Psychotherapy can last 2 weeks or 10 years. The psychotherapeutic process (with or without a therapist ) should go on the entirety of one's life. (Most people do not want to do 10 years of psychotherapy and most people need 10 years of psychotherapy.)
Some people just want some symptom reduction or problems solved so they can get back to where they were or want to be. That is OK. Some people want to grow and develop as far as possible. They want to heal all the wounds they can. They want all of themselves functioning at the highest level. (There's never a point at which you have arrived and cannot develop and grow further.)
That does not mean that you need a therapist at all times. The therapist does serve as a catalyst to reinstate self-healing and self-regulation, serves the function of being a witness to what needs to be witnessed, serves as a pair of eyes to help you see blind spots (and we all have lots and lots of blind spots), serves as a surgical blade to cut through what needs to be cut through, serves as a parent when you need re-parenting, serves as an educator when you need educating, a supporter and cheerleader when you need support, and a skillful frustrater when you resort to manipulation.
We come to therapy because we are discontented and/or because we want to grow. We want to alleviate painful things in our lives. Pure symptom reduction can, however, be problematic because, in certain cases, you can reduce symptoms at the cost of arresting your development. To grow you must go through a temporary period of healthy suffering and healthy frustration. If you go right to symptom reduction you cannot grow in this case.
Learning to process pain to our benefit rather than avoid it is crucial. Pain is the body-mind’s message: ‘pay attention to me” and “something needs attention”. It plays an important role in life. Unfortunately we live in a society that is very phobic toward pain and wants to medicate and alleviate it as soon as possible. However, when pain is intense enough it causes us to let go of our old coping skills and risk trying new ones. If you always take the edge off your pain with alcohol or another drug of choice, you will keep your old coping skills. A therapist role is sometimes to help you through this healthy suffering. An hour of healthy suffering can prevent months of unhealthy suffering. Healthy suffering opens the door to real happiness. There's no way to bypass this no matter what you've heard.
When we are not aware of the full extent of our pain we are also not aware of the full extent of our wounding. The amount of wounding goes unconscious inside of us and we redefine what is normal based on our baseline experiences in the baseline experiences of the people around us. The unconscious is the master of disguises and selective memory. In reality, what is considered normal is actually highly wounded. Very few escape wounding, even including most of the people who have memories of a happy childhood.
In general, when you come in for session you may or may not have something you want to focus on or work on. It is not required that you have some specific agenda to work on. Dr. Carr will give you his full attention and focus on the behavior, condition, feeling and concern that appears most prominent at the moment. The idea is that you, as a human organism, will present either consciously or unconsciously the thing that needs to be worked on the most. It is the job of the therapist to pick up on what it might be because a can be very subtle and very eluding at times to both the client and the therapist. Sometimes things like fear, shyness, distrust and resistance are the first things to present themselves in the first sessions. This can show up as body language, tone of voice, and type of eye contact. You're not being analyzed just caringly attended to.
The first phase of psychotherapy may have an emphasis on 2) Establishing rapport and trust by getting to know each other 1) The mutual setting of goals: general & specific, short term & long-term 2) Evaluation of all problems and their possible roots that go beyond the superficial. How much pain, dysfunction and discontent might there be really? 3) Education: the understanding of basic concepts & language and the achieving of emotional literacy. Ninety nine percent of people in our society are not emotionally literate, meaning that they do not have a basic understanding of how emotions work.
The second phase of psychotherapy involves going deeper into what is initially needed to begin healing. (This will probably be going on concurrently with the first phase). Sometimes the main thing that is needed is to be listened to without coaching or advice. The need to be heard and validated must often be addressed first. Sometimes what is needed is to have your own thoughts and feelings reflected back to you in a way that allows you to respond " yes that's what I mean. I'm so glad you really heard me!".
Before going further it will be better to go over a basic model of accessing and healing the self. This model will show what is approached as well as how and why it is approached. We are multi-level organisms and any truly deep and comprehensive therapy must deal with all levels. It is not enough to work on one level with the hope that the affect will effectively trickle up or trickle down to other levels.