Why therapy works

As a first-time client, I remember when my therapist described her method of working. I think she said something around ‘person-centred’ or ‘Jungian’ – my mind boggled with what that meant (I had no idea).

What I really wanted to know was whether therapy was going to work for me and maybe something about how and why. So, now, being on the other side of the fence, I decided to look deeper into the scientific question of how and why therapy works.

In my research, I came across a book by Louis Cozolino, called wonderfully, Why Therapy Works. (2016).  Fundamentally, Cozolino is a Professor of Psychology with a special interest in the function of the brain - he lectures and writes about the therapeutic process and neuroscience - but in such a way that is totally accessible. He writes:

That psychotherapy works was a basic assumption of my training, and all of my training was focussed on how to practice… I came to believe that in order to understand how psychotherapy works, we have to start from the bottom up, beginning with the brain… how the brain responds to stress and how that response can result in symptoms and suffering…and that we can leverage the power of human relationships to regulate anxiety…

- Cozolino, 2016

Louis describes how, in spending time in therapy, talking in a way that is open and likely more transparent, our brain and our subconscious get tickled into new thoughts, reactions and deeper opportunities for consideration. So, where we might have formed ideas that were fairly ‘static’: ‘this will always be the way’, ‘things will never change’, ‘I can’t see any improvement in this situation’… what happens, in a very subtle way, is the potential to open new neural pathways. As more options become available and our subconscious gets more voice – more airtime – we have the option to release long-held ideas that may not benefit our own well-being. In time, we start to strip away at denial, talk honestly about things we’ve never talked about and have our feelings acknowledged… and so we start the journey of research into ourselves.

What’s cool about the brain and therapy is the potential to change. Our brains can change their functional architecture, creating new neurons or pathways – it’s called neuroplasticity. The therapist’s job is to create an environment that is safe enough for a client to explore their lives and challenge long-held beliefs. Cozolino describes it as amygdala-whispering.

I don’t want to suggest that anyone can benefit from counselling. Clients who are suffering from major trauma are not best placed necessarily with counselling. There are trauma techniques and support that are different to the counselling process and anyone who has experienced major trauma should look for support from a trauma specialist.

Different techniques or methods unlock doors for different people – so how do we know what methods or approaches might work for us?

As a client, if we’re at a stage of believing that therapy might be valuable, it likely will be. We’re trying something new, a process of self-discovery and there’s clearly, even in that action, a certain movement, a shift.

Then choosing a therapist who will meet the requirements – providing a safe place – certain conditions: confidentiality and boundaries, and a keen, listening ear is the next step. In this time of digital directories, clients can scan information online about various therapists and choose someone who might in some way ‘talk to them’, whatever that is: the look of a friendly face; a nurturing listener, specialisms, experience and background - whatever ticks the boxes for that client. And although the therapist might kick off with a list of what they’ve studied, what their approach is, how they practice and whether the client understands the references or not, it matters little… as the journey begins… and the process happens.

References:

BACP (2016) Ethical Framework for the Counselling Professions. Lutterworth:  British Association for Counselling and Psychotherapy.

Cozolino, L. (2016). Why Therapy Works: using our minds to change our brains. London: W.W. Norton & Company Ltd.,

Rogers, C. (1961). On Becoming a Person. London: Constable & Company Ltd.