Questions About Therapy:
Therapy Works: Here’s How
Does Therapy Work?
If you’ve never been to therapy, you may wonder how meeting with someone to talk about yourself could possibly make any difference in your life, or lead to personal growth. Maybe you know some devoted therapy-goers who say it saved their marriage, or helped them become emotionally healthy, or gave them the confidence to go after their dreams. But how could simply talking with someone about your feelings and your struggles bring about big, important changes like these?
First of all, you’re on to something — simply talking with a therapist won’t change your life. Talking with a therapist is a wonderful way to create clarity, insight, and increase your self-awareness. These are all essential components of a meaningful growth process. But sooner or later, if you want to create change in your life you need to take meaningful action to get different results. Endlessly logging hours on a therapist’s couch free-associating about how you feel is not, on its own, meaningful action. It’s just part of the process of how therapy works.
But if you’re considering online therapy or therapy in Denver, there’s probably something standing between you and the action you’ll eventually need to take. Therapy works by helping you understand yourself, and the path forward.
For example, if you’re seeking therapy to improve your relationships you may know you need to work through trust issues that create an anxious attachment style in your relationships — but do not know how to change that on your own. Therapy can help you understand the old, subconscious patterns currently running the show. Or you may be aware that you’d feel better if you got more exercise and spent more time with friends, but you are so depressed that you hardly have the energy to get out of bed in the morning.
Awareness is important, but on its own, it’s usually not enough to alter deeply-ingrained patterns of thinking, feeling, and behaving. If it was, no one would be underemployed, or bogged down by bad habits, or stuck in a relationship that makes them unhappy. Big, external changes start with small, internal shifts, and a therapist’s couch is a great place to start making those shifts internally.
Let me tell you more about the process of therapy, and how it can help you bring about significant, positive change in your life.
How Does Therapy Work?
The foundation of your work in therapy will be your positive relationship with your therapist. This is a very important factor — in fact, research shows that the relationship between therapist and client is the single most important factor in whether the therapy will be successful, more so than external circumstances, or any special therapeutic technique the therapist can use.
The relationship you have with a therapist isn’t like other relationships in your life. It’s a professional relationship with professional boundaries, but it’s also highly personal. If you’ve found the right therapist, they will validate and empathize with your feelings. They will listen without judgment and show you understanding and respect, even when you’re relating events that don’t paint you in the best light. This safe, judgment-free dynamic helps you to build trust with your therapist, and to become comfortable sharing openly and honestly with them.
This all may sound a lot like a relationship you have with a good friend. But unlike a friendship, a therapeutic relationship is centered on your healing and personal growth. In therapy, you’ll focus on your own feelings, hopes and concerns and won’t be expected to spend an equal amount of time tending to your therapist’s needs.
You may have good friends you feel comfortable talking with about difficult topics — I hope you do! — but, if they’re like most people, they may try to “solve” your problems or tell you what to do, when what you really need is someone to hold space for you and empathize as you share.
This special relationship with your therapist becomes the support system for your healing and personal growth. Alongside your trusted, emotionally safe guide, you can begin to explore new ways of thinking, feeling, and behaving that will be more helpful to you.
In the first stage of therapy, as you’re building a relationship with a good therapist and helping them understand you… you’ll start understanding yourself differently too.
While insight is not enough to create change on its own, the self awareness you cultivate in talking to your therapist will become the foundation for the rest of your personal development process in therapy.
Does Therapy Help?
Therapy Works for Grief
If you’ve ever talked with a friend about a terrible breakup or divorce, or the grief you felt when someone you loved died, or about how it seemed like your life was falling apart, you know that simply expressing your feelings (without anyone trying to rush you towards feeling better!) can be a huge relief. Sometimes, that’s exactly what therapy is for. People who are filled with painful emotions over circumstances outside of their control, or are struggling with toxic shame, or who struggle to forgive themselves. A huge benefit of counseling can simply be talking to someone who listens, providing validation that the situation is truly terrible and that they’re not crazy for feeling the way they feel about it.
Having this safe space to be sad, mad, or hurt is actually very important, because healing from very difficult life experiences requires having time and space to lean into the hard feelings that you might rather avoid. “The only way out is through,” you might hear a wise therapist say, because the work of grief is an experiential process that can’t be rushed through. In the safe space of talk therapy sessions, you will have the chance to dive down into the depths of your feelings, touch the bottom, and then push back up — creating personal growth in the process.
Therapy Works for Trauma
Similarly, therapy for trauma works because it helps you have healing experiences. Living through terrible things leaves an emotional legacy that can impact you long after the damaging events first occurred. Effective therapy for trauma often has an experiential component that helps you revisit painful life experiences in a productive way that ultimately changes how you feel. This is through a process called “exposure therapy” (which can be achieved through a variety of different techniques and modalities.) However the end result is the same; through therapy you’ll eventually be able to leave the past in the past.
Therapy Works for Growth and Change
But therapy can be a lot more than a container for difficult feelings, or processing trauma. It can give you valuable insight into why you feel the way you do, and why you make the choices you make — because of difficult experiences in toxic relationships, dysfunctional family roles, or even just your personality. Through conversations with your therapist, you’ll begin to notice habitual ways of thinking, and a good therapist will help you challenge some of those beliefs. Your therapist will shine a light on blind spots and help you become aware of your usual way of operating in the world. As your “story” starts to change, and your thoughts shift, your feelings will naturally shift alongside them.
This can be achieved in a structured way, like through cognitive behavioral therapy, or in a more organic way, through narrative therapy techniques or experiential therapy techniques. Other types of therapy including Internal Family Systems therapy, positive psychology, and solution focused therapy can help you develop new awareness and make changes in the way you think, feel and behave. Learn more about these and other evidence-based approaches to therapy.
You may believe you’re trapped in an unfulfilling job, for example, but talking with a therapist could help you see a more fulfilling career path. Once you no longer feel so trapped, you’ll likely get some relief from the stress, anxiety, or despair that feeling stuck was causing you. From that more emotionally grounded place, you’ll likely find it easier to begin taking the steps you need to take to make a big career change, or to move forward in your professional development goals.
Your therapist may also pick up on relationship patterns that you’re not yet aware of. Maybe you entered therapy to cope with a particularly devastating breakup, but talking about your relationship history helps you see that you get involved with emotionally unavailable people over and over. You may realize that you’ve been trying to get your sense of self-worth by earning love from people who aren’t able to fully give it.
Once you notice this, you can begin thinking of ways to give yourself the love you’ve been trying to get from detached, emotionally-distant or narcissistic partners, so that these painful relationships no longer seem so attractive to you. Then, you can begin actively working to create a more fulfilling relationship with a partner who can love you back.
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What Is Therapy For?
Therapy Works for Mental Health
First and foremost, therapy is intended to diagnose and treat mental health conditions. While it’s also great for building self-discovery and spurring personal growth, helping people get relief from symptoms is its primary purpose — especially if you’re hoping to use insurance for therapy. Unlike life coaching, which is exclusively for the purpose of personal growth and goal attainment, therapy is behavioral healthcare. (Learn more about coaching vs. therapy here).
So how does therapy work for symptom reduction? The same way it works in the examples above. Just as patterns of thinking, feeling, and behaving keep us stuck in bad jobs and bad relationships, they can keep us stuck in cycles of depression and anxiety. A depressed person feels sad and empty in the present and hopeless about the future. An anxious person feels overwhelming worry about things that, for most of us, are no big deal. These feelings come from distorted ways of thinking, and making small adjustments to the way we think can be the first step in feeling happy again.
Different kinds of therapy can be used to treat particular conditions, like anxiety, depression or PTSD. Treatments vary widely depending on what clients are struggling with, but they all involve finding new ways of thinking and better ways of dealing with difficult feelings. It’s also important to know that many different kinds of therapy can be equally effective in the hands of a competent therapist with whom you have a strong working alliance. What’s most important is that you’re working with a qualified therapist who uses an evidence based approach — less important is the specific therapeutic modality they use, so long as it feels meaningful, valuable, and effective for you.
How Long Does Therapy Take?
How long you spend in therapy depends on what your goals are, the type of therapy you need, your therapist’s approach and how well you respond to treatment. But, in general, studies show you should be experiencing some benefit within eight to ten sessions. If you’ve been working with a therapist for this long and you haven’t noticed any progress, it may be time to talk about a new treatment plan.
Your first therapy appointment will begin with an assessment process. Your therapist will ask questions about what brought you in, whether you’ve been to therapy before, any mental health symptoms you may be experiencing, your family history, job status, and any significant relationships in your life. This helps your therapist get to know you, what you’re struggling with, and how they can help.
After two or three sessions, your therapist should have a plan for what your work together will look like. If they don’t share this plan with you, feel free to ask; you’re ultimately in charge of your growth and healing, not a passive participant in the process. You may talk with your therapist about what goals you have for therapy, and how you’ll know when your work together is done. Keeping the end in mind from the very beginning will give you a yardstick to measure your progress by, and keep you from spending more time in therapy than is really beneficial.
As therapy progresses, you should have a sense of forward movement, or progress toward your goals. If you entered therapy because you wanted to kick your habit of emotional eating, have you noticed any change there? If your goal was to get some help with depression, are you feeling any better? A good therapist should check in with your progress as time goes on, and change course if you appear to be stuck.
Once you’ve accomplished your goals for therapy, you have a few choices. Some clients continue to check in with their therapist for occasional “booster” sessions, or transition to more action and growth-oriented work in coaching. Others choose to simply be done. Whatever you decide, you should come out of therapy with more understanding and compassion for yourself, new insights into your history and patterns, and a toolkit of emotional and cognitive skills to help you make big changes that last.
The Benefits of Therapy
If you’re a newcomer to therapy, you may imagine that it’s “just talking.” Remember that how you’re feeling before you begin therapy can impact your expectations of therapy. For example, if you’re suffering from depression, you might think it will never work for you. If you’re suffering from anxiety, you might worry that your therapist will think you’re crazy, or that therapy will lead you to discovering things about yourself that you’d rather not know.
One of the most important things that effective therapy teaches you is how to create a different relationship with your thoughts, and to notice the impact that your thinking has on the way you feel. For many people, that aspect of personal growth begins before they even schedule their first therapy consultation, when they think for the first time, “Therapy works, and it can work for me too.” That is a new, hopeful thought that can lead you to get help and take the first empowering step on a transformational journey of growth.
Finally, it’s important to know that therapy is a process that leads to positive change over a period of time. You might have sessions that feel like major “aha” moments or break throughs, and you’ll also have sessions that feel less dramatically helpful. Even then, you’re still making progress: Moving forward in the long term is a process of making small, internal shifts that lead to big, external changes. It may involve a lot of talking at first, but eventually good therapy will always move you towards taking life changing action.
I hope that this discussion helped shed some light on how therapy works, and why, and gave you some clarity and direction on whether therapy would be helpful to you.
Your partner in growth,
Dr. Lisa Marie Bobby is the founder and clinical director of Growing Self. She is a licensed psychologist, a licensed marriage and family therapist, and a board-certified coach, as well as the author of “Exaholics: Breaking Your Addiction to Your Ex Love,” and the host of The Love, Happiness & Success Podcast.
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