Therapy 101

What is Therapy?

In my opinion, therapy is an opportunity. An opportunity to learn, grow, build, and explore. It is a unique and confidential experience that allows you to focus completely on yourself without judgment or bias. The American Psychological Association defines it as a way to "help people of all ages live happier, healthier and more productive lives." Essentially, therapy is a place where you can resolve problematic behaviors, beliefs, feelings, and relationship issues. Beginning therapy can be a big step toward being the healthiest version of yourself and living the best life possible—no matter what challenges you may be facing. 

Does therapy even work?

Well, in my experience, that is entirely up to the client. We all enter therapy at different "stages." An example of these "stages" can be understood through the Transtheoretical Model or often referred to as the Stages of Change. This is a model therapists often use to assess where each client is at; essentially how ready they are to commit to the therapy and implement change. Where do you fall?

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  1. Precontemplation - People are often unaware that their behavior is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behavior and place too much emphasis on the cons of changing behavior.
  2. Contemplation - People recognize that their behavior may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behavior takes place, with equal emphasis placed on both. Even with this recognition, people may still feel ambivalent toward changing their behavior.
  3. Preparation - In this stage, people are ready to take action within the next 30 days. People start to take small steps toward the behavior change, and they believe changing their behavior can lead to a healthier life.
  4. Action - In this stage, people have recently changed their behavior (defined as within the last 6 months) and intend to keep moving forward with that behavior change. People may exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
  5. Maintenance - In this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages.
  6. Termination - In this stage, people have no desire to return to their unhealthy behaviors and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs.  

It is perfectly ok to enter therapy in the contemplation stage. This is very normal. You most likely would not be sitting across from a therapist if you were not contemplating some kind of change. It is important to recognize where you fall, as it sets a general expectation of "therapy working." The more open to change, the more likely you will see improvements in yourself, your relationships, and your overall outlook. Remember therapy is a marathon, not a sprint. 

Benefits of Therapy

Forbes (Walton, 2014) did a great job highlighting the many benefits of therapy. Keep in mind this list does not include ALL benefits, rather the most common experiences. Marian Margulies, PhD, a psychologist in New York City and candidate in psychoanalysis at the Institute for Psychoanalytic Education at the NYU Medical Center was interviewed to share their experiences of why therapy can be extremely helpful. 

1. Therapy’s effects persist over the long-haul

A huge benefit of talk therapy is that its effects are long-lasting. This is because you’re not only working through stuff, but you’re also developing the tools to help you deal with future stuff. 

2. Physical symptoms get treated, too

Psychological trauma can trigger physical symptoms – and depression and anxiety are well known to have significant, and sometimes debilitating, physical effects. Going to therapy, assuming it’s successful, can help these issues fade away. “There have been some studies that show that many physical ailments are ameliorated when someone engages in therapy,” says Margulies. “When people do not express feelings but swallow them and keep them buried and out of conscious awareness, one's body often reacts. It acts as a barometer that reads: danger! Something is amiss and needs attention. Somatizing via stomach aches, headaches, sleeping problems, and ulcers are just some of the ways our body reacts to stress and psychic pain.”

3. Repressed emotions will come back to haunt you later on

The most serious drawback of not talking about things may be that unexpressed feelings and traumas can pile up and explode later. “Lots of people avoid talking about their feelings about a whole host of things,” says Margulies. “But repressing or damping down one’s feelings doesn’t make the feelings go away. If anything, they linger and fester, only to explode when an innocuous comment is made.” Even if you don’t have a full-on breakdown later on, not fully processing events and emotions often creates negative thought patterns that can inform every area in your life – your relationships with your spouse, parents, kids, coworkers, and even yourself. So learning how to process them can change how you maneuver in many different ways.

4. It will give you a whole new perspective on other people, too 

An awesome benefit of therapy is that it not only helps you understand yourself better but it helps you understand other people. When we hold negative thoughts in without processing them, they become ingrained so that we see the world through that lens – and we make lots of assumptions that may or may not be true. 

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5. It helps you deal with future curve balls

Since big and small problems are going to come up from time to time, knowing how to deal with them in a healthy way is an essential skill. “Conflict is a part of everyday life,” says Margulies. “It’s helpful to be aware of one’s feelings around conflict. If, for example, you are angry with your boss who is piling up work for you when you are getting ready to go away, you are bound to feel resentment and conflict. By reflecting on what’s going on outside (your boss’ demands) and inside (your mounting anger, irritation, and fear of losing your job if you say ‘no’), you are in a better position to resolve the conflict. Talking things through with someone and reflecting on what feelings are evoked, and why, leads to a greater understanding of oneself. 

6. Talking about things gives them shape

Have you ever noticed how turning a problem around and around in your head often gets you precisely nowhere? It’s so easy to feel dwarfed by a problem when it’s just an amorphous blob in your head – but talking about it gives it a beginning, middle, and end. And that helps you wrap your brain around it. “When I think of the process of engaging in talk therapy, I think of the analogy with writing,” says Margulies. “The more you write, the more you know what you are trying to say – it clarifies your thinking. Similarly with talking and with talk therapy, one becomes more aware of what is making one feel anxious, sad, angry or frustrated. And then one is freer to decide how to manage these feelings or take action to alleviate them.”

Even if you can’t get to therapy, just talking about a problem with a friend can be helpful: Lay out the issue, and it will become clearer, more logical, and therefore more manageable.

7. You know you’re not alone

Seeing a psychologist can be a huge relief in-and-of itself since you know you’re taking action against what ails you. It also comforting just knowing that you have a built-in support structure that you can go to once a week.

8. It will rewire your brain

One of the coolest things about therapy is that it can bring about change at the level of the brain. We think of medication as changing the depressed brain, but there’s very compelling evidence that talk therapy does the same. With brain imaging methods, psychotherapy has been shown to alter activity in the medial prefrontal cortex, the anterior cingulate cortex, the hippocampus, and the amygdala. These areas are involved in self-referential thoughts (“me”-centered worry thoughts), executive control, emotion, and fear. (For some interesting research and reviews, see herehere, and here.)

One very effective method, cognitive behavior therapy (CBT), helps people identify the negative thought patterns they fall back on habitually – which are no doubt wired into the brain like deep ruts – and replace them with new and more positive mental habits. In addition to helping people experience fewer symptoms of depression and anxiety, it, too, seems to bring about brain changes that are measurable.

9. It enables you to teach the next generation a better way

The best thing about dealing with your own stuff is that, if you have kids, it helps you teach them a better way. “Parents can help their children learn a vocabulary of feelings early on by modeling it themselves,” says Margulies. “This gives children the feeling that it is not only okay but healthy to express themselves through all the colors of their emotions. That it is important to express anger when they feel they’ve been ignored or unfairly treated or when someone says something hurtful. The alternative is to repress the feeling, feel resentful, perhaps act out one’s anger in defiant behavior. The time to start talking about feelings is as early as possible.”

What is the first session like?

  • First sessions often include: reviewing paperwork (e.g. informed consent), therapist discussing their individual approach and style, discussion around your presenting concern, therapist will often explore your background and history, discussion around therapy goals, and most importantly assessing if you and the therapist are the right "fit" 
  • Sessions often are 50-minutes in length and occur weekly
  • Judgement-free, non-bias, and a safe confidential space to talk freely 
  • Support and encouragement 
  • Resources or referrals when necessary 
  • It may feel uncomfortable at first, after all you are talking to a stranger, but overtime you will feel more at ease as you get familiar with the process and therapist

Ok, I am interested, but where do I even begin?

The therapist-client relationship is by far one of the most important aspects of the therapeutic experience. You have to feel comfortable with your therapist in order for it to "work." I am often asked, "do you have a referral?" Though I often have names that I recommend, YOU are the only person that can decide if a therapist is a "good fit." The first meeting is essential to get a "vibe" of the therapist's personality, their style, and their approach. I often suggest for clients to pick out 2-4 therapists that look like they may be a good fit based on their online profile. Then I encourage clients to call at least 3 to get a "sense" of how they work and if your particular issues fits within their expertise. If possible, schedule an appointment with your top 2 based on your phone conversations. The first in-person meeting will allow you to really determine if it is a good fit. Though this can be frustrating as you may have to pay double, in the run long it will definitely pay off, not to mention ultimately save you time and money. 

Finding a Therapist 

  • Psychologytoday.com
  • Goodtherapy.org
  • Google "your city + therapist"

So, what are you waiting for?

::: Disclaimer: Please note, the information offered on this website/blog is not, nor is it intended to be, therapy or psychological advice, nor does it constitute a client/therapist relationship. Please consult a mental health provider for individual support regarding your own personal health or well-being or call 1-800-950-NAMI for resources and support. :::

Kelly Vincent