Do you know how therapy actually works?

I met with a new patient recently who had never met with a therapist before. Now, I love working with people with a whole range of experiences in therapy, but there is something really magical about the opportunity to introduce someone to the power of therapy. 

Like many who are new to this experience, she was tentative at first, a little anxious about doing it “right.” She was unsure how to start or what to share. She also knew that she wanted to be there (and had been encouraged by loving friends), but wasn’t sure that she really understood how exactly it might help. 

Honestly, even those who have been to therapy for a while at times find themselves uncertain about how therapy actually works. They might notice that they feel better going or that things are flowing in their lives differently, but why? How? 

For those who like to understand the why and the how (and it’s okay if you don’t, you don’t have to understand why it’s working for it to work) – I want to share some of the reasons that therapy is a process unless any other. 

Therapy comes in many different flavors, and the mechanisms by which it helps and heals can be different depending on the type of treatment. However, there are some common elements that are true across modalities, and that’s where I want to focus. 

    1. Therapy is at its core a relationship that heals. It provides the experience of relating to another human being that – at its best – is empathic, attuned, and forward-moving. Even for those of us that have positive relationships in our lives, the therapist-client relationship is a different animal. When we feel connected and supported by our therapist, we literally rewire relationship networks in our brains. The neurological changes that come from this experience can last a lifetime and help us live vastly differently. 
    2. Therapy helps us process our experiences so that they stop making us sick. We all face adversity, stress, and pain. Left unprocessed, these experiences go underground and seep into our emotional and physical wells. As a result, we end up operating from pained places instead of whole places, and that can look like sleep problems, irritability, unhealthy perfectionism, headaches, lack of motivation, concentration issues, rejection sensitivity, stomach distress, or a thousand other manifestations of our stuck emotional issues. 
    3. Therapy helps us look at things differently. Have you noticed how we can think and think and think about an issue and stay in relatively the same place with it? True processing almost always happens with another human being, and requires an interactive process. The other person becomes like a second brain, someone sitting atop a mountain far enough away that they can see our mountain more clearly, separate from the brush that we see when we look at our own. The best therapy is a thought partnership, an opportunity to co-create understanding and healing. 
    4. Therapy helps us know the when, why, and how. We often come to therapy knowing what is not working for us, but we haven’t been able to determine a path forward. Therapy helps us create a coherent narrative of what is happening and how to think about and address it. It also helps us define when is the right time and what to consider in potentially making changes.
    5. Therapy offers a unique form of accountability. If you feel like you need to do your therapy “homework” to avoid disappointing your therapist, it would be helpful to talk about that with your therapist. What I’m thinking about here is the fact that in a good therapy process, we want to evolve by trying out new behaviors and experimenting with new ways of being because we are learning to truly value our deepest natures and truest selves. And we get excited to share that with our thought partner/therapist! Having a regular therapy appointment is powerful not so we can have someone shame us for not changing (if that’s happening, run!), but so that we have a commitment to ourselves to keep showing up differently. 

Specific therapy models also offer value to individuals through specific interventions, like working through panic attacks or defusing from negative beliefs. Some help you decrease intrusive thoughts patterns or stop misusing alcohol or end cycles of conflict in a particular relationship. There are so many ways in which therapy can support a new way of living.

At the end of the day, the proof is in the outcomes, though. What makes me so confident in the power of therapy is that we can even see the benefit on brain imaging scans. Many studies have shown positive brain changes in people who have undergone psychotherapy, and in fact these neurological changes are similar or sometimes greater than changes from taking medication.

The power of therapy is immense and is a gift that we can give to ourselves and the families and communities that benefit from us being our best selves.

Dr. Ashley Solomon is the founder of Galia Collaborative, an organization dedicated to helping women heal, thrive, and lead. She works with individuals, teams, and companies to empower women with modern mental healthcare and the tools they need to amplify their impact in a messy world.

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