How Does Therapy Work?
One answer to this question is that it may work in different ways for different people, and so I try to find a kind of therapy that will suit you. Certainly, you are the most important single factor influencing the outcome of the therapy. Your motivation and commitment are key. After that, it appears that the relationship between the therapist and the client has a vital part to play. The therapist needs to be warm, empathic and non-judgemental. On top of this, I believe the openness of the therapist is crucial. In the atmosphere that these qualities can foster, defences can come down and your own access to your own wisdom will be experienced. As a generalisation, I find that clients have a very good idea of what is at the root of their difficulties and can often find solutions to them.
At the same time, I also think that the workings of the unconscious mind are fascinating; clients often talk of a series of matters which they have not consciously connected but all of which turn out to be linked by a common theme with a direct bearing on a central issue or event.
As therapy proceeds, there may be a sense that the issue changes: someone who believes at first that they would like to be better at handling stress may decide that this is one example of a more general difficulty with self-esteem.
Talking things over can help in itself: as in the saying that a problem shared is a problem halved. There may be an emotional release involved. Focussing upon particular issues may help.
Often therapists say back to you what you have said to them. This has been compared to the therapist being like a mirror in which you can see yourself. The words you use may give a clue as to levels of thinking of which you may not be fully aware on a conscious level.
Probably the most helpful thing a therapist can do is to provide a space and a time for the client to use. Our busy lives can mean we focus upon everything in our lives but ourselves and our own needs and how we can ensure they are met. There can be many more aspects to therapy. In suggesting what they may be, I want to assure you that in any given session, there may be only one or two examples of all the different possibilities that I am going on to list. You will not be overburdened with a mass of information.
Firstly, I personally make some use of ideas from cognitive therapy but rarely in the totally focussed way that pure cognitive therapists do. I like to encourage clients to read the booklet on Cognitive therapy that is on this website and try to spot patterns of thinking for themselves. How we think can have a great bearing on how we feel. For example, a person who makes a minor mistake at work and then expects to be sacked for it is doing what Cognitive therapists “catastrophising”. Such styles of thinking can be recognised and replaced by more moderate and realistic ones through practice, and this can help with anxiety, depression and phobias.
I recommend particular “homeworks” for couples and people with eating and sexual difficulties, and sometimes individual clients if they wish. These behavioural interventions can make a great difference. They play a key part in working with alcohol, drug and sex addiction.
Two further points. In therapy, people often behave in similar ways to the ways that occurred between them and their parents. There are various ways of making use of this interesting state of affairs. And therapy often gives you an explanation for things, so the world, and you, come to feel more manageable.
From what I have said, you will see that I try to balance theories of therapy that emphasise the flowing and free nature of the therapeutic relationship, and those that stress structure and focus. What you can talk about, you can think about, and so you have less need for fear and defensiveness.