Each of us has preconceived notions about everything—beliefs that are shaped by our society, pop culture, and the people closest to us.
And therapy is no exception.
In fact, because there’s so little information on therapy, we tend to hold a lot of beliefs about what we think goes on. One reason for this lack of information is that it’s actually intentional.
That is, according to Ryan Howes, Ph.D, a psychologist in Pasadena, Calif., therapy is intentionally mysterious. “Therapists are legally bound to keep the contents of their sessions confidential, so everything that is said behind that closed door stays there.” (There are a few exceptions.)
“We therapists are professional secret keepers, so you may hear general concepts about therapy from us, but specific details about real identified clients is off limits for us,” Howes said.
We also don’t exactly trade stories about therapy. Most people who see a therapist keep it to themselves. They fear that others will think they’re “weak or crazy,” Howes said, even though it’s the complete opposite: “It’s the most courageous and humble people who are willing to reach out for help or to make a good life great.”
But because of the secrecy, shame, and inherent mystery of therapy, we rely on depictions in Hollywood to fill in the gaps—most of which are either “sensationalized or wildly distorted,” Howes said.
“A quick glance at the therapists on TV and in the movies reveals a parade of sadistic, seductive, magical, or inept therapists who make for great characters but poor representations of the profession. Most therapists aren’t like Dr. Phil, Lisa Kudrow, or Richard Dreyfus in ‘What About Bob?’”
Another reason many of us know so little about therapy is “because there is as much variety of clinical methods as there are patient concerns, making it often difficult to describe standard methods and treatment approaches,” said Alicia H. Clark, Psy.D, a psychologist in Washington D.C., and author of the book Hack Your Anxiety: How to Make Your Anxiety Work for You in Life, Love and Work. It’s tough to “describe how therapy works when treatment is highly individualized,” she said.
So, in other words, it’s not surprising that therapy can surprise us—and you just might be surprised by the information below.
Therapy is preventative. We often think that therapy is for crises. We think we need to go when our world has exploded: when we’ve faced an excruciating loss, when we’ve been blindsided by infidelity, when we’ve suffered some terrible trauma. So it might surprise you to learn that therapy is actually “one of the best methods of preventative health care you can do for your mind and your body before problems get too big,” said Tara Fairbanks, Ph.D, a therapist in Santa Monica who works with adults and couples.
Therapy involves doing intentional work on the most significant areas of our lives, such as: “your relationships, your emotional reactions to significant events and life transitions, your patterns of interacting with the world,” she said.
Therapy can be exciting and fascinating. Many people dread therapy, and are afraid of it. “There seems to be a common misperception that therapists judge and diagnose patients, leaving people feeling worse about themselves and less confident,” Clark said. However, a therapist’s job, she said, is to help you harness your strengths, and to feel more confident about yourself and your life overall.
Clark’s clients who initially thought therapy was scary regularly tell her that they wonder why they waited so long to come in. They enjoy the process and look forward to their sessions with her. They “ultimately marvel at realizing how powerful it can be to face things they have let hold them back for too long, and find better, more effective solutions,” she said.
Howes noted that clients who were initially anxious about therapy actually become excited about it. “Therapy is like taking a class where you are the topic, and learning what made you the person you are today can be fascinating material. It starts with a therapist who is genuinely curious about who you are and what makes you tick, and for some this curiosity is a new and interesting approach.”
And this approach helps you to look at yourself through a new—inquisitive, kinder, less judgmental—lens, as well. Clients have told Howes: “I felt upset with my partner the other day, and then I asked myself why I was feeling that way, and here’s what I came up with….” “I wonder why I’m always chasing unavailable partners.” “What am I really looking for in a career?”
Therapy can be a relief. “[A]n initial surprise people tend to experience is a feeling of relief,” said Katrina Taylor, LMFT, a psychotherapist in Austin, Texas, who specializes in helping men and women address childhood and traumatic experiences that may be holding them back from living a full and meaningful life.
The relief often stems from “speaking to a trained professional and having the experience of being known and understood,” which “can be powerfully healing.” It is powerful when our experiences, pain, and raw emotions are acknowledged and recognized by someone who isn’t judging us at all. It’s powerful when we realize we’re not alone or weird or broken.
Many clients also tell Taylor they feel unburdened, “sharing…what was previously overwhelming, secret, or even unable to be put into words.”
Therapy is unsurprising. “Some people come to therapy expecting that an incredible insight or breakthrough awaits them in each session,” Howes said. Maybe you expect your therapist to be a kind of healer or wizard, he said. But while most therapists are highly skilled and will help you discover important information about yourself, they’re also real people.
As Howes clarified, therapy is just “two real people focusing on you and your issues and trying to connect the dots and problem solve together.” For some, he said, this is disappointing. But others find comfort in knowing “they don’t need to feel better immediately or take the therapists’ opinions as gospel truths.” They also find comfort and safety in therapy’s predictability and consistency.
“We meet at the same time each week, my office decor doesn’t change much, I have a consistent curiosity and positive feeling toward [my clients],” Howes said. “They enjoy the dependability of our interaction. It’s like life gives them enough surprises, and therapy is one place they don’t have to brace themselves for a radical change each week.”
Therapy is hard work. “Unlike a medical doctor, a therapist typically doesn’t ‘do something’ to you, you’re an active participant in the process,” Taylor said. Therefore, the more active, honest, and vulnerable clients are willing to be, the more they’ll get out of the process.”
What does being active look like?
According to Taylor, it means taking the lead in sessions. For instance, you might reflect on what you’d like to discuss in therapy and what you’d like to work on. Instead of waiting for the therapist to bring up a topic, you bring in your own topic.
Therapy requires clients to be introspective, and to honestly explore relationships patterns and personal foibles, and “to be willing to take risks to do something different,” Taylor said.
In fact, most of the work happens outside the therapy office. Because you’re working on applying what you learn in therapy to various situations in your life.
Therapy can help even the most self-ware among us. Many of Fairbanks’s clients and friends wonder what therapy can do when they already have a lot of insight into their challenges and relationships. Maybe they realize they get into relationships with people who are emotionally unavailable. Maybe they know they work too hard at trying to feel lovable.
But what has surprised her clients is that this knowledge, which previously hasn’t led to tangible changes, does so in therapy. That’s because therapy “is like having a safe practice ground to translate insight into new patterns.”
Therapy is a great place to rehearse, take action, and experiment. According to Fairbanks, this might look like first practicing assertiveness skills with your therapist, and then using them with your partner, colleagues, parents, and friends. This might look like working through old wounds that created shame, and then adopting self-compassion—sharing your authentic self with your therapist, and with others, believing you’re “worthy of love and respect and seeking relationships with people who treat [you] as such.”