Therapy. What is it?


Some people say, “Why would psychotherapy help? I’m always talking about my problems to friends, and talk doesn’t change anything.”

It’s certainly good to have friends who are there for you and ready to listen. But if the talk is not changing anything, it may be that the kind of talking being done is just talk, rather than the nature of “talk” that is part of a deeper process which happens in good psychotherapy. Talk is only the tip of the iceberg, when the deeper process happens. Talk is the obvious, easily noticed part of the process, but more happens in the body and the emotions.

There is a rhythmic cycle to the deeper process that is noticeable if one pays attention. Years of working as a psychotherapist have given me a chance to notice some features of the rhythmic deeper process, and I’d like to describe them. See if you recognize them. It may help you talk in a way that more quickly gets you from feeling troubled about something to experiencing growth and relief.

There are three phases to this rhythmic cycle.

The first phase is the one in which talk is the dominant feature. People need a good part of the therapy session to tell their story. This involves reporting, for my benefit and for their own understanding, the events that have happened and the implications that have then resulted in upset feelings or unhappiness.

It is important to give this enough time until you feel quite satisfied that all important facts and considerations have been vocalized and accurately expressed–and sympathetically understood. There is a little sigh of relief that usually comes when you get to this point. Arriving at this point makes everything a little better, even if the next two phases don’t happen. Feeling pressured to get to the point, being given advice, or worse yet, being judged and criticized will usually delay or prevent the little sigh of relief that marks the end of this phase.

The second phase is subtler, and it often seems it would go unnoticed if I didn’t gently point out that it is happening. This is when your body spontaneously begins to get a whole-body sensory reaction to the issue or situation you’ve been talking about. It might be a kind of welling up sensation that you feel in your throat or that changes the way you hold the muscles in your face, or it could be a quivering in your belly. These developments happen in the body, not in the words, and they are fleeting. The flow of words can easily continue and you may distract yourself from noticing the bodily event. But that would be too bad, since honoring the subtle bodily developments can offer real moments of opportunity. These are the spots where your organism can feel your whole complex issue in its totality, and if you handle them properly, the full power of your mind, which is more than your intellect, will process things toward insight and resolution. 

Some people have been conditioned to think that these developments are dangerous or embarrassing, and might say something like, “I don’t want to fall apart on you.” But if handled properly, they do not at all lead to undesirable developments. Rather, they open things up and generate flexibility and new perspectives and creativity that will sometimes amaze you. 

The key to properly handling these delicate moments is to cultivate a friendly and respectful attitude toward yourself and the full range of your experience. With the help of a good listener or therapist, you can more easily access this kind of attitude toward yourself. The things for which it is the hardest to be self-accepting about are the very things for which you need to have an attitude of unconditional self-acceptance if you want to be able to make positive change.

When you achieve this respectful acceptance at the moments when your body is actively feeling the sense of the whole intricate issue, you may become more emotional for a little time. It’s a kind of tender moment. Some people experience it as an opening into a level of feeling that is associated with intimacy and unusually rich human experience. It is important to just allow these developments to unfold and patiently wait to see what meanings emerge from the process. You can short-circuit it if your intellect jumps in and tries to make it all rational and logical right away.

There is often a move from brief moments in the second phase back into the first story-telling phase, as you recall more aspects of the situation that need to be taken into account. Then a re-occurrence of the second phase may occur.

When enough of this has happened, there is a spontaneous movement into the third phase, which is the icing on the cake. In this phase, new insights present themselves. Problems may resolve themselves, and you can explain to yourself exactly how to see and implement solutions. New action steps can be identified that you know you can take, but that you couldn’t identify before–or if you could, you were at a loss as to how to move in the new direction. There is also a change in how you feel emotionally. Now there is relief, sometimes excitement or enthusiasm, and almost always a more solid sense of yourself as well as renewed compassion for yourself and for others.

When these three phases occur in a therapy session, the client leaves the session satisfied and inspired. All three phases may not happen in every session, but I believe the fist two should happen in nearly every session, and the third ought to come at least every once in a while. If it never happens, something in the process is not right. In such cases, you should raise the subject with your therapist and try to talk about what you think might not be working for you. 

If that doesn’t help, consider trying another therapist. The therapist that is right for you will match your needs well enough to easily create the conditions that allow you to move through the three phases with regularity. When you experience the cycle regularly, you are likely to make steady progress on whatever issues you are working on, and it will be obvious to you that you are making progress.

By Dr. James R. Iberg



About Jennifer Shay, LCSW, ACSW

Licensed Clinical Social Worker
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