What REALLY is Therapy? A Comprehensive Guide by a Bay Area Therapist
As a Bay Area Therapist, people have asked in my personal life what I do. I say “therapist” and sometimes there is a look of confusion. Sometimes potential clients ask me, what is therapy about? Again I find it difficult to answer. So here’s my attempt to answer that.
First, let’s start by addressing how “Therapy” is all-encompassing and vast in its methods, theories, and styles. It’s like asking “how does cooking work?” There are so many cultures, cuisines, it’s hard to really pin it down. But there are also a lot of misconceptions out there, from “it’s just like talking to a friend” to “they just talk about your parents.” That’s because the average person who goes to therapy gets results but does not know why it works. In fact, even therapists are not entirely sure how therapy works sometimes, which is why we have so many therapies that are based on underlying theories such as Cognitive Behavioral Therapy, or Psychodynamic Therapy.
The purpose of this blog is to educate you as a consumer of therapy about what it really is about.
We will not go so much into all the different types of therapies (this is too vast.)
Instead, I want to explain how therapy works in terms of what its purpose is, how things change, and what you can expect so that you are a more competent consumer of therapy.
Why is Therapy so Misunderstood? Bay Area Therapy Insight
Why is therapy so misunderstood?
The very principles that make therapy effective—confidentiality and personalized approaches—also render it one of the most misunderstood professions. The foundation of therapy lies in its confidential nature. This confidentiality is vital for creating a safe space where clients can open up and explore their deepest thoughts without fear of judgment or exposure. However, this also means that the intricacies of what happens in therapy are known only to those directly involved. The outside world, including those who might benefit from therapy, is left to speculate.
This gap in understanding is akin to trying to comprehend a novel by only reading its summary. The depth, the emotions, and the transformative journey are lost in translation.
To add to this, therapists are often stuck describing their work with therapy jargon that they pick up from their training in an attempt to communicate their work. Terms like 'DBT', 'Gestalt therapy', or 'existential therapy' are thrown around, leaving the average person confused. This isn't dissimilar to a scientist explaining a complex theory in terms laden with technical terms; the essence gets lost to those not versed in the language.
If you are looking for a therapist, you are probably confused, anxious, and overwhelmed and a therapist throwing around graduate-level vocabulary is the last thing you need. But because therapists don’t know what else to do to communicate their work, it can be challenging.
In the absence of transparent, easy-to-understand information, clients and the public are left to form their own conclusions about therapy based on personal experiences or hearsay.
These interpretations, while valuable, are subjective and varied.
One person's experience of therapy as a life-changing journey might contrast sharply with another's perception of it as an endless, aimless conversation.
These personal stories, although rich in individual truths, often fail to capture the universal essence and potential of therapy. Recently, TV has tried to capture this essence but because the purpose of media is for entertainment, the real essence of what therapy is like is often skewed for entertainment. As a result, there are so many misunderstandings, myths, and wrong ideas about what therapy is.
Therapy is a Relationship
Your therapist cares about you.
They really do. Therapists are human beings with real feelings.
They might not always express how they are feeling, and depending on their style they might be more engaging or more passive. But therapists care about the work they are doing and they care about their clients. This is important because the fact that your therapist cares about you is actually crucial in how successful therapy is. Other professions heavily rely on expertise or technical ability to get the outcomes done.
Think of a doctor, their ability to diagnose, and prescribe the right treatment or medication is the most important thing.
Yes, doctors do care, and that is important, but it's NOT central to their work meaning it doesn’t make or break being a doctor if they don’t care.
Therapy is different. If your therapist doesn’t care (or most often can’t care because they are exhausted, or burned out) they CANNOT do their job. You as a client won’t feel cared for, and that will ruin the therapeutic relationship. In research, the therapeutic relationship is KING in how it determines therapy outcomes.
If the relationship is poor, you won’t get good outcomes. They also care in a way that there is a one-sided nature to therapy. Other than payment, therapists don’t need anything from you. They don’t need and shouldn’t talk about their problems, or get anything from you. Even if they do share parts of their lives, the ultimate goal is to build more trust, and help you.
The Importance of Authenticity in Therapy
One of the most important elements in the therapy relationship is the elements of intimacy, honesty, and authenticity.
These are not just optional extras; they are the very heart of effective therapy.
You simply cannot achieve meaningful progress in therapy if you're holding back. Hiding parts of yourself or your experiences from your therapist leads inevitably to poorer outcomes. It's like trying to navigate a maze blindfolded – you might make some progress, but it's going to be slow, frustrating, and far from efficient.
Think of the therapeutic relationship as the foundation of a building.
Without this solid base, no matter how many theories or interventions are piled on top, the structure won't hold. It's this foundation that enables everything else in therapy to work. This means that as a client, your role involves striving to be open and honest, trusting your therapist to guide you through the therapeutic process. This does not always need to happen in the first session. Just as you are striving to open up, your therapist is also building trust by showing curiosity, empathy, and compassion.
Therapist Feedback is Important
You might not believe it, but therapists are fallible. They are humans after all.
Good therapy requires that you offer and give feedback to your therapist.
“Why would I do that? Shouldn’t they know what to do?”
Unfortunately, therapists are not magic genies that can see and know everything. That means they can’t read your mind, and because authenticity and honesty are the foundation of therapy, giving honest feedback about what is not working for you, where you feel stuck, and your feelings around therapy are important. Without it, you may never express your needs, build up resentment, and the therapy process can go south quickly.
Also, clients can sometimes internalize things that the therapists as negative not because the therapist’s intention is to harm but because of your own relational patterns. Addressing this is important because it can lead to deeper healing and transformation. The risk of not expressing your needs in therapy is devastating. It's easy to even get disappointed in one therapist, not express yourself and just move on only to repeat the same pattern. If something in therapy is not working, talk about it with your therapist and work with them to improve it.
This can be one of the most difficult parts in therapy, and it's not often talked about because of the misconceptions that the therapist SHOULD be perfect and KNOW everything.
Doing Therapy is A MEANS to an OUTCOME
Therapy is a journey, but it's crucial to remember that it's a journey with a purposeful destination.
This is where the importance of collaborative goal-setting comes into play. Therapy is a partnership, a dynamic and engaging collaboration between you and your therapist, where together you map out the goals you aspire to achieve.
This process is not just a professional formality; it's a deeply personal and empowering aspect of your therapy experience.
However, it's essential to be mindful of the pitfalls of a therapy journey without clear goals.
A goalless therapy can feel like being adrift, moving but without direction. This lack of focus isn't just unfulfilling; it can be counterproductive. The aim of therapy should be helping you get to your destination, where each session is a step closer to your desired outcomes. Often, the path towards your outcomes is not straightforward because every individual is different.
Not even the therapist knows exactly what path YOU should take all the time. Therapy is not as simple as following a roadmap. It's more like following a compass where you want to head NORTH, but the route is not always planned out.
How do you develop Therapy Outcomes?
So, how do you develop your outcomes?
The key is to ask this question, "When I am ready to end therapy, what do I want my life to be?"
This question isn't about setting an arbitrary end date but about recognizing and celebrating the milestones you hope to achieve along the way. Whether your goals involve improving your relationships, gaining confidence in your professional life, or discovering your passions, this question helps keep the therapy focused and forward-moving. It should be tangible, real, and relevant to your life. Defining clear, tangible goals in therapy isn't just beneficial; it's essential. It's what transforms therapy from a mere conversation into a powerful tool for personal growth and change.
Your investment in therapy, both in time and money, should yield discernible, positive changes in your life. These goals provide a metric to track your progress and see the real impact of your therapeutic journey.
Most importantly, therapy is hard. Sometimes in the wandering, or when therapy can be tough (this will happen), it's easy to forget why you came to therapy in the first place. You can feel overwhelmed, and it can be easy to quit. When that happens, having real, positive, and tangible goals is worth it, because it can keep you motivated when therapy is rough.
What about Psychotherapeutic Theories?
Ok, so it's easy to focus on the theories… DBT, CBT, EMDR, etc., and ask which one is better? And get lost
While theories are important, they are not THE most central part about therapy (remember the relationship is.) They are still important, and one way I invite you to think about theories is to consider theories as our vehicles.
They each uniquely designed to navigate us towards healing and personal growth. Think of these theories as different forms of transportation, each chosen based on the journey ahead.
Just like selecting a mode of transportation, choosing a therapy theory depends on your individual needs. Are you looking for the directness and speed of a car, representing a straightforward, solution-focused approach? Or do you resonate more with the reflective pace of a bicycle ride, symbolizing a deeper, explorative journey into your psyche? The choice of theory aligns with the path you need to tread.
The other purpose of therapy theories is the goal to identify and address life's blockages. These might be emotional, like unresolved trauma, or cognitive, such as harmful thought patterns.
The purpose of therapy, in any form, is to uncover these obstacles, understand their roots, and develop strategies to navigate around or through them.
Each theory has an idea of what the blockages in growth are and helps you address those challenges directly. Then, each theory equips you with the tools to make real changes and fix the problem.
For Cognitive Behavioral Therapy, it's about correcting your thinking. For Psychodynamic therapy, it's about gaining insight about yourself. Some theories are direct, targeting specific behaviors or thoughts, while others take a more indirect route, exploring emotional patterns or past experiences. In essence, therapy theories are more than just clinical approaches; they are pathways to transformation. They offer a route tailored to your individual needs, guiding you through the complexities of healing and growth.
Therapy is an Active Process
"Who's really in charge of the treatment or change?"
This can easily be misunderstood in therapy because of the misconceptions that surround therapy.
Often clients can think that the therapist is the “expert” and it is a passive experience, where the client receives “treatment” and the therapist dispenses it. While there are elements of therapy where the therapist takes the lead – especially in providing professional expertise and direction – the process should never be entirely therapist-dependent.
Therapy is an active, engaging journey, not a passive receipt of services.
Another misconception about therapy is that the therapist is passive.
This is the stereotypical, nodding head, aloof, therapist that just makes the space and does nothing. This is where sessions might feel like mere conversations without direction or purpose. Perhaps you’ve experienced sessions where the therapist mainly listens, nodding along, but offers little in the way of guidance or feedback.
This can leave you feeling like you’re wasting your time, merely rehashing problems without moving towards solutions. Therapy should be more than just talking about your problems; it should be a proactive process of working through them.
So, who’s really working?
The answer is a collaborative one: both you, the client, and the therapist share equal responsibility.
The therapist is not just a guide but a facilitator of growth. Their job extends beyond mere guidance; they create a nurturing space where you can safely explore your thoughts and emotions. They offer feedback, challenge your perspectives, and encourage self-discovery. Sometimes there are “interventions” that are more passive where the therapist's intervention and technique can initiate a healing process. But even then, you as the client need to be open to it, and afterward reflect on that experience.
As a client, your role is equally crucial. Therapy requires honesty, openness, and a willingness to delve into uncomfortable territories. Your commitment to implementing the changes and insights gained during sessions is vital. Remember, therapy is not something that is done to you; it’s something you actively participate in. Your dedication to your well-being and willingness to embrace change are key factors in the success of therapy.
You are the one that is going to walk home, reflect, and implement what you received in therapy.
You are the one that's going to set boundaries with people or change your relationships with your loved ones.
You are the one that’s going to do the homework or try changes in your life.
In summary, the responsibility in therapy is shared. The therapist brings professional expertise, guidance, and the framework for growth. You bring your experiences, honesty, and commitment to change. Together, this partnership creates a dynamic environment where real change is not just possible but probable. It’s about transforming therapy from a passive experience to an active journey towards healing and self-discovery.
A Bay Area Therapist that Help You get Outcomes
If you've been navigating the confusing world of therapy, seeking clarity amidst the jargon and misconceptions, it's time to discover a therapy experience that truly resonates with you. As a Bay Area therapist specializing in trauma, I focus on helping emotionally unavailable, people-pleasing adults find their path to feelings and healing. Let's explore together how therapy can be a transformative journey, tailored just for you.
If you are ready, I invite you to reach out for a free 15-minute consultation. This initial conversation is an opportunity for us to connect, discuss your goals and challenges, and explore how we can work together towards your healing and growth. It's a chance for you to ask questions, get a feel for my therapeutic approach, and decide if I am the right therapist for you.
Don't let misconceptions about therapy hold you back from the growth and healing you deserve. Contact me today, and let's begin this transformative journey together. Your path to feelings and healing starts here.
