What to Expect from Psychotherapy

By Matt Bynum, MA, LPCC

These days, it feels like mental health is getting much needed attention in many circles. On both a national and local level, more and more people seem to be working to decrease the stigma of asking for help. This is truly wonderful. But there are still a lot of misconceptions and unknowns about therapy floating around. What is therapy exactly? Why do people go to therapy and what do they get out of it? What happens in the therapy office? What is the therapist’s role?

What follows are some answers to these questions. Keep in mind that different therapists will have slightly different answers to these questions. In fact, there are as many “therapies” as there are therapists, because each clinician will bring their own experience, modalities, and approach into the room. Furthermore, if a therapist is good at what they do, they will do their best to adjust the therapy to fit your specific needs.

What is therapy? Why go to therapy?

Psychotherapy, (or counseling), is the process of regularly meeting with a mental health professional to work through problems and dilemmas in your life and gain some renewed sense of vitality or flexibility. People seek individual therapy for lots of different reasons. Be it addiction, past trauma, a break-up, major life transition, relationship issues, anxiety, depression, or strong desire to look at painful habits. That being said, it is absolutely OK to see a therapist if you are wanting some increased self-knowledge and personal growth. There is a common misconception out there that someone needs to be “messed up” to go to therapy. That’s simply not true. What does that even mean? Everyone encounters challenges. Therapy is a place to explore the human struggles we all have. Ideally, it can help you create new ways of looking at problems and work towards solutions.

Ultimately, therapy is the process of talking with a professional about things that are affecting your mental and emotional health. Typically, this is one hour per week, and lasts anywhere from a few sessions to multiple years. Many people believe that therapy is just sitting and talking with someone about their childhood ad nauseam until the end of time. While it is true that a therapist will ask what events have helped to shape you throughout your development, there is more to the picture. Your therapist will ask you about what you care about, your current relationships, your strengths, and other parts of your identity, such as your goals.

In fact, in the first session, your therapist will ask you what you want to get out of the process, to ensure you are both on the same page about what the focus of your work together should be. The therapist’s job is to assess how you’re doing, ask the right questions, and offer feedback, coping tools, or new ideas.

What do you do in therapy?

The “what” of therapy is perhaps the most difficult to explain. Ultimately, you are exploring different feelings, thoughts, behaviors, memories, ambitions, fantasies, and trying out new potential ways of being with a helping professional. I like to think of therapy as a practice in vulnerability. It is a chance to show up and be fully seen as a person, in a non-judgmental space. But make no mistake, it is hard work and takes courage! Your therapist will ask a lot of questions to get a sense of how your mind works, including the thoughts and beliefs you carry around. Your job is to bring material which feels emotionally charged to the session and be willing to talk about it. This can include situations which feel stuck, make you feel angry, sad, and so on. Through time, and by building a relationship with your therapist, you can learn to relate to problems in new and even creative ways.

What do you people get out of therapy?

In most cases, people report getting a lot of different outcomes from therapy. These range from increased clarity, a sense of groundedness or stability, more self-awareness around their patterns/thoughts in life, or working through some older material in a new way. Ultimately, the time you spend with your therapist should be driven by your goals and desired outcomes. What you get out of therapy depends on what you want to get out of the experience as well. Someone who is struggling to deal with a traumatic experience may have different goals than someone who is trying to adjust to a major life change. Your therapist will work with you to clarify what your goals are. That being said, therapy can, at times, feel like a long and winding road, so it’s helpful to come with an open mind to explore different arenas of your life.

What’s the therapist’s role?

The therapist’s role in the relationship is multifaceted. One thing they will do is ask a lot of questions about your life experience and beliefs. The goal here is two-fold:

1. Make sure that they can understand you as well as they possibly can. In doing this, the therapist can honor your strengths and get to know you in a more holistic way.
2. Through questions, try and help you see things in a different light, accept things which feel hard to accept, or gently nudge you at looking at certain “edges” which may feel difficult to explore. This includes the full range of emotions and thoughts, including those which you do not necessarily “default to” regularly. In this manner, it is possible to confront yourself in new ways and examine the narratives you may have about your life.

Ultimately, the therapist is a trusted, non-judgemental companion on your path. They are the expert on human behavior and psychology, but you are the only expert on your life. Therefore, therapy is a collaborative process. As you go along, the therapist will check in with you and feel how things are progressing. 

Wrapping up

To me, therapy is perhaps best thought of as a metaphor. Think of life as a tangled-up jewelry box. Inside the box are a variety of “knotted up” experiences from our past and present. A bent earring here, wrapped around a twisted necklace there, curled around an old ring there. Everyone has areas which feel stuck and knotted up, and hard to untangle. Through the process of therapy, you can begin to “untangle” certain parts of your life, and lay things out, one thing at a time.