What is psychotherapy?

Psychotherapy is "talk therapy.” It’s two people talking, sometimes the client is lying on a couch (not as common anymore, but if your therapist has a couch and you want to lay down, go for it). The person attending therapy can be referred to either as a client or a patient, depending on where and how you are seeing your therapist. A private practice therapist is more likely to call you a client, while someone working with a medical team is more likely to call you a patient. There is a lot of ambiguity and “it depends” in therapy.

That paragraph describes some characteristics of therapy, but doesn’t shed more light onto what it actually is. The American Psychiatric Association defines it as "a treatment that uses verbal exchange, and sometimes behavioral interventions, within a professional relationship, with the primary goal of fostering the growth and development of healthier and more satisfying patterns of response to stressors so that an individual can lead a self-directed life." In other words, we talk about what you want to change, and together we figure out the best way to make that change.

An analogy I like to use is that going to therapy is like going to the gym. We can imagine the therapist is something like a trainer, and that our emotions, experiences, and memories are the weights, movements, or exercises. When you are new, we just want to get you moving, exploring. Treadmill at a low pace, or lifting low weights. As you become more comfortable, we increase the resistance, and the work gets harder. But not everyone has the same goal. Some people are powerlifters. Others are trying to lose weight. Others are just working on their health and longevity. Therapy is similar. The goal is yours. The pace is yours. My job is to meet you where you are and help you get where you want to go.

If you want to become a long distance runner, you probably don’t want to train with a powerlifter. Not every therapist is right for every person, and that is okay. Research (Wampold, 2021) consistently shows that the relationship between therapist and client is the strongest predictor of change, more than any specific technique or theoretical orientation.

For most people, if you are thinking about therapy, give it a try. You don't need to know what you want to work on. The goal can come later. You don't need to know how to describe your issue. That is part of what we do together. Therapy doesn't change you. It provides the space and the connection to allow you to change.