How does therapy work?

Life feels hard. You’re feeling anxious, stressed, overwhelmed. You’re feeling flat, lost, unhappy. You’ve been through difficult life experiences that are weighing you down. Perhaps you’re not functioning as well as you’d like to. 

Let’s face it, we all struggle at times in our lives, especially when it comes to becoming parents, and everything that goes with this tumultuous life stage.

You might be contemplating talking to someone, but also wondering “what would be the point?” “How could talking to a psychologist help me?”  

Nowadays we rely on reviews to find out about other people’s experiences. As  psychologists, we are prohibited from eliciting and publishing client testimonials, making it difficult for people to find out how therapy works for others. 

However, the psychologists at the Antenatal & Postnatal Psychology Network constantly receive feedback from our clients about their experiences of therapy. So we decided to pull together feedback we’ve received over the years, to bring to light the commonly reported benefits of therapy. 

Please note that no identities have been revealed in the compilation of this list. The headings are written in the first person and are in no particular order.

Feeling heard, accepted and validated
Some people come to therapy reporting that when they were growing up, their feelings were not heard. With the best of intentions, parents can minimize or dismiss the feelings of their children, sending messages that their feelings are a sign of weakness, that they should just get on with things, or that their feelings signal catastrophe. 

Clients have reported that therapy provides them with a safe environment in which to identify and share their feelings. Once a good relationship and rapport has been established with their therapist, clients value that their feelings are accepted, are encouraged to be ‘felt’ (rather than shied away from or feared), and that their feelings are valid (“it makes sense that you feel that way”).

Feeling ‘lighter’ by getting things off my chest
In some instances, a client’s therapist is the first person to whom they have disclosed past experiences, distressing thoughts, or shameful feelings. By simply getting this information out, clients report feeling lighter – less consumed by their self-criticism, shame or fear of being judged. Within a trusted client-therapist relationship, repair can begin with the acceptance, validation and non-judgement the therapist brings.

Learning that all feelings pass
Interestingly, many clients report that being allowed to feel and express their feelings, along with having their feelings accepted and validated, provides an environment within which they learn that feelings evolve and change over time. By talking things through, feelings shift, and the intensity of the original feelings (often shame) diminishes.

Understanding why I think and react the way I do
In exploring the past, people learn about the ways in which they experience, and deal with their feelings – both internally and in relationships with other people. With insight into why they think and feel the way they do, their responses can be de-automated, giving them more choice and capacity to respond more adaptively. Clients learn to bring self-compassion to what was once habitual self-criticism.

Recognising that my expectations and assumptions underlie my feelings and behaviours.          
In exploring the past, people learn about how their expectations were formed and how their expectations cause them to feel and react in certain ways. In therapy, clients learn to challenge their expectations, and to defer to their values as their guide, rather than to their habitual internal narratives.

Examples of unhelpful beliefs:

As a mother, I should know exactly what my baby needs at all times.
If I can’t exercise 3 times per week, I won’t exercise at all.
Everything I do should be done perfectly otherwise I’ve failed.
If I don’t get enough sleep tonight, I won’t be able to function tomorrow.
I am uninteresting to others, so I avoid meeting new people.
My child should know to behave well when we go out.

Examples of assumptions:

She thinks I’m a terrible mum because she uses cloth nappies, and I don’t.
My partner won’t know what to do if I leave the baby with him.
The mothers at mothers’ group think I’m a bad mum because my baby cries more than the other babies.
No one cares about my grief after my miscarriage.
I’m a bad person because I had that awful thought.

Learning to see another person’s point of view /emotional experience
It can be enlightening when people realize that they have been making assumptions about other people’s behavior or responses to them. They learn that there are many potential explanations other than the ones they were subscribing to. When people learn about their own projections onto other people, they also learn that other people project their fears too. When clients see that everyone sees things from their own perspective, they can come to recognize that trying to please others is futile, and that even if theyarejudged by another person, this is tolerable.

Learning how to live in the present and not engage in ‘what if’ thoughts

Clients learn the value of living in the present moment, of asking themselves “what’s required of me now”, rather than entertaining a litany of catastrophic thoughts about what could go wrong in the future. With practise, recognizing and stopping “what if” thoughts can liberate clients from worry.

Learning to accept what I can’t control

Clients can become practised at recognizing what’s not in their control. As a result, they can develop more confidence about acting on what isin their control, and accepting what is not controllable. 

Learning of skills

Skills learnt in therapy include 

• becoming more assertive in relationships 
• learning better ways of communicating and listening 
• learning to self-regulate when triggered
• learning coping strategies for when things get hard
• facing fears (in a supported environment), and becoming less fearful and anxious
• learning how to survive loss and rebuild life
• learning how to set goals and commit to achieving them
• accessing compassion for self and others in place of criticism and judgement 
• identifying values, and making decisions based on these
• understanding and responding to baby’s cues, thereby becoming a more confident parent
• becoming a better parent by hearing, accepting and validating children, while being clear on boundaries and limits

Overall, clients have reported becoming better versions of themselves - more tolerant of their own and others’ imperfections, feeling worthy of being cared for and seeing the value in caring for themselves. And, as a result, clients have reported an improvement in their moods and relationships, and a strengthening in their sense of selves and their meaning in life.

Written by Dr Renée Miller
​Principal Clinical Psychologist
Antenatal & Postnatal Psychology Network