How Does Psychotherapy Work?

Therapy can be a difficult, confusing, and anxiety-provoking process. So why do it? Most people who come to therapy are feeling unhappy, uncomfortable, and dissatisfied with their lives. They often have a sense that something is wrong but they are not sure what it is and they don’t know how to fix it. Through hard work and serious exploration, I can usually help people understand why they are feeling this way and what they can do to change unhealthy patterns into healthy ones. I find that if you are willing to trust in me, trust the process, and do the hard work you will experience incredible results. I have had many patients tell me that working with me has been the most intense and the most rewarding therapeutic experience of their lives.

That said here are some typical questions that people have about psychotherapy and my answers.

I believe that in order to facilitate real and lasting change, it is necessary to confront feelings that we may have been avoiding for most of our lives. This means that therapy can be an uncomfortable process; however, the end result is that as you work through painful or anxiety–provoking feelings, you will come out on the other side feeling stronger, happier, and more at peace. While I cannot take away the pain or anxiety you might feel in working through these feelings, what I can do is make the experience as comfortable as possible by being supportive, empathic, and having a good sense of humor. I will constantly monitor your anxiety to make sure that it will not overwhelm you, and if your anxiety becomes intolerable we will immediately work on decreasing it so that you are not overwhelmed.

I do not believe that it is not my place to tell anyone what to do, so I try not to give advice (although from time to time I find myself breaking my own rule). The reason for this is that I am no more knowledgeable about the future or what is “right and wrong,” than anyone else. Each of us have to make our own decisions and choices about how to lead our lives, and we usually do so with limited data (because no one can predict the future).

Typically, the more “data” we have about ourselves and a situation, the better choices we can make. I can help you learn more about what has driven you to make choices and decisions in the past, as well as what feelings you may be having about what is going on in the present. So if you have made decisions that were driven by feelings or impulses that you didn’t fully understand, we will help you gain a better understanding of those. Having more of this data will likely help you avoid making the same mistakes over and over again so that you can make wiser choices for yourself. Ultimately it is up to you choose to use that data to make a decision.

Nope. Only you can fix you. What I can offer is my skills and expertise in guiding you through the process of better understanding yourself so that you can do the hard work of changing internal patterns of thoughts, feelings, and behaviors that have been keeping you stuck and creating uncomfortable symptoms, such as anxiety and depression.

That is up to you as I do not assign homework. Once you have a solid understanding of internal patterns that are keeping you stuck, you will usually recognize times when you are engaging in those patterns and will know what to do differently. I will sometimes recommend books that I think may be helpful for you based on your particular problems.

You don’t have to do anything you don’t want to do. It is 100% up to you if you want to face these feelings or keep them tucked away. It would be unethical (and impossible) for me to force you to do anything. What I can do, with your willingness, is show you patterns of thinking and behavior that may be getting in your way, and we will talk about the consequences of these patterns together. Then it is up to you to decide if you want to try to do things differently. If you do want to change (and I hope you do!), I will help guide you through new ways of reacting to your feelings so that you can start to develop healthier patterns of relating to yourself and others.

For psychotherapy to be effective, you will need to work hard at changing long-standing patterns of thinking and behaving. I have no control over how much work or effort you put into that process, therefore, I can’t guarantee any results. What I can ensure is that I will put forth my best effort, using my years of advance training and expertise, to help guide you through the process and help you see what you will need to do to feel better. The rest is up to you.

That is also up to you. Every individual comes with unique goals for therapy. We will spend the first part of your therapy helping you to develop these goals. It is perfectly fine if you come in already knowing what your goals are or if you have no idea! Once we establish those goals we will use them as guideposts for our work together. I will frequently check in with you about how you are doing reaching your goals, and once you have met those goals we will discuss whether you want to end therapy for now or work on new goals.

I find that most people who put in good effort by coming to therapy consistently and are willing to face uncomfortable feelings will be able to reach their goals and establish healthier patterns of relating to themselves and others. Through this work they often find that their symptoms of anxiety and depression either lessen significantly or disappear completely.

I don't currently provide couples or family therapy and therefore I don’t have family members come to our sessions. It is important to keep your therapy with me as your own space, and since your family member is not a patient of mine I cannot treat them. I also believe it is a conflict of interest to treat more than one family member at a time. I do frequently refer my patients for family or couples therapy with other providers, however. This can be an important complement to your individual work, especially if you are struggling in your family relationships.