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Why Therapy Works & My Personal Perspectives on How Healing Happens

Therapy Session

Because I like people and because I am constantly intrigued to learn about people and to understand how an individual narrates and defines their life and their personal sense of meaning and even though I have been practicing psychotherapy for over 10 years, I still have moments of awe and simplistic questioning “Why do I get to get paid for talking to people all day?” “How does therapy work and how is this different than just having conversations all day with a friend?”


Therapists have a code of ethics and have been trained to execute personal boundaries and neutrality – thus a therapist dialoguing with one of their friends is very different than the framework within a professional client/practitioner relationship. And there is still something to be said for “being on the clock” and enjoying the work that you do but still being in the head space of work and professionality. 


But what are really the features that make therapy work and transcend it beyond just talking or rehashing emotions?


Here are my personal principles on why therapy works and my framework for facilitating growth and healing:

  • Introspection Does Need to be Guided: Most of us can get very cerebral and heady.  We are capable of so many complex thoughts, ponderings, and over analysis patterns and yet there can be personal biases around what the brain gets mentally stuck on.  Most of us then end up recycling the same thought patterns over and over and then it is hard to question our own inner logic and assumptions.  A lot of the benefits of therapy come from the process of guided Introspection and receiving logical and neutral feedback about individual thought patterns and thought errors.  And to comment more on thought patterns…

  • Changing Negative Thought Patterns: A therapist is going to help an individual to not just recognize their negative thought patterns but to also create new mental schema’s or to actually start to replace negative thought patterns with more positive and affirming thought patterns.  New thought patterns generated through psychotherapy tend to take a strength-based approach and help to enhance feelings of self-efficacy and self-confidence.  And to say more about strengths…


  • Receiving Unbiased Feedback about Individual Strengths: A good therapist points out the strengths that an individual has.  It is often hard to see our own strengths and positive traits (and by nature when an individual is suffering from depression or anxiety, different “blind spots” or inability to see the positive start to develop).  Many people also find it hard to give themselves internal praise or compliments.  A good therapist helps to boost confidence by offering sincere positive feedback – to some degree we all need a little bit of “cheerleading” feedback in our life, but we also need recognition of the unique strengths and assets that make us who we are. 


  • Changing Behaviors is Hard – a Therapist Helps: Once we identify negative behaviors that are limiting life success or happiness, it is hard to create actionable behavioral modifications or changes.  A therapist can help define what are realistic and measurable behavioral changes and then hold an individual accountable for committing to these changes.  Many of us are quick to want to bite off more than we can chew, so to speak, and therapists can set the realistic timelines and concrete action steps while also providing an externalized accountability system. 


  • Nervous Systems talk to Each Other: Our nervous systems are constantly taking in feedback or responsiveness from the people that we closely interact with.   A therapist role models calm and non-reactive responsiveness, and repeatedly being in contact with a non-judgmental and calm professional helps to re-wire our own nervous system so that an individual can feel more relaxed.  Unconditional positive regard from a therapist is also taken in and felt through the nervous system and can help facilitate enhanced self-esteem and internal positive regard. 


  • Two People are Stronger than One Person: There are many complex problems in life and it simply helps to talk things out loud and to have feedback and theories from another person.  A therapist is trained in how to ask useful questions – questions that guide deeper introspection or questions that can gently challenge limited belief patterns.  Or sometimes another person knows how to ask questions that are in reference to our “blind spots” (the topics or areas in our life that we may be intentionally avoiding or actually “blinded to”). 


  • Weaving in Meaning & Deepening our Personal Narrative: In sharing our stories out loud – especially childhood stories and reflection on the stories or legacies from our family line – a therapist can help to point out the deeper themes or patterns that exemplify personal meaning.  We may also benefit from examining potential Intergenerational trauma (the ways in which trauma or the longer-term effects of trauma become inherited or passed down from generation to generation) and examining how our personal narratives or sense of meaning may be derived from family themes and legacies.  There are both positive narratives and negative narratives that emerge from our family and upbringing and many individuals benefit from peacefully integrating family influence into personal identity. 


  • Cathartic Effect: The history of psychotherapy is founded on the knowledge that talking openly about emotions helps to release the pent-up negative charges.  Or put in other words, it can feel like a cleansing or purging effect to openly discuss difficult or painful emotions.  It is not always easy to have cathartic conversations with loved ones, as most of us fear emotional “dumping” on a person and the neutrality of a therapist being solely focused on the individual and no one else at that moment and not being biased by any other personal motivation or relational element tends to facilitate greater cathartic release.   Much of our body is designed within a discharge system – we simply need to discharge or release emotionally in a way that is similar to the process of digestion/elimination.


Jessica Giordano, May 2020

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