Stop Pregaming Therapy

Stop Pregaming Therapy

If you attended college in the U.S., then I’ll bet you’ve heard of pregaming. It’s when friends or students might load up on cheap drinks before visiting that expensive bar downtown. Pregaming made us feel smart and feel like we had outsmarted the system. Today as I begin a new journey here as a clinician at the Village Institute, I’m discovering that patients are trying to do the same and pregame therapy. By coming up with answers before we’ve even figured out the true problem, our patients think that they can skate around some of the requirements of therapy, like having honest, tough, and intimate conversations that might be uncomfortable at first.

The act of avoiding discomfort presents itself regularly. One patient had asked me before we had even met for our first session, “How many sessions will it take before I start seeing results?” She had already skipped to the end of our time together before we had even had the chance to meet. The problem in both of these circumstances is that too much time is being spent on the answer, and not enough time was being allotted to the question. Luckily, the need for immediate gratification is often broken down in therapy- and is usually indicative of other issues and defenses at hand.

More recently, a friend of mine was considering therapy to work through procrastination and avoidance habits. He pre-diagnosed himself with Adult ADHD to ‘get ahead of the game.’ He was pregaming therapy! This was his attempt to have the satisfaction of having a self-hypothesis confirmed, because the ambiguity of walking in and having no idea where a session could take him was overwhelming. It became quickly apparent that the issue here wasn’t a diagnosis of ADHD, but the anxiety behind relinquishing control and being vulnerable to a stranger. The fear was based upon the possibility of not having his avoidance tool at his immediate usage in the therapy room, so if he was able to walk in with some type of all-knowing powers already, he could somehow get around the discomfort. Ironically, the best work in therapy is done within the discomfort.

Whatever the appeal is for you in beginning therapy- allow this to be, but embrace the possibility of therapy being a journey, not a destination. More possibilities always come from the wisdom of knowing what we don’t know.

Session Lesson Short #1:  "Everyone thinks of changing the world, but no one thinks of changing themselves.”