If you are considering starting therapy, you might have read that therapy sessions often take place weekly. There are also different approaches and it has become more common in the past few years for therapists to offer flexible booking systems and less frequent sessions. You might wonder if fortnightly sessions would work just as well? I believe the frequency is an important part of what makes therapy effective, and here are my thoughts about why that is and why psychodynamic therapy involves weekly sessions.
My reasons for sticking to a weekly frequency fall broadly under four categories: continuity, relationship, a reliable space, and depth over quick fixes.
I feel it’s also important to say that I do understand cost-concerns, especially in the current economic climate that makes private therapy feel like a real investment for most and completely out of reach of many. Nonetheless, I strongly believe weekly sessions are most effective and as such, provide the best value for your money in the long term. Depending on where you are in the country, there are also many lower cost services available if the cost of therapy is a concern, and most private therapists also provide some lower cost spaces if paying full fees would genuinely be out of reach.
Continuity
When sessions are spaced too far apart, it’s harder to stay connected to the emotional work. Weekly therapy keeps the thread of the work alive. In this type of therapy, we are focusing not just on the events in your external world, but also your internal world. It isn’t about what happened, it’s about how you felt, what reactions you had, the reflections you have had since. When sessions are frequent, they don’t become just a catch-up of everything that’s happened since the last meeting but there is enough time to really stop and notice how events, interactions and situations affect you and how you respond to them.
Seeing my clients on a regular basis also means I’m working with a relatively small number of clients at a greater frequency, and will hold your story in mind. You might not have considered how many clients a therapist can see if you are used to a full-time working week being up to 40 hours or more in other professions. But therapy is by its very nature intense and requires concentration, and for this reason, most of the ethical membership bodies in the UK have historically recommended we don’t have more than 20-25 client hours in a full-time week. Many therapists choose to work with even fewer people than this.
Relationship
One of the most valuable parts of psychodynamic therapy is the way it pays attention to what happens in the relationship between therapist and client. Meeting weekly allows those relational patterns to emerge and be understood together more easily. Psychodynamic therapy is psychoanalytically based and as such, derived from an approach where frequency is one of the main “tools” that creates the right conditions for the work to be done within the therapeutic relationship.
It also makes it safer to experience ruptures and take relational risks, when you know your therapist is still there for you the week after. You are both committed to the process and you know your next session is in the diary, even during the most difficult periods of therapy when it might feel easier to stay away. These are important experiences that you can take into your other relationships outside of therapy.
This is also a very personalised approach, and as such, requires me to get to know you. That is much easier if we meet on a regular basis and can track your moods, thoughts and feelings over time. And it simply means we end up spending more time together – usually around 40-45 sessions in a calendar year if we are working together longer term (when taking into account planned holidays, inevitable cancellations due to illness and public holidays).
A reliable space
The consistency of meeting at the same time each week helps build safety and trust, which are essential for exploring difficult or vulnerable experiences. Many people who come to therapy are very good at managing on their own without help because they’ve grown up having to learn this at an early age. Having someone you can rely week by week can be a completely new experience and where healing and growth really start to happen. This is often what we are talking about when we talk about therapy being relational or the healing power of the therapeutic relationship.
Knowing you have your weekly slot in your therapist’s diary also gives a sense of safety. You don’t need to compete with their other client’s for spaces or wonder if your therapist wants to see you next week – you already know they have committed to seeing you.
In a more practical way, many people also find it becomes easier to fit your therapy sessions into a busy schedule when you know exactly when they are. Maybe you prefer having a session before or after going to the office, or on a day you usually work from home, or during the weekend.
Depth over quick fixes
Rather than focusing only on symptoms, psychodynamic therapy explores underlying feelings, memories, and unconscious patterns. That kind of exploration needs time and continuity. It’s helpful to be able to track your thoughts and feelings as they emerge. There’s enough time to let things come into your mind – often it’s the thoughts feel “random” or “a tangent” that produce some of the most useful work in therapy.
In psychodynamic therapy, much of the work happens within the relationships – it’s not about homework to take away. That said, the work doesn’t stop between sessions and a weekly frequency also helps you to main momentum. It gives you the chance to try out new ways of being in relationships outside of therapy, and then talk about it again in your next session to learn and understand more about yourself.
Psychodynamic therapy is also about creating space in your own mind to start noticing patterns, thoughts and feelings. One of the helpful learnings from therapy comes from internalising this process. Over time, you’ll notice you are more curious about your thoughts and feelings, and can make sense of your experiences in a way that feels reflective and less overwhelming than before.
Interested in starting therapy? Contact me to find out my current availability for counselling and psychotherapy in Shoreditch, London or online.