What Makes Psychotherapy Work?

Have you ever wondered how psychotherapy works?  What makes it different from talking to a trusted friend or family member?  How do therapists view their role?  Most are surprised to discover that the key factor that makes psychotherapy effective is in the unique relationship you have with your provider.    

The relationship a person has in a psychotherapy setting is unlike any other.  It is defined as a one-way relationship wherein one person shares very deep and personal details about themselves while the other discloses little in order to serve in a helping role.  This may feel awkward at first.  And many people may want to know more personal details about their therapist, as you would when getting to know a new friend.  Yet this boundary allows the person seeking therapy to more fully open up without worry or concern for taking care of the therapist. 

At its essence, therapy is a safe space to be fully authentic and vulnerable.  You can express your full range of emotions, share troubling thoughts, explore your dreams and your fears to their fullest extent.  You get to talk about your inner experiences which are simply not socially acceptable to talk about pretty much anywhere else.  And all of this is held gently by your therapist, with understanding and compassion.  You don’t need to worry about how your therapist will take it all in, whether or not you will be judged or rejected.  It is the therapist’s job to supportively listen and fully see you without casting judgement.  We call this having unconditional positive regard. 

People seek out psychotherapy for a whole range of reasons.  Some want help managing symptoms of a mental illness, such as anxiety or depression.  Others are looking to work on their relationships, adjust to life’s challenges, or cope with grief.  While still others are focused on understanding themselves better in order to achieve their goals and passions.  Regardless of the reasons people seek therapy, it is the unique nature of the therapeutic relationship with the provider that is the key to therapeutic progress.

Some people take time to gradually open up like peeling layers of an onion away over the course of months or years.  Others find themselves pouring out deep, personal feelings and secrets within minutes of walking into the therapy office.  Each person’s pace of sharing is completely personal.  And the relationship each person has with a therapist is unique.

The therapist is tasked with riding along the waves of what each person needs in that moment.  We focus on deep listening for full understanding.  It is this opportunity to be fully heard and seen that is so unique.  Yes, we are trained professionals with an educated understanding of the mind, relationships, and strategies to build wellness.  We offer up our educated perspectives to help people understand themselves and reframe their own stories in ways that may provide healing.  We often teach specific skills to help manage a symptom, work through a situation, or improve communication.  We help people in set their own goals in achievable ways and check in on progress toward these goals.  We give people opportunities to practice things that might feel scary in the real world.  We encourage, uplift, and support.  But most importantly, we sit patiently with a person wherever he or she is at.

It is this willingness to simply be with a person who is vulnerable without backing away, dismissing, or shaming, that holds great opportunity for healing.  Therapists tolerate and process intense feelings with you.  Our role is to remain present, steady, warm and genuine. And through all of this, to be aware of our own very human feelings without allowing them to interfere with the therapeutic process.    

Therapists must take excellent care of themselves in order to serve in this role.  This means we must not only take care of our needs for sleep, food, exercise, and physical comforts but we also must regularly take inventory of our emotional selves.  We must tend to our own needs for being cared for by having supportive colleagues and an understanding social network.  And we must set up clear boundaries that keep this healthy wellness in place during times of stress and change.  Knowing your therapist has healthy boundaries allows you to do your work better, so you do not need to worry if your therapist is stressed, hungry, or distracted.

Most people who enter therapy are surprised by how intimate this relationship becomes when it is so one directional. But the caring in therapy is genuine and goes in both directions. Therapists feel honored to be included on these personal journeys and are invested in seeing patients find wellness.

There is great value in having this unique relationship and unique setting to talk deeply about yourself as you work through difficulties and grow. It can be a wonderful resource to turn to when needed throughout your lifetime as challenges arise. Finding a therapist who feels like the right match for you is an essential step in building this powerful therapeutic relationship.  And this may take a bit of trial and error.  No one therapist will be a great match for everyone. Choosing someone who feels right for you at this point in your life is very personal. But most people know when they have found a therapist who feels competent, warm, and safe.  

Written by Suzanne J. Smith, Ph.D. for Lakefront Psychology Blog.  If you are interested in more original articles about mental health, wellness, perinatal mood, relationships, or parenting, please subscribe to the blog using the button below.  If you are interested in scheduling an appointment at Lakefront Psychology, LLC for a psychotherapy consultation, please call 216-870-9816.

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