Why and how does psychotherapy and counselling work?
Psychotherapy and counselling work. It can treat everything from depression to obsessive-compulsive behaviour, eating disorders to post-traumatic stress but there’s no single explanation for how psychotherapy and counselling works because each therapeutic relationship is unique and tailored to individual needs. At its heart is the strong relationship between the counsellor and the client. It’s harder though to pinpoint why it is effective.
The Right Therapist
Finding the right therapist is key. Therapists have different ways of working and it depends on what the client feels most comfortable with. I trained in person centred therapy which is very much as you would expect – it is centred to the client. I do bring in other modalities too and I would say my approach is now integrative. It remains empathetic, congruent and non judgemental though. Person Centred Therapy allows the client to speak openly about their concerns and in doing so things become clearer. The client develops a way of thinking and a way of working through things. The therapist doesn’t offer advice. Some clients though prefer other ways of working. They might want a more directive approach for instance. That is fine and clients should never be afraid to ask for what they need. The therapist won’t be offended if the client needs a different approach.
A Safe Space
Boundaries are really important in psychotherapy and counselling as they help to create a safe space for you to explore your thoughts and feelings. Examples of boundaries are having your session at the same time each week. Another may well be that the therapist reveals little about themselves. Sometimes though therapists might share something if they feel it is relevant. These boundaries help build trust and consistency so that the client always knows what to expect. This helps the client feel safe. The therapist/counsellor will contract with the client at the beginning of therapy. Again this helps the client to understand how the process will work. One of the key things for me as a therapist is that the client comes to trust the session as a safe space to talk about their worries. Many clients have told me that it is a huge relief to be able to speak openly without being judged. To me this is one of the most powerful reasons why therapy works.
Psychotherapy and counselling allows a client to process trauma. This is when stressful events that you experience or witness make you feel unsafe, helpless or vulnerable. The focus is on compassion, listening and understanding, rather than making a diagnosis. Talking therapies are exactly what they say they are. Speaking out loud is the process. The therapist won’t expect this necessarily to be a fully coherent explanation. It can be more like a stream of consciousness. Often clients apologise to me when they first start talking as they say they don’t know where to begin. Things occur to them as they are speaking and they often go off at a tangent. This is fine and again is an important part of the process.
A Space To Reflect
Having the time and space to reflect on what has happened to you in the past and what is happening now is very important. The therapist may well ask questions which will help the client reflect on what has happened. It often provides the client with a certain distance from the issue which enables the client to look at things with a fresh and objective eye.
People often ask me how counselling works and why I find it a rewarding job. They say “Isn’t it just talking? How does that help? Why don’t they just talk to their friends or their family? That is if these people are sympathetic. I often say that even if they do have a supportive family and a circle of friends they may not want to burden their family or their friends. Also all these people have a back story and will often offer advice. They are well meaning, but they can be biased. A therapist offers the chance to speak to someone who is neutral. Again I think this is key. It can open up new ways of thinking, feeling and behaving. The client become more conscious of things that have held them back, often for fear of being judged. This new found freedom of expression is to me one of the most powerful revelations in therapy. I have often witnessed clients crying with relief about this. Seeing someone finally being able to do this is one of the reasons why I find the work rewarding. It is often the first step on the road to healing.