How does therapy work?

If you’ve never had therapy or counselling before, how it works can be a bit of a mystery. How will talking to a stranger about your problems change things?

In fact, even if you have had therapy or counselling before, it can still be a bit of a mystery! Changes in therapy sometimes happen when you’re not working on them or expecting them. You just realise one day that that thing that used to really bother you isn’t such an issue any more. And you maybe won’t understand exactly how it changed or why it did.

I’ve always found it hard to put into words how therapy works. That’s partly because it’s complex. Therapy seems like such a simple thing - just two people talking - but it works through many different processes. And it’s partly because my words never live up to just how powerful therapy can be. That’s why I resort to saying, “Just try it and see,” instead!

But in case “Just try it and see,” doesn’t do it for you, here is my attempt to put the complex processes of therapy into words.

Getting things off your chest

At the simplest level, people feel better when they get things off their chests. Our thoughts and feelings want to be heard. If we keep them inside, the feelings build up. They can start to feel intolerable and interfere with our lives. When you open up to a psychotherapist or counsellor, it’s like a release of the pressure inside you.

Getting in touch with your feelings

In order to be able to get your feelings off your chest, it helps to know what they are. Many people struggle to identify their feelings. When things get bad, they may know they’re upset, but they might be unable to pinpoint specifically what they feel - grief, frustration, despair, etc. Part of how therapy works is by helping clients to get in touch with their feelings so they can be expressed and understood.

Being validated

It seems to be human nature to doubt ourselves. We all have an inner voice that says things like I shouldn’t have done that, I shouldn’t have those thoughts and I shouldn’t be so upset about that. Our inner voices talk a lot of nonsense at times. In therapy, I help my clients to counteract that nonsense by understanding and validating their thoughts, feelings and behaviours. For a client it can be very helpful to hear, “I can see why you did that,” or “Of course you feel that way; given what you sent through, why wouldn’t you?”

Developing self-compassion

That validation piece is an important part of developing self-compassion, which itself is an important part of how therapy works. As clients hear their therapist or counsellor being compassionate towards them, they gradually internalise that attitude, developing their ability to show compassion towards themselves.

Hearing your thoughts and feelings out loud

You’d be surprised how often clients say, “Oh, now that I say it out loud…” When you have to put your thoughts into words for someone else to hear, it forces you to spell them out and refine them. That simple process can give you clarity about what you truly think and feel.

Being seen and heard

At a deep level, we want to be known. We want other people to see who we are and accept us. One of the most powerful things about counselling is that you can feel seen, heard and accepted by me. That feeling is special and rare.

Gaining insight

When you tell me about your life, I’m listening out for patterns and connections. They might be repetitive behaviours that sabotage your progress, limiting beliefs about yourself that stem from childhood, and so on. These things are hard for you to see in yourself - you’re too close. With a trained eye and a bit of distance, I can spot them and gently share them with you. Then we can look at changing them if you want to.

Using the relationship

I don’t just notice those patterns in what you tell me. I’m also paying attention to how I feel when we’re together. I’ll pick up on how a client is in the relationship with me, wonder if they behave similarly in other relationships (people generally do) and think about how that might contribute to the problems they want to address. Then I’ll carefully explain my thoughts to the client to see if they resonate.

Experiencing healthy boundaries

We’re a very boundaried lot, us therapists! We stick to clear boundaries when it comes to session time, length, location, payment, etc. If your family or friends tend not to have clear boundaries, or perhaps you’ve had your boundaries breached in the past, experiencing clear boundaries can be immensely powerful. It creates a feeling of security and you will be able to learn from me how to hold and communicate healthy boundaries in your own life.

Developing the ability to cope

It’s a bit of a woolly heading, but it’s a really important part of how therapy works. By working through their problems in therapy, clients develop a stronger ability to cope with whatever life throws at them. We talk about clients internalising their therapist. So when things get tough, they might ask themselves What would Kate say? When a client leaves therapy, they rarely say their life is totally free of problems now; they often say they feel able to cope.

I said it was complex, didn’t I?! There are a lot of things going on in therapy. But the beauty of it is that you don’t need to think about any of those things. Let me do that. You just need to turn up and tell me what’s on your mind.

If you have any questions, please contact me. And if you would like to book an initial consultation, you can do so here.