Psychology FAQs | Byron Bay

When you’re looking for a psychologist, it’s normal to have questions before starting.

What’s involved? What should you expect?

Below are answers to common questions about counselling and psychotherapy, and assessment and diagnosis.

Practical questions

How may sessions do I need?
Will you make me talk about my childhood?
Psychotherapy? Counselling? What’s the difference?
To diagnose or not to diagnose?

Therapy approaches

What is Gestalt psychotherapy?
What is ACT?
Why don’t you do EMDR?

Miscellaneous

Why is your logo a black crow?
What is it like to be consciousness?

How many sessions do I need?

Existential psychiatrist Irvin Yalom has written about successful therapy that lasted a single session.

Author Oliver Sacks saw his psychoanalyst twice a week for 49 years.

In my experience, most people can get a useful insight into their thinking and behaviour, and learn a new way of relating to themselves, others, and the world in a few sessions. A few is the same length as a piece of string. But let’s say somewhere between one and ten.

Sometimes it takes much longer to experience the change you want to experience.

The fitness trainer metaphor

Improving emotional and mental fitness is like improving physical fitness. Whether you’re really out of shape, injured, or a top athlete, how often you see a trainer depends on your goals, your eagerness for results, your willingness to train at home alone, and your financial priorities.

A practical solution

If finances aren’t an issue, plan for eight sessions. Once a week for four weeks, then fortnightly for two months. That gives you three months of solid engagement, and at the end of that you can decide whether or not to do more.

If finances are an issue, work out how many sessions you can afford and state that up front. A skilled therapist who knows they only have you for three sessions can focus the therapy so that you get something useful from it.

Will you make me talk about my childhood?

Your childhood is not my primary interest. My primary interest is you. The person you are right here, right now.

The menu metaphor

I’m like a restaurant maître d'. Let’s say you’re not interested in vegetables. Well, the menu does have vegetables on it. And many other dishes. I don’t tell you what to eat. As far as I’m concerned, they’re all excellent dishes. (I’m not the sort of maître d' who puts non-excellent dishes on the menu!) I chat with you casually, and no matter which dish you choose, I say “Excellent choice!”

The poisoned arrow metaphor

The Buddha told the story of a man who’d been shot by a poisoned arrow. A doctor was at hand, but instead of removing the arrow and teaching the man how to care for the wound, she stood back and acted like a detective. “Who shot the arrow?” she wanted to know. “Why did they do it?”

It may be that back in your childhood, you were shot by a poisoned arrow. The wound hurts. The protruding arrow gets between you and others. So now you’re thinking to go to a psychotherapist. The last thing you need a detective-therapist asking a bunch of questions about your childhood. You need a doctor-therapist who can remove the arrow and teach you how to care for the wound.

That said, poison wounds can cause derangement. They’re painful, and when the pain flares up, we can hallucinate that people are shooting arrows at us right now.

Because of this, wound care does involve some detective work. We need to ask ourselves, “This experience I’m having right now of being shot at—when was the first time someone shot me? Who was that person? Did anyone come to my aid? What did I have to do to survive that situation?”

When we have the answers to these questions, we’re able to realise that we might be hallucinating. We’re able to attribute our pain to its proper cause in the past. Then we’re better able to see the people who are here with us right now. Instead of defending ourselves against a hallucination, we’re able to tend to the wound.

Psychotherapy? Counselling? What’s the difference?

He says tomahto. She says tomayto.
I use the terms interchangeably.
For some people …

counselling
means short-term therapy
that focuses on teaching you a skill
or giving advice
or just giving you some empathic support

and

psychotherapy
means long-term therapy
that is less structured than counselling
and involves working on a deeper level than counselling.

But is this a real distinction?
The distinction makes sense to me
and it breaks down in practice really quickly.
I don’t think there’s any value in getting hung up on it.
So I tend to use the terms interchangeably.

To diagnose or not to diagnose?

That is a tricky question.

An accurate diagnosis can be very helpful. For example, my wife has a certain look on her face. Does she have indigestion? Or is she upset with something I’ve done or not done? Think quick, Christopher, and get it right!

Sometimes, a diagnosis can be harmful. For example, my wife once again has a certain look on her face. I diagnose her with frustration disorder. The diagnosis is accurate. (Just trust me on this. I’ve made up this disorder, I know the criteria, and she meets the criteria.) This accurate diagnosis serves no useful purpose. In fact, it prevents me from relating to my wife in a productive way. Blinded by the diagnosis, I’m now less inclined to explore the nuance of her thoughts and feelings, and to explore the subtlety and detail of what’s giving rise to her thoughts and feelings. I don’t need to do any of that, because I already have the answer. Why is she frustrated? Because she has frustration disorder. I no longer see her as a normally functioning, rich and complex person. I’ve reduced her to a mental health condition.

A mental health diagnosis can be genuinely helpful. It can get you access to life-changing medication, funding, and services. It can explain years of confusion in a single sentence. That can be an enormous relief.

But a mental health diagnosis can also be harmful. Labels are sticky, and they tend to stick. A diagnosis can change the way you see yourself, and how others see you. It can reduce a rich, complex person to a condition. It can shut down curiosity about what's really going on.

If you’re thinking about being assessed for a mental health diagnosis, ask yourself these two questions:

How will this diagnosis be helpful?

Will it get me something I need? Medication, NDIS access, a clearer treatment path? Will it give me information I can act on?

How might this diagnosis get in the way?

Could it prevent me from engaging with my problem in a productive way? Could it become an explanation that stops me from exploring further?

These aren’t easy questions. If you’re asking them, feel free to talk about them with me.

What is Gestalt psychotherapy?

A line drawing of a woman with her head resting on her hand, facing away.

A gestalt is a figure that emerges against a background. For example, what do you see in the above image? A young woman looking away? An old woman looking down to the left? If you only saw one of these women, take your time and allow your attention to settle on the image. Eventually, the lines in the image will spontaneously rearrange themselves and you’ll see the other woman. Each woman is a new gestalt.

Gestalt psychotherapy teaches you to engage with life in a similar way to how you engaged with the above image. The therapist supports you to slow down and observe—your thoughts, your body, others, the world. The therapist doesn’t need to tell you what to see. The therapist is curious about what you do see, and trusts that what you see will spontaneously change, that the landscape of your life will spontaneously rearrange itself into a new gestalt.

Gestalt psychotherapy is inspired by Taoist philosophy. Both encourage us to be present with what is, even when—especially when—we don’t like what is. When we resist what is, we brace against ourselves, others, and the world. We become rigid, and this rigidity makes us depressed, dissociated, manic, the whole rainbow of madness. But when we open to what is, we discover, to our great surprise, a sense of ease, of free-flowing energy and connection.

Being present with what is can be difficult to do. It requires support. That’s why Gestalt therapists exist.

I thought Gestalt therapy was that thing where you talk to an empty chair.

Gestalt therapy did invent the famous empty-chair exercise. It’s a great exercise, but it’s just an exercise. What makes Gestalt therapy Gestalt therapy is not its many interesting exercises, but the philosophy from which the exercises emerge.

Gestalt psychotherapy is inspired by Taoist philosophy? What’s that?

On the website for my translation of the Taoist philosopher Chuang Tzu, I discuss Taoism here.

What is ACT?

ACT (acceptance and commitment therapy) is a simple, useful framework that teaches you to:

  1. Identify what you would be doing if you were living the life you want to live.

  2. Observe and tolerate what you are thinking and feeling in this very moment. (This is the acceptance part of acceptance and commitment therapy.)

  3. Notice when your thoughts and feelings are pushing you to act in ways that are different to what you would now do if you were living the life you want to live.

  4. Resist that urge. Take a moment to calm yourself. And now, do the thing you would do if you were living the life you want to live. Do it even though you don’t feel like doing it. (This is the commitment part of acceptance and commitment therapy.)

ACT complements Gestalt psychotherapy. Both teach similar skills. Awareness of thoughts, feelings, and values. Acceptance of thoughts and feelings. Being calmly present with thoughts and feelings. Allowing your attention to alight on your values, what you care about. Supporting yourself to move in the direction of what you value, what you care about

Why don’t you do EMDR?

EMDR (eye movement desensitisation and reprocessing) is hands down the post popular therapy for trauma. The World Health Organisation, the Australian Psychological Society, and other prestigious bodies list it as a top tier evidence-based treatment. At dinner parties, in waiting rooms, in client review meetings, when the issue of trauma comes up, EMDR is the treatment that my friends, patients, and colleagues gush about.

Here’s a fable that gives me pause.

Forty years ago, a therapist put on a purple hat while doing conventional therapy. She wasn’t very good at science, so she made up a theory that the purple hat displaces the light spectrum, which causes the trauma spectrum in the brain to displace and realign. She trade-marked this purple hat therapy, claimed that it cured all trauma in a single session, and aggressively marketed it as a new miracle therapy. The theory was pseudoscientific nonsense, the claims about its effectiveness were breathtakingly false, but the purple hat was a memorable image, and the idea of light spectrums realigning trauma spectrums sounded sciency and cool, so therapists and the public latched onto it. To the killjoys who pointed out the nonsense and unethical conduct, defenders responded, “But look, the therapy works!” The killjoys pointed out, “Well, to the extent that it does work, it only works as well as conventional therapy. That isn’t surprising, because the purple hat therapists also use conventional therapy techniques. The purple hat is irrelevant. If anything, all the hullabaloo about the purple hat distracts people from doing what does work.” The killjoys then discovered to their amazement that no one likes a killjoy, but everyone loves a purple hat!

I ask myself, was EMDR founded by people who didn’t understand or respect the scientific method, and who used aggressive, unethical marketing techniques? The evidence says, yes. For the details, read Herbert et. al. (2000) and Rosen (2023).

Are EMDR’s eye movements (EM), Mesmer-like finger-waving, and reprocessing (R) theory like the purple hat? The evidence says, yes. For the details, read Rosen & Davison (2003).

So, if finger-waving doesn’t fix trauma, what does?

Exposure therapy. A therapist who supports you, gently and gradually, to tolerate being present with the sensations and thoughts associated with the trauma. Which therapists do that? Any competent psychotherapist.

But wait! If EMDR is a purple hat therapy, why is it endorsed by so many prestigious institutions?

Amazingly, the criteria these institutions use to endorse a psychological therapy are completely blind to whether or not the therapy is a purple hat therapy (see Rosen & Davison, 2003). If you’re thinking, “No, that can’t possibly be right,” I can only say that you are having a very healthy response.

Why is your logo a black crow?

In mythological storytelling, crows are one of the trickster animals. My family name is Tricker. I really didn’t have much choice.

In one Aboriginal Dreamtime story, Crow, who was at this time white, used trickery to steal fire from the seven sisters who held the secret. The sisters lived by a river and each kept a hot coal on the end of her fire stick. In the process of stealing the coals, Crow caused a bush fire. The smoke and ash turned him black and gave him a course voice, while the seven sisters were whooshed up into the night sky. When everything had settled, the seven sisters were settled in the night sky, where they remain to this day. You can see their fire sticks twinkling as the Seven Sisters constellation (the Pleiades). And Crow now had coals for cooking worms. Psychotherapy can be like this. A protective part of us guards the hot coals. A bold, curious part tricks the protective part and gets hold of the coals, which aren’t just dangerous, but useful. In the process, we are changed. The too-hot-to-handle coals become safe, like stars in the night sky. The fire thief develops character and is now able to transform flavourless things into things rich with flavour.

In one of my favourite Beatles songs, the Singer sings to a blackbird singing in the dead of night:

Blackbird singing in the dead of night
Take these broken wings and learn to fly
All your life
You were only waiting for this moment to arise.

What is it like to be consciousness?

I’m glad you asked. I’ve submitted my answer to the International Journal of Transpersonal Studies. If they publish it, I’ll put a link here. If they don’t publish it, I’ll practice emotional regulation skills.

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