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How Does Therapy Work?: What Therapists Fail to Explain

Updated: May 2

When I started providing therapy, I made the mistake of assuming that my clients understood what the purpose of therapy was and how it worked. I would start the process of therapy without ever explaining what therapy actually was or how it could make a difference in my client's lives. It was as if I was expecting them to just trust that therapy would help them. I know I'm not alone in this. Many of my clients, friends, and family members have expressed that they don't understand what therapy really does.

I'm writing this article to change this. I wanted to explain what therapy is and how it helps. I want to explain more than, "It helps you feel better." Therapy is so much more than talking out loud – it holds the potential to physically change your brain for the better. Yet, therapists seem to skip over this fact. This article covers:

What is Therapy?

Definition of Therapy 📘

Therapy, in the context of this article, refers to "talk therapy" or "psychotherapy." Therapy is a series of intentional conversations guided by a licensed therapist. A therapist works to create a safe, confidential, non-judgmental space where someone can explore their thoughts, feelings, behaviors, and past experiences. Therapy should begin with setting clear, achievable goals. For example, these goals might include decreasing symptoms of anxiety or depression, improving self-esteem, or improving communication skills.

Once goals are established, a therapist should guide conversations around these goals by identifying dysfunctional thoughts and behaviors that may be holding someone back from achieving what they want. Every question your therapist asks should be asked with your therapeutic goals in mind. Therapy allows people to understand what they are doing and why they do what they do, and then work to change it.

For some people, therapy may involve diagnosing a mental health disorder to better understand the nature of their experiences and to give language to their experiences in a way that assists them in making positive changes in their lives. Mental health diagnoses can provide research-based examples of what people with the same symptoms have historically experienced and what they can do to feel better.

Common Misconceptions 🧐

Therapy is not just venting. It is not the same as conversations you would have with a friend. Conversations in therapy are one-sided, meaning your therapist will rarely (if ever) talk about their own life; their only intention is to assist you in meeting your mental health goals. Therapy is structured to dive deep into your thought patterns, challenge unhelpful beliefs, and support meaningful changes.

How Does Therapy Work?

To truly grasp how therapy works, it is essential to understand how our brains function. Our brains are like a forest filled with trails. The more you think a given thought or do a particular action, the more defined the trial becomes. This also works in reverse – the less you think a thought or the less you do a particular action, the weaker the trail becomes. Brain cells called "neurons"make up these trails. Neurons communicate with each other and form pathways in our brain. These pathways are why humans form habits, emotional reactions, and ways of thinking. Sometimes, we develop neural pathways that are healthy and helpful. However, we can also develop unhealthy neural pathways that prevent us from getting what we want out of life. Click play on the video below to see what neural pathways look like inside the brain.

A therapist is like a personal trail guide for your brain, helping you learn what paths are safe, which are dangerous and should be avoided, and, most importantly, how to explore new trails. Therapists listen to learn about what you have experienced and how your trails have formed. A therapist should work to identify what ways of thinking (or what "trails") support you and which ones hinder you. Once this is established, a therapist should ask questions and facilitate conversations with your personal goals for therapy in mind.

Just like exploring new areas of a forest, therapy helps you venture into new areas of your thoughts and feelings. When you start trying new ways of thinking or behaving, your brain begins forming new pathways. It's like clearing a new trail in the forest. The more you practice these new thoughts and actions, the stronger and more established these new trails become. As you focus on these new paths, the old, unhelpful ones start to fade. They become like unused trails that gradually get overgrown and harder to see. This means that the unhelpful habits or thoughts that used to feel automatic become less prominent, making it easier for you to choose your new, healthier paths.

Therapy doesn't just help you create new pathways; it makes your whole "brain forest" more resilient. It's like becoming a skilled navigator who can find their way through any part of the forest, even when new obstacles appear. You learn to adapt, to face challenges confidently, and to keep moving forward toward the life you want to live.

How to Make The Most Out of Therapy

Now that we have covered what therapy is and how it works, you may be interested in how you can make the most out of your therapy sessions. Here are five tips from a licensed therapist on how to maximize the benefits of therapy:

1. Identify What You Want to Change 💡

Start by pinpointing exactly what you want to get out of therapy. Knowing what you want to change gives you and your therapist a clear direction to work toward.

2. Reflect When Asked Questions 💭

When your therapist asks you questions, take the time to truly reflect on your answers. The more honest and reflective you are, the more you'll discover about yourself.

3. Journal In-Between Sessions 🖋️

Writing down your thoughts, feelings, and any revelations you have can make a huge difference. It helps you remember the insights gained during sessions and observe patterns over time. You might jot down new trails you're considering or obstacles you've encountered. Sharing these observations with your therapist can deepen your next session.

4. Share What's Working and What's Not ✅🚫

Communication with your therapist is key. If certain approaches or discussions are particularly helpful, let them know. Similarly, if something isn't working for you, it's crucial to speak up. It helps tailor the therapy to your needs, making each session more effective.

5. Engage in the process 🧠

Therapy is a journey you actively participate in, not a passive experience. Engage with the exercises and strategies suggested by your therapist. Try them out in the real world, outside your sessions. The more you put into therapy, the more you'll get out of it.

What to Do If Therapy Isn't Working

Sometimes, even with the best intentions, you might feel like therapy isn't helping the way you hoped. It's okay to feel this way, and there are steps you can take to make things better. Here's what you can do:

Tell Your Therapist 📣

The first step is to have an honest conversation with your therapist. It might feel a bit scary to say you're not feeling better, but therapists are here to help you. Tell them what's on your mind. Maybe you're not clicking together, or perhaps the way they're helping isn't what you need right now. This chat can open the door to making changes that could improve your therapy experience. Your therapist might try new ways to help or might suggest seeing someone else who has a different approach.

Considering Medication 💊

Sometimes, talking and therapy techniques aren't enough on their own, especially if you're dealing with certain mental health issues like severe depression or anxiety. Medication can be another tool to help you feel better. If you think this might be something you need, talk to your therapist or a doctor. They can give you information about your options and help you decide if medication is a good choice for you. Remember, medication works best when combined with therapy, as it tackles the problem from two angles.

Give It Time 🕒

It's also good to remember that therapy takes time. Changes in the way we think and feel don't happen overnight. It's like learning a new skill or sport; you get better with practice and patience. So, sometimes, the best thing to do is to stick with it a bit longer, especially if you're just starting out.

Find a New Therapist 🙋‍♀️

If talking doesn't help or you just feel like you and your therapist aren't a good match, it's okay to look for a new one. Finding the right therapist is a bit like making a new friend; not everyone will be the perfect fit. It's important to find someone you feel comfortable with, who understands you, and who has the right skills to help with what you're going through.

If you're feeling stuck or unsure about your therapy, these steps can help guide you toward a solution that works better for you. The most important thing is to keep looking for the help that you need and deserve. You're not alone in this journey, and with the right support, you can find your way to feeling better.

Interested in Starting Therapy or Finding a New Therapist?

Even after understanding how therapy works, it can still be hard to find a therapist who is a good fit for you. If you found this article helpful and would like to learn more about my therapy services, I would love to speak with you! I am able to provide therapy services to people in the state of Florida. If you live in Florida, feel free to click this link to schedule a free phone consultation.

Don't live in Florida? No worries! Psychology Today and Therapy Den are both great websites that allow you to search for therapists in your area by specialty. You can read therapists' biographies and schedule free phone consultations to see if they might be a good fit.


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