What is psychotherapy?

Sometimes we are hesitant about starting new things simply because we don't know what to expect. Fear of the unknown is the primordial fear. So in the post, I want to explain a bit about what psychotherapy is and what you can expect.

Psychotherapy is "talk therapy." 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." Basically, 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. You get out what you put into it. The therapist provides the resistance. When you are new, we just want to get you moving, exploring. Treadmill at a low pace, 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 the same. 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. And like the gym, finding the right trainer matters. Not every therapist is right for every person, and that is okay.

For most people, if you are thinking about therapy, that curiosity is enough to begin. 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.

But what are the weights and the equipment in therapy? They are our emotions, our experiences, our memories. Research consistently shows that the relationship between therapist and client is the strongest predictor of change, more than any specific technique or theoretical orientation. This is one of the most robust findings in psychotherapy research, documented extensively by researchers like Bruce Wampold in The Great Psychotherapy Debate. As Devon Price writes in Unlearning Shame, every time we choose to turn toward other people instead of away, we give ourselves an opportunity at connectedness, which is essential to healing. Therapy is a place to experience that connection, to build the skills for connection, to develop frustration tolerance, resilience, and emotional vocabulary. It is, at its core, a human relationship in service of your growth.

What "works" means in therapy, and what the research actually shows, is worth examining more carefully. We will get to that in another post.

Therapy doesn't change you. It provides the space and the connection to allow you to change.

Mike O'Rourke is a Licensed Clinical Social Worker Candidate in Montana, available for in-person and telehealth therapy. Book a session or consultation.