How Does Psychotherapy Work?

If you are considering psychotherapy or counseling and feel intimidated or daunted by the prospect of going to see someone, you are not alone. Many people feel that way. I myself felt that way before I first tried psychotherapy many years ago. Perhaps you have emotional, behavioral or relational difficulties that you may have wanted to talk to someone about. Maybe someone you know has recommended that you try counseling or psychotherapy.

Why should anyone consider psychotherapy? How does it work? It is difficult to describe how psychotherapy works to someone who never tried it before.

Have you ever tried to describe what hiking on a mountain is like to someone who has never done it? Would you describe the physical characteristics of a mountain, such as the fresh earthy scent, rocky terrain, delicate flowers hidden behind rocks, massive trees or steep peaks that one might encounter while hiking? Would you describe the experience of hiking itself? It can be arduous but also peaceful or delightful process. At the end of a hike, one may feel exhausted but also exhilarated with a sense of satisfaction that you achieved what you set out to do. For those of us who love hiking, the draw of the unexplored mountain or the favorite path can be irresistible. However, for those who are new to hiking, would those descriptions be enough to know what hiking on a mountain is really like?

I believe that it is just as difficult to describe psychotherapy to those who are new to the process. I would describe it as a special journey that you undergo with an experienced guide (licensed psychotherapist). Your goals may be small or very ambitious. No matter what your goal or quest may be, it will likely be more helpful if you have a competent guide. Your specific goal when you start out may be: becoming less depressed, sad or anxious; becoming more productive at work; or improving the quality of your relationship with your significant other. Perhaps you have been feeling depressed for a long time and simply want to feel better. You may achieve your therapy goals, and get much more out of it than you anticipated. You may discover aspects of yourself that you have not known before. After achieving your goals, you may find yourself reaching out for more, much more than you previously thought was possible for you.

Benefits of psychotherapy may be surprising or could be delightful. For example, I worked with a person who initially came to counseling to “fix” her poor organizational skills. During the course of counseling, she & l learned that her family’s critical ways of interacting with her affected her from functioning at her best. Once she realized this, her focus shifted from “fixing” herself. It became more about how she could work better with herself rather than perceiving herself as inadequate and deficient in the way that as her family had tended to consider her. When you become your own ally, it is much easier to help yourself.

Just as hiking is not without its risks, psychotherapy is not without risks. One risk is that you may not achieve your goals despite you & your therapist’s best efforts. Another risk may involve becoming upset or distressed, while facing the thoughts, emotions or memories that you locked up for a long time. It is difficult to predict in advance all of the benefits and risks that you might experience by participating in psychotherapy.

What you get out of psychotherapy depends on many factors. First, it depends on whether you want a shorter term therapy with well-defined, specific goals or longer-terms counseling where you explore many issues. Longer term therapy may generally offer something more rich and meaningful. Second, it depends on how much effort that you put into the process. It is not the kind of effort where you would have to exert mental effort such as in solving a mathematical problem. However, it is kind of effort where the more of your authentic self is invested in the process, the more you get out of examining and exploring it. However, becoming honest or authentic in psychotherapy does not happen overnight. Trusting someone with the most private aspects of yourself that you have never shared with anyone is difficult, and it is best done carefully and gradually.

Another important factor is whether you feel that you & your guide (therapist) work well together. If not, it is important that you talk about it. Exploring those uncomfortable feelings or tough spots with your therapist can help you learn a lot about yourself. Those new insights can shed light on your relationships with your significant others. Sometimes you may need to change to a different therapist.

No matter who you have decided to commence your psychotherapy experience with, starting is the most important step. After that, the second most important part is making sustained effort be ready to explore. Sound simple. However, I have found that many people wait a long time, and suffer a great deal before taking this important first step.