How Therapy Works
Therapy is a collaborative process, where you and I work together to figure out the best approach to work towards what you want for yourself. Useful therapy can look a lot of different ways for a lot of different people. My priority as a clinician is finding and then doing what works.
There is evidence that psychodynamic and depth-oriented therapy has longer lasting effects, because it gets deeper into the causes and addresses the root causes of distress, rather than focusing on symptom reduction. Developing insight is important, but that insight needs to be felt and understood experientially for it to be useful.
A core idea of psychodynamic practice specifically is going beyond basic symptom reduction to get at what’s underneath your distress. Behaviors and patterns have meaning, and often relate to our early life experiences. There’s almost always more to a story than we can see by ourselves. Therapy that addresses what’s going on below the surface leads to longer lasting results, and ultimately helps people to live more fulfilling and comfortable lives.
Frequency
Many people come to therapy once a week, but others find it helpful to have two or three sessions per week. More frequent sessions facilitate a deeper kind of work, and progress can happen more quickly.
Is it just talking?
Not exactly! The majority of a session is talking, but within that, there are different kinds of communication and interactions, including listening, receiving, challenging, assessing, reflecting, and developing curiosity and insight—all in service of exploring your internal world. The stories that we carry about ourselves and others underscore so much of how we move through the world, and often these stories are unexamined or outside of our awareness.
How do I know if it’s working?
Progress in an individual’s therapy is dependent on what goals they bring in, and what their unique circumstances are. Some generic goals, or common effects of an effective therapeutic process are increased empathy, increased ease in day to day tasks and activities, greater sense of calm, increased mental flexibility and self-awareness, greater compassion for self and others, less volatile emotions, and overall less distress.
How long do I have to be in therapy?
There is a common fear that open-ended therapy has no end date. The timeline is nonspecific at the start, and progress is conceptualized as stages of treatment (beginning phase, working phase, and termination phase), rather than lengths of time. Because these therapy processes are so idiosyncratic and person-specific, the criteria for termination are deeply individual as well. People reach a point where they are able to recognize their own growth, and find themselves needing increasingly less support.
As people move towards termination, it is often appropriate to decrease frequency (ex: moving from weekly to bi-weekly). Regardless of the circumstances that bring it about, an intentional and expected ending facilitates continued growth when the therapy is over.