some potential candidates, the ultimate test of the rightness of the fit often requires an initial consultation. The number one factor in the outcome of any therapy is the relationship with your therapist. This therapeutic alliance is based in three areas:

1) The bond between the therapist and the client: important core factors would include a sense of trust, safety, empathy, and mutual respect

2) Agreement on goals: a belief that there is a collaborative understanding of what you want to achieve from engaging in therapy

3) Agreement on tasks: a joint development of a map for how to reach the outcomes you desire

Other important considerations are the therapist's experience, way of communicating, professionalism, and level of engagement. 

The Importance of Relationships

Ultimately, the difficulties that bring people to therapy are rooted in relational wounds. This can take the form of your relationship with others, your relationship with yourself, and/or your relationship with the world. For healing to occur, the relationship with your therapist needs to support the creation of a space to explore your hurts and your hopes. The safety this affords gives you the opportunity to try out new ways of relating in the session, both to yourself and another person. As you do so, you challenge old narratives about how you are or should be while opening up new possibilities for the future that are more aligned with your needs and values. 

The only way to get a sense of whether a therapist can offer you these things is to meet with them. Many offer free initial consults where you can express what you're looking for, learn more about them and their approach, and ask any questions you may have. While there is no standard template for making a decision about which therapist to choose, it is important to trust your gut. 

Some people may place their focus on the type of therapy that is best for them. Just know that this accounts for approximately 15% of the outcome of the therapy - a component, but by no means the most important one. Others look for credentials and training - again, this can be an indicator of dedication, investment, and professionalism, but does not necessarily reflect how this translates into a session or whether they're the right person for you. 

Key questions to ask yourself after a consultation may include:

1) How did I feel with this person? Safe, heard, understood, comfortable, respected?

2) Have they worked with other people on the issues I'm facing?

3) Does their approach align with how I want to go about seeking the outcomes I desire?

While some people may come to therapy hoping that the therapist can do something to them to help them to heal, the process is much more about working together to understand the issue; clarify needs and desires; develop solutions; and experiment with new ways of being. You can ask yourself: is this someone I would want to collaborate with on this work?

You've Found Your Therapist

Let's just stop for a moment to appreciate and validate how much has gone into this process: the recognition of the issue, the willingness to seek help, the efforts to search for it, the time to meet with one or more therapists, the process of reflecting on who offers the best fit, and the commitment to attend an initial session. Some would say the work has not even begun yet, but there has clearly been an investment in the foundations of change. 

However, it only makes sense that a first session will feel new and uncertain. Common thoughts can include, "where do I begin?", "what's this going to look like?", and "can I heal this pain?" While there is no one way that therapy unfolds, a general map of the process can help to build understanding, willingness, and commitment. Maps are a useful metaphor for therapy as they reflect the idea of a general terrain that can provide orientation while not prescribing one route. They can evoke an interest in exploration, a wider perspective, and a realization of alternative possibilities.  

A helpful map for understanding the process of addressing core wounds in therapy can be found in the 3 A's: Awareness, Acceptance, and Action.

Awareness

It’s natural to look away from some of our greatest hurts. It was painful enough the first time, so why revisit it? However, our experiences remain with us and alter us whether or not we give them our conscious attention. They colour our worldview, bias our interpretations, and live as an undercurrent in our present. They may reveal themselves in the actions we take and those we avoid. Unless we create spaces for reflection to explore our experiences, thoughts, feelings, and beliefs, they may carry us unknowingly along paths that don't serve us and result in dissatisfaction and confusion.

When we allow ourselves to become aware of parts of our lives we’d rather forget or ignore, we can begin to work with what we find. Instead of staying solidified, our experience becomes malleable when we become willing to explore it and the options available for responding rather than reacting to life begin to expand. Therapy sessions can offer a rich setting for developing your awareness of yourself and the stories you're living out. 

So often, the person who needs to hear those stories the most isn't the therapist - it's you! By speaking aloud what has previously remained outside your awareness or not been allowed to be spoken, you form a deepened relationship with yourself. The ultimate goal of therapy is to help you to develop this capacity to hear and see yourself more clearly so that when the sessions end, which they inevitably will at some point, your process of growth can continue. 

Acceptance 

Unfortunately, awareness can be fleeting. Long-term habits, the pain of remembering, or the general busyness of life, can result in insights being tuck back out of sight. Or people stay stuck in awareness through their difficulties in accepting the past. We can wallow in it (“It’s so awful it happened”), we can rail against it (“It never should have happened”), or we can engage in wishful thinking (“If only it didn’t happen, then I…”). Each of these reactions allow the past to maintain its’ power in the present. By accepting what we've discovered, we can transform feelings of anger, sadness, grief, and pain by inviting the light of compassion to shine brighter. 

The past happened. It affected us. It changed us. Much of this happened unconsciously. But now we have the opportunity to change our relationship to it by combining awareness and acceptance. Mind you, acceptance does not mean saying it was ok, it should have happened, we deserved it, or any other interpretation that justifies another’s wrong or minimizes our own pain. It’s simply the acceptance that what happened did in fact occur. 

This acknowledgement alone reminds us that the circumstances took place in the past and are not happening now. Who of us has not wished we could change some aspect of the past? Unfortunately, entertaining this desire is ultimately disempowering as we lack the ability to move backward in time. We regain our power through awareness of what is; acceptance of what was; and commitment to what could be. We can’t change what happened but we can change how we understand it and how we respond to it in the present. In the end, it is our actions in the present that create our future.

Action

Once awareness and acceptance have been cultivated, whole new ways of responding may begin to open up as you become more determined to reclaim your present. What has happened was difficult enough, but its’ legacy may have created greater harm. You begin to foster a desire to take back the way you view and define yourself, others, and the world. The most effective means of changing your thoughts and beliefs is to change your actions.

So you make a beginning, wherever and however you can. Therapy sessions can help you to consider new ways of being in the world and then practice them between sessions so you can bring back what you discovered and experienced. Remember: there are 168 hours in a week and most people meet with their therapist for one of those hours. It is much more important what you do between sessions than what you do in them. Sessions can help foster insights, process emotions, and clarify needs, but it's the actions that happen outside of them that create lasting change. Without the follow through outside of the therapy hour, sessions can be limited to an intellectual exercise. 

In the beginning, new actions may feel awkward or uncomfortable, but eventually become freeing and empowering. Much of what keeps people stuck is the repetition of patterns of behavior that create limited possibilities or sustain self-fulfilling prophecies. The realization that you have other choices available to you; that only you can make them; and that life could be different creates a momentum for change.

The past cannot be erased but it can be transformed. When we choose to become more aware, accept the past, and start to take conscious actions in the present, we also change our future.

Circular, Not Linear

This map for how therapy works and your role in it does not unfold in a linear way. You may initially focus on cultivating awareness and struggle to come to a place of acceptance. Rather than acceptance being cultivated in session through an emotional processing, you may break through by taking an action outside of it. That action itself may create a new awareness that in turn changes your view of the past. These three steps (Awareness, Acceptance, and Action) do not occur neatly or separately, but they are each indispensable aspects of how change occurs. 

The path through therapy cannot be predicted or controlled. It is an invitation to show up with open-mindedness; a willingness to be vulnerable; to make an investment in yourself;  acknowledge your worth; and build your belief in the possibility of deeper healing and more fulfilling living.