Why therapy is so much more than “just talking”: A glimpse into the therapy session
by Dr Liza Chervonsky
When I tell people that I’m a clinical psychologist, the reaction is often one of great curiosity. Although most people are open to the idea of therapy, fewer people know what truly happens behind the closed doors of the therapy room. “So… I come to therapy and I just… talk? For the whole session?”. This is often asked, with perplexment written on their face. “Sounds like an expensive friend”. I’ve heard this many times and I can imagine that for every one that says it loud, there is another wondering about this in silence. Therapy involves “talking” but at the same time it is much, much more than that and so, I’d like to share a little bit more of that world with you.
When a person comes in for their first session, there is often a bit of anxiety and apprehension. Although there are many that are bursting to tell their story and begin the work, there are just as many who are cautious and unsure. For some people, this could be one of the first times they really start opening up about their thoughts and feelings. For others, they may not even be sure what their thoughts and feelings are, and for others they may feel so tangled and confused that they don’t know where to start at all.
Part of my role is to help my clients begin to feel safe in opening up. Many have not had the best responses to expressions of their inner world in the past, so part of the work is helping them develop a more positive relationship with their thoughts and feelings. We cannot do the deeper work if they are riddled with guilt, shame, and anxiety each time they open their mouths to speak. So we begin there. In creating a sense of safety in the room and in oneself. You may wonder whether this is really that important, but I cannot stress to you enough what kind of effects this task can have. Imagine not being able to listen to your thoughts calmly and with curiousity. Imagine being so afraid of your own mind that you keep trying to avoid it with technology, drugs and alcohol, food, compulsive exercise, or mental tricks. It would be absolutely exhausting and it would be a constant battle to talk through your thoughts and emotions in therapy, if you were trying so hard to get away from them. So we work on that first.
There is also often a difference in how trusting a person is when they begin therapy. For people who have generally had more positive relationships, they are much more able to trust their therapist and the process. However, there are so many who are coming in to therapy with a history of emotional pain, physical pain, neglect, betrayal, unpredictability, and generally negative or toxic relationships. For these people, each new interaction is a potential threat and they have learned to be on guard, just waiting for any sign that might signal danger. It is an exhausting way to live. So part of the early work is to understand their defensive process and to help them feel safer in the therapeutic relationship. For some people, the therapeutic relationship is one of their first healthy and positive relationships and can serve as a guide when they build on or develop new relationships in the future. So if a client finds themselves having any reaction towards me, I encourage them to share. I tell them that this is one of the most important processes in therapy and is so valuable to work with, especially if the reaction they have to me is typical of the reaction they have to people in their outside world as well (e.g. mistrust, disgust, frustration, anxiety, wanting to please, wanting to control).
The processes I have described above I believe are some of the most important in therapy – developing a better relationship with your thoughts, emotions, your inner world and with other people. From there, you can start building with positive momentum. If you are no longer at war with yourself or others, so much of your mental space and time will be freed up so that you can really start living the life you want.
Although there is so much more that can be described, I couldn’t do it justice without writing a chapter or a book! But for those who want just a little bit more, here is a summary of some more of the processes that can occur in therapy:
Developing self-awareness and insight into your patterns of thinking, emotion, and behavior.
Challenging and reviewing unhelpful thoughts or beliefs.
Understanding where some of your thoughts, behaviours, and coping strategies have come from and why.
Learning to tolerate discomfort and unpleasant experiences, without feeling overwhelmed by them.
Running experiments in therapy and in your daily life to challenge some pre-existing beliefs.
Using the therapeutic relationship and the reactions to the therapist as a guide and tool in therapy.
Changing your behaviour and the way you relate to others.
Processing past experiences, to help reduce the intensity of memories as well as their effect on everyday life.
Developing more healthy internal models of thinking and responses to the self and others.
Dr Liza Chervonsky is a clinical psychologist and the director of Inlight Psychology in Bondi Junction. She uses CBT, DBT, ACT, Mindfulness, and attachment theory in her practice. She treats a wide range of presentations, including anxiety, mood disorders, anger management difficulties, relationship and interpersonal problems, social difficulties, family difficulties, work and academic problems, perfectionism, confidence issues, and personality disorders.
If you would like to learn more about the Inlight Psychology Team, click here.
If you would like to book an appointment with Liza, please don’t hesitate to contact us on 8320 0566 or email@example.com.