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Why therapy works: The Therapy

purplecouch-insideI’m not going to use this post to get into the different counseling theories; I’m going to be much more general here because it almost doesn’t matter what theory your counselor uses as long as you both genuinely commit to the process.

That’s not to say that all therapies are created equal or that counseling is one big placebo effect. There’s research that shows, for example, that cognitive-behavioral therapy has a positive impact on anxiety and that EMDR (Eye Movement Desensitization and Reprocessing) is an accepted treatment for trauma. But that won’t matter if you don’t feel comfortable with the form of counseling that your therapist is using.

If Gestalt theory (like the famous empty chair technique) doesn’t resonate with you, then it doesn’t matter how “good” the technique is, it won’t work for you. Likewise if your therapist is using that exercise because she’s heard it’s supposed to be effective but she doesn’t really buy in, then she’s probably not going to do a good job of overseeing the process.

This is why when people tell me, “I tried counseling; it didn’t work.” I tell them that they should try again with a different counselor because now they’re ahead of the game; they know what doesn’t work for them.

See, when we talk about the three pieces that create the successful therapeutic whole — the client, the counselor and the treatment — we’re talking about the relationship between the client and the counselor. We’re talking about the ritual of coming together, of sharing and listening, of the power of “an emotionally charged, confiding relationship.”

In other words, it doesn’t matter if you go to the best psychotherapist who ever lived if you don’t have an emotional-attachment and trust in your relationship.

Isn’t that fascinating? I think it is. And it makes sense.

You don’t have to be best friends with your therapist — best that you not be — and you don’t have to find someone who mirrors your every belief and value (more on that in a later post). But you do need to be able to trust and feel safe with her. If you don’t or can’t, you won’t get good therapy. There’s more good stuff about the client/counselor relationship in the article I linked:

  • [A] therapeutic rationale accepted by patient and therapist;
  • provision of new information by precept, example and self-discovery;
  • strengthening of the patient’s expectation of help;
  • providing him with success experiences;
  • and facilitation of emotional arousal.

That’s what you need to have a great counseling relationship and if things get in the way of that, you won’t get good results.

 

1 Comment

  1. Hi, I’m really enjoying your posts and linked articles. Frank’s paper looks very interesting but I immediately wanted to give critical feedback about the use of ‘he’ & ‘his’ throughout. (I really appreciate that you don’t do that.) Since I couldn’t leave it there i’ve had to leave it here, sorry about that!

    Reply

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