What happens in therapy?

Going to therapy, either for the very first time or returning to receive further life support can be really daunting. 

It can feel like a mysterious process, and given most of the literature can be quite difficult to understand, it can feel like a disempowering process where therapy is ‘happening’ to you. 

So what actually happens in therapy?

Well… how the therapy looks can be different depending on the modality of the therapist. Which ‘maps’ they are using to understand and frame your experiences. 

And the modality will also determine which ‘tools’ the therapist uses, for example, an art therapist will use art and creativity, a CBT therapist will work with thoughts and behaviours, a Gestalt therapist may use the empty chair exercise. 

But ultimately a therapist's primary objective is to listen to your inner world. To understand you. Then to help you to understand your self, your experiences and your feelings by reflecting back what they see. Healing occurs when this understanding takes place, in a safe, empathic environment. The therapist is there as a guide. 

To walk alongside you as the client, through your self-discovery and to support you with the areas of your life that need you - perhaps to build self-esteem, perhaps to build self-love, perhaps to build boundaries, or to help you process anger or to sit alongside you in grief. 

Understanding anxiety may be part of your process and the therapist will bring in their ‘tools’ to help you learn to manage in your everyday life. But at the same time, psychotherapy may help you to understand where your anxiety comes from. 

And at a deeper level, if your anxiety is rooted in dysfunctional relationships, the therapeutic relationship serves to heal this dysfunction. Because to heal a problem with relationships, you need to experience a kind, caring and accepting relationship with another. Perhaps you are feeling depressed. 

Again, there are ‘tools’ that can help you to manage your life that your therapy can teach you. And the therapy can help you to understand why you’re feeling depressed, how your experiences have led you to this point and why you have learned to manage in this way. 

Again at a deeper level, if your depression has arisen as a need to protect you and to feel safe from dark, difficult feelings which you haven’t felt safe enough to feel and share, by sharing in an empathic space and building trust that someone cares, you are attending to not only the feelings but the fears that people can’t be trusted. And hopefully questioning those fears and re-learning something new. Perhaps you may learn that there are people who can be trusted. 

So you can see that there are many layers of healing taking place in the therapy. 

You will be learning tools to manage, you will be understanding your self and how you came to be who you are. You will be healing your wounds. 

At a deeper level, you will be changing the blueprints of how you have come to view the world and what it has to offer you, particularly in relationships. This is the beauty of being human. We are not set in stone and neuroplasticity means we can re-learn almost anything. 

To understand that the process is happening between both the therapist and the client can be empowering to both. The therapist’s role is there to hold the boundaries and support the client. The client's role is to show up and trust the process. 

In trauma-informed work, the therapist may be more directional to manage the pace of the work, as the client may have learned dysfunctional ways of managing overwhelm and numbness… This pace-making is an essential part of the process, supporting the client to learn healthy ways of managing. However, if the process is shared with the client, it should include them to feel involved, feel empowered. Trusting the process but allowing the client to know what that process is to foster feelings of being a change agent in their own lives. 

Of course, to name everything that happens in therapy is impossible in one short article, however, the essential stuff of the therapeutic space is this - to be heard, seen, challenged, empowered and most of all to be working towards healing. Not as a patient where something is happening to you, but as a client, where you may not know exactly what’s going on but you feel involved and informed enough to show up each session with trust in the science and the magic that can occur between two human beings.