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What is therapy, and how does it work?
What is therapy, and how does it work? Perhaps it’s easier to begin with what therapy is not. Therapy is not advice-giving, it’s not a friendship, and it’s not a magic wand or a quick fix to make one’s problems go away. Therapy is a process of learning and growth facilitated by a human relationship—a relationship between you and your therapist. In essence, it is a kind of ongoing conversation between you and your therapist. Therapy takes place in an atmosphere that is at once comforting and challenging: the comfort of therapy—building trust and rapport with your therapist—allows you to talk about problems and experience feelings that you might ordinarily feel too uncomfortable to address. The therapist’s training allows him or her to help you establish an optimal balance of comfort and challenge in your therapy. Therapy can be hard work, and it takes commitment and effort, but over time, numerous positive changes can occur. You can gain new insight into your thoughts, feelings, actions, and beliefs. You can become more aware of your actual lived experience—for example, the feelings you experience in various situations—and the meaning of that experience for you. You may have new experiences in therapy—you may relate to your therapist in a new way, or experience a new feeling about something in your life—and these new experiences may challenge you to grow. Eventually, these insights and experiences can help you to make desired changes in your life. Ultimately, therapy is about freedom—about no longer being a prisoner or victim of your thoughts, feelings, beliefs, or past experience. As you come to better understand your heart and mind and soul, you can work through areas in your life where you feel “stuck,” take greater responsibility for your own life, make better choices for yourself, and find a greater sense of happiness and fulfillment.
Therapy is to some extent an art, not a science, and so there can never be an ironclad guarantee that a given course of therapy will have any particular outcome. However, you are more likely to have a positive outcome in therapy if you have clear goals in mind (or can devise them with the help of your therapist) and if you trust and feel comfortable with your therapist. Don’t be afraid to tell your therapist if you believe your therapy isn’t working. Good therapists want you to be truthful, not to sugarcoat your feelings. Interestingly, such conversations can sometimes deepen therapy very quickly.
Does therapy take a long time? That depends upon you and your goals. Some people may spend a few months in therapy and feel “finished”; others may spend six months, a year or two, or many years. Some goals are more conducive to short therapies than others. There’s no way to know ahead of time how long you’ll need or want to stay in therapy, but here’s a very general rule of thumb. If you’re dealing with something of a recent nature (for example, you’ve been happy most of your life, but you became depressed a few months ago), or if your goals are relatively circumscribed, you may find a brief therapy sufficient. If you’re dealing with something chronic (for example, you’ve been depressed as long as you can remember), or if your goals are far-reaching, then you should plan on staying in therapy for a longer time.
Isn’t therapy just a crutch for people who are too weak to face life? Therapy is for ordinary human beings who, for one reason or another, become overwhelmed by some difficulty in their life. For some people there is a stigma about going to therapy, but this is gradually changing. Throughout history, most people have had to work extremely hard merely to survive, and self-reflection has been a luxury that few people could afford. Today, many people are no longer in a position of such hardship. But we arguably inhabit a world that is far more complex, both in technological and social terms, than that of our ancestors. Even the hardiest among us can stumble psychologically or emotionally somewhere along the way in our journey through life. Just as we are not ashamed to see a doctor when we get sick, so should there be no reason to be ashamed of seeing a therapist.
The problem isn’t me, it’s the oppressive environment around me. It’s true that people are not always responsible for the bad things that happen to them, and the point of therapy shouldn’t be to blame you for things that are not your fault. Think of the Serenity Prayer popular in 12-step programs, which talks about things we cannot change, things we can change, and knowing the difference between the two. Therapy can help you to identify those things that are, in fact, within your power to change, and this knowledge can free you to make conscious choices about responding to oppressive circumstances, past or present—choices that you can take responsibility for and live with. The focus of therapy is ultimately you—your thoughts, your feelings, your actions, and your beliefs. Sometimes it is appropriate to focus on other people or on one’s surroundings—for example, in working for social change. Your therapy may not focus on this directly, but if therapy makes you a stronger individual, it can place you in a stronger position to, say, work for social change if you so choose. And by helping you to better distinguish what you cannot change from what you can, therapy might even help you to cultivate a greater political consciousness.
Yes, it is. Not only that, therapy can be time-consuming, and it can make you feel downright miserable at times. (The old physical conditioning maxim of “no pain, no gain” unfortunately seems to apply to therapy as well.) You might try looking at therapy as a long-term investment in your overall well-being and quality of life—an investment that can continue to pay dividends years after the therapy is over. (The dividends could even be literal if, for instance, increased confidence or clarity gained in therapy helps you to ask for a raise, find a higher-paying job, or change careers.)
How do I find a good therapist? Feel free to interview different therapists until you find one who seems right for you. You might ask them what their background is, how they work, what they charge, and anything else that you feel is relevant. Even if you don’t get answers to all your questions, you will get a sense of what each therapist is like. Ask for recommendations from someone you trust, like your doctor or a close friend. One other thing: trust your gut. If you find yourself feeling truly uncomfortable with a therapist—perhaps they’re behaving in a way that strikes you as incompetent, or unethical—thank them for their time and leave. There are many good, ethical therapists out there seeking to provide the highest quality of service; don’t settle for anything less.
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