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How Does Psychotherapy Work?

It is hard for some people, particularly those who tend to be pragmatic, hard-headed and no nonsense folks, to understand how psychotherapy works. The fact is—it does work! Let’s reflect for a moment on how and why it works, so that your expectations for therapy are clear and reasonable.

Psychotherapy works because a therapist provides you with a safe place. First, you are safe physically, safe from danger, abuse and/or manipulation. The professional parameters that surround the profession of psychotherapy are important ingredients in helping the process work. Secondly, you are safe psychologically and emotionally. You need not fear being judged, evaluated, discounted or ridiculed. We live in a very competitive, judgmental culture (and sometimes come from families that have similar characteristics), where we are constantly evaluated based on our wealth, appearance or accomplishments. Therapy works because we have a safe place in our week to let down and be who we really are.

Psychotherapy works because in this safe place you are able to be deeply honest. You can say things that you normally would not reveal about your deepest feelings, thoughts, fears, hopes, hurts and dreams. If there is anything that you have not talked about openly, that you have kept hidden from others, perhaps even from yourself, this is your time and place to share. Talking about painful, embarrassing or frightening material is not easy, but generally the talking process helps us out of our anguish by both venting and gaining alternative perspectives on our hurt.

Psychotherapy works because you are regular and faithful in your attendance in therapy. Some people are inclined to quit therapy when it gets hard or seems unproductive or when they do not achieve results soon enough. Give it some time. As the regularity of therapy starts to become a pattern in your week or month, you will start to plan your next sessions. You will look forward to those sessions, because you have been working on things in between sessions. Indeed, some people believe that the most important work in therapy is done in between therapy sessions.

Psychotherapy works because you have in you therapist a trained listener. Most therapists are trained to not just listen carefully, as our best friend might, but to listen for deeper levels of communication or noncommunication. Therapists will ask probing questions or make insightful comments that will lead you to share more deeply, to recognize the previously unconscious motives and issues that can explain why you do what you do or who you really are. You will discover that you are more complex and interesting than you ever imagined.

Psychotherapy works because you are totally accepted. Your therapist is a non-judgmental, accepting person. There is nothing that you cannot talk about with your trusted therapist. Surely at times your therapist may not think your choices were very wise, you probably don’t either, but your therapist will consistently like you, affirm you and accept you for who you are. As you experience this unconditional acceptance, you will begin to accept yourself more than you have before, and self acceptance is the key to personal growth.

Psychotherapy works because you have in your therapist a wise guide. Most therapists are pretty smart, smart not only in book knowledge but also about human nature and relationships. When the time is right, your therapist can suggest strategies, approaches, homework or action plans that will help you achieve your goals for therapy.

Psychotherapy works because you will be challenged periodically. An effective therapist is not there to simply hold your hand, but to help you grow. Growth comes about when you experience both acceptance and confrontation, in a single relationship. Growth sometimes requires that you be pushed a bit, pushed to do what you know you need to do, but fear doing. Therapy can and should help you grow.

Psychotherapy works because you have invested yourself in the process. Some people question the financial aspects of therapy, suggesting that money ruins everything by making clients doubt the sincerity of their therapist’s good words. Actually the fact that you will pay for this service helps you take it seriously, invest yourself fully in it. You will come to the therapy sessions determined to get your money’s worth, so to speak. You will value the process and the time. You will do your homework. You will become invested in the process, in yourself and in becoming well.

What I have said above is equally true to relational therapy—couple or family or group therapy. The same ingredients are present and effective. In therapy with more than one person, the focus of healing is often more on relationships than on your inner soul.

R. Scott Sullender, Ph.D. Licensed Psychologist PSY 8931

Updated January 2017

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