If you’ve ever typed “types of therapy” into a search tool and felt more confused after reading the results, you’re not alone. Terms like cognitive behavioral therapy, dialectical behavior therapy, and EMDR can sound clinical and intimidating, but this guide helps you understand these approaches with definitions written for real people like you.

Whether you’re considering therapy for the first time, exploring options for a loved one, or simply trying to ask better questions when working with a therapist, we can help you through it all.

Why Knowing Your Therapy Options Matters

The beauty of therapy is that there is no one approach: it looks different for everyone, depending on their needs. The right treatment for someone navigating grief may look very different from what works for someone managing borderline personality disorder or processing childhood trauma. You may have heard of cognitive-behavioral therapy (CBT), which is very effective for many people, but it’s just one of many therapy approaches that trained professionals can use.

Knowing what’s available and which modalities address different needs empowers you to have informed, meaningful conversations with potential therapists or current therapists. It also helps you trust the process once you begin the healing journey.

The Most Common Types of Therapy, Explained

How Do You Know Which Type of Therapy Is Right for You?

The truth is: You don’t always know in advance, and that’s okay. Most skilled therapists are trained in multiple modalities and will tailor their approach to your specific needs, history, and goals. The most skilled therapists have a diverse toolkit of methods they can draw from, adapting their approach to match each person’s unique needs, interests, and developmental stage.

That said, going in with some knowledge gives you the ability to ask meaningful questions. When looking for the right therapist, or during your next session, try asking your therapist these questions:

Asking these questions will help you find the right fit for your healing journey, and a good therapist will welcome them.

A Quick Reference: Therapy Types and What They Address

There are so many therapeutic approaches out there, and we’ve only covered a few. Still, here’s a breakdown of the theories we discussed and what they can help support:

Taking the Next Step

Understanding these approaches is the first step in building a better you. Finding the right therapist is a significant part of improving your mental health, but you don’t have to do it alone. GoodTherapy’s therapist directory allows you to filter by therapy type, specialization, location, and more, so you can find someone who truly fits your needs.

If you’re still exploring whether therapy is right for you, our blog on what to expect in your first therapy session can help you get started.

Remember, reaching out is not a sign that something is irreparably wrong with you. It’s a sign that you know your well-being is worth investing in.

Ending a relationship and letting go can be incredibly difficult no matter how toxic it is. Part of this is for simple biological reasons, as some scientific studies have shown that being in love activates the same areas of the brain as being high on cocaine.

Brain scans of lovers and people experiencing cocaine addiction both display increased activity in the pleasure centers of the brain (most notably the dopamine centers) and decreased activity in the frontal lobe, which is the area responsible for cognition. This means that while falling in love can make us feel good, it can also profoundly affect our judgment.

It is for this reason that love can sometimes be compared to an addiction. In love, much like addiction, there may be negative side effects such as abuse or gaslighting. But despite all of those bad circumstances, it can still be difficult to kick the romantic attraction and feelings of love when letting a relationship go.

If you find yourself feeling trapped in a relationship you know is not healthy, consider these 15 tips for letting go of it for good:

1. Recognize the Problem

Awareness is the first step.  Educate yourself or consider talking to a therapist or counselor about what constitutes an unhealthy relationship. Take a good, hard, and objective look at your relationship and be honest with yourself.

Ask yourself these questions:

• Is this relationship serving my highest good?
• Is this relationship negatively impacting other areas of my life?
• Is this relationship detrimental to my self-esteem?

If you answered yes to any of these questions, consider ending or talking to a professional about the relationship.

2. Allow Yourself to Feel

[fat_widget_right]Letting go of a relationship is usually not easy. It can be painful to end a relationship even if the relationship was not serving your highest good. Honor any feelings of grief you may have, and allow yourself to feel those emotions rather than attempting to suppress them. Accept grief as a part of the experience, and allow yourself the time you need to heal.

Reach out to one of our therapist in Raleigh, NC or find a therapist closer to you.

3. Discover the Lesson

Many people who move on from a toxic relationship feel guilt or shame as they perceive the time they spent in the relationship as a waste. However, every person who comes into our lives can teach us something. Rather than looking at your relationship as wasted time, try to find the lesson in it. What did this person teach you? What are you taking away from the relationship? How have you changed as a person, and how might you do things differently next time?

In life, lessons may often be repeated until they are learned. Look for the lesson from this relationship and you may be less likely to carry the same lesson over into your next relationship.

4. Create Separation

It can be hard to distance yourself from someone you’re used to spending so much time with, but it is usually necessary if you want to move on from the relationship. This doesn’t mean you can’t maintain a friendship with your ex, but it’s usually best to allow some time for both parties to heal before you try to spend time together as friends.

5. Let Go of the Mementos

It can be tempting to hang on to all the old relics of a past relationship. Doing so, however, may prevent you from moving on with your life. If you must keep the old love letters, movie ticket stubs, photos, or romantic gifts, you may want to store them somewhere out of sight until you’re ready to move on.

6. Take Off Your Love Goggles

Love often has a way of clouding your perception, which sometimes makes it difficult to a see someone for who they really are. If you really want to get out of an unhealthy relationship, you must be willing to take off your love goggles and look at the person objectively. Consider talking with a close family member or friend or even finding a therapist to help you look at the relationship impartially.

It isn’t uncommon to only hold on to the good memories of an ex and completely shut out the bad memories. Maintain your perspective by remembering both sides of the experience. Remind yourself of the good times, but don’t forget those bad times or you could end up forgetting why you ended the relationship in the first place.

7. Compose a Letter to Your Ex

Consider writing out all your feelings in a letter, even if you have no intention of sending it. You can choose to give this letter to your former partner or destroy it when you’re finished. The point of the letter is to allow you to release your feelings. Writing or journaling can help you reflect on the relationship as a whole, while giving you a way to further your mental and emotional wellness.

8. Focus On Empowering Yourself

Try your best to shift focus off the relationship and back to yourself. Consider trying new things or putting your energy into a hobby you’ve neglected. Remembering why the relationship was unhealthy and focusing on what it is you do want in a relationship can be empowering.

Most importantly, work on your relationship with yourself. Focus on cultivating self-love and respect. Remind yourself that you are worthy of love and that you deserve a healthy relationship.

9. Rewrite Your Story

We often tend to place the weight of our identities into our self-professed life stories. We believe we are what we continually tell ourselves. Examine your story and rewrite it in a more empowering way to start making positive changes in your life.

If you continually tell yourself you lost your soul mate and you’re destined to be alone, you might struggle to hang on to a relationship that is no longer serving you. Reframe your story and consider the fact this relationship may have just been one step on the journey toward an even better relationship in the future.

10. Practice Forgiveness

Release any feelings of guilt or regret you have surrounding the relationship. Forgive yourself for anything that happened in the past because you can no longer change it. You can only move forward and learn from it.

Be willing to forgive your former partner as well. Let go of any resentment you have regarding the relationship. Look at your partner with compassion and empathy and understand that all humans are susceptible to mistakes.

11. Live in the Present Moment

Life exists in the present moment. Choose to live in the present rather than getting lost in nostalgia. Often, people stay in a relationship that is no longer healthy because they are clinging to the past. Judge your relationship based on how it is at present rather than how it once was.

12. Accept What Is

We must be able to accept things as they are if we want to move forward. Many people remain in relationships that are unhealthy hoping they can somehow change their partner. It is important to remember you cannot change anyone, especially if they have no willingness to change themselves. If the relationship isn’t working for you, then you have the choice to leave and move on. That is something you can change.

13. Contribute to a Cause You Care About

If you’re having trouble letting go of the past, consider getting involved in a cause you feel passionate about. Doing this can not only occupy your time and mind as you process feelings and let go of the relationship, but it can also help shift your focus to something bigger than yourself. Studies have shown volunteering can significantly improve overall well-being. This can provide perspective and help you feel good as you also help your community.

14. Practice Self-Care

Most importantly, work on your relationship with yourself. Focus on cultivating self-love and respect. Remind yourself that you are worthy of love and that you deserve a healthy relationship.Letting go isn’t easy, and it isn’t uncommon to forget our own physical and emotional health after a painful breakup. The grief can be overwhelming and we may start to neglect our own needs.

Help yourself by choosing to practice self-care every day. Get plenty of rest. Eat nutritious food. Indulge. Take a hot bath. Get a massage. Whatever it is, just do something to meet your personal needs.

Furthermore, learning how to practice self-compassion. Moving on can be a big and scary step, so be gentle with yourself as you heal and create a new life after this relationship.

15. Embrace the Impermanence of Life

Forever is a misleading term. The only constant that exists in life is change. Despite our efforts to the contrary, we truly cannot hold on to anything in life forever. Everything—friends, family, and relationships—come and eventually go.

When it comes time for something to end, rather than clinging to what no longer is, realize impermanence is the nature of life and try to embrace it. Appreciate the good moments you had, cherish those memories, and let them go in exchange for new experiences.

Know When to Ask for Help

The first few moments, days, or weeks following a breakup can seem debilitating. For some, ending a relationship means a loss of identity, support, and normalcy. Ending a relationship—even a toxic one—can be incredibly challenging and emotionally draining. However, you do not have to do it alone. Know when to seek support if you need it.

If feelings of grief, shame, guilt, or other negative emotions persist and begin affecting your daily life after a relationship ends, consider finding a qualified therapist or counselor who can help you process and acknowledge your feelings in a healthy way. A qualified mental health professional can help you examine the past relationship in a safe place free of judgement while you work toward achieving a more complete sense of self after the relationship has ended.

Even if you feel like there is no hope after severing an important tie in your life, remember you can heal and you deserve a healthy relationship that meets your needs and complements you and your happiness.

References:

1. Lahat, I. (2014, July 9). The brain looks the same when we’re in love or high on cocaine. Retrieved from http://www.businessinsider.com/the-brain-looks-the-same-high-on-love-or-cocaine-2014-7
2. Tabassum, F., Mohan, J., & Smith, P. (2016). Association of volunteering with mental well-being: A lifecourse analysis of a national population-based longitudinal study in the UK. BMJ Open, 6(8). doi:10.1136/bmjopen-2016-011327

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Dear new client: Welcome to the wonderful world of therapy! I know it can be hard to come in for your first appointment—really hard. You are here to meet me, a stranger who will hear about parts of your life that no one else hears about, and entrust I will do everything I can to help you. To make things easier, here are 10 crucial things I want you to know.

1. Honesty is the best policy.

If you’re not honest in the therapy space, you’re missing out! This is a rare opportunity to be 100% honest without the prospect of being judged. You’re paying for therapy, so lying is counterproductive. Are you using drugs? Tell me. It helps me better understand and work with you on everything from coping skills to medication use and interactions, to social skills, to behaviors that may or may not be attributed to substance use, to relationships, to even finances. Cutting? Tell me.

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2. Therapy is an investment in both the present and the future.

The skills you learn here, and the support and insight you receive, will not only help you with the situation you’re in, but will become part of the “toolbox” on your lifelong journey. You’ll gain knowledge that improves your ability to cope with stress and mood swings, helps your understanding of why and how you do things, and facilitates communication between you and others in your life including loved ones, friends, and business connections.

3. Keeping appointments and being on time is critical.

Part of therapy is consistency. If you’re late, we not only have less time together, we also have to think about the reasons you’re not arriving on time. Making therapy a priority is important. And yes, you may be charged a fee if you don’t show up or you cancel late. The time you’ve reserved is yours and yours alone. When you don’t show up, two things happen: other people needing help who would love to have your time slot are not able to, and I don’t get paid for my time. I rely on this in planning my family and work finances.

4. If you have any concerns, tell me.

I can’t fix or address what is wrong unless I know about it. I won’t get angry or offended or lose my cool. Therapy is all about the therapeutic relationship between the therapist and the person in therapy. If you’re offended about something I said or how you feel treated or mistreated, give me a chance to help you understand or change things. Some things that may seem trivial, such as the fear of being overheard by others in the waiting area, can be addressed and/or explored. If you’re worried because I seem angry, let’s talk about that. My thinking face can look like a grumpy face at times. Knowing your concerns and allowing me to address them is a way to work on empowerment.

5. Nothing is off limits.

Don’t be embarrassed to bring up things, even uncomfortable ones such as sexual experiences or feelings, anger or rage, dreams or fantasies. Believe me, I’ve heard and dealt with nearly everything. I’m not easily embarrassed or fazed. You can also say something such as, “There is something I really want to bring up, but I’m embarrassed.” I’ll help you work through your feelings, and even if you don’t talk about it right away, we can work toward creating a space where you feel okay sharing it.

6. Don’t worry about me.

I have support systems in place if I need help. I seek supervision from peers or others who have more expertise in a given area than I do. Therapists don’t operate in a vacuum, nor should they. I can handle your anger, sadness, and grief. I also know my limits. This is why some therapists refer people to other therapists for some issues. If, for example, I am uncomfortable working with someone who is struggling with a terminal illness because it’s outside my expertise, I will help you find someone who can better assist you.

In the case of therapy, if I were to have an outside relationship with you, I couldn’t be a productive or helpful (or ethical) therapist. Unlike a friendship where both people support each other, my only focus when we meet is you.

7. There’s a good reason I can’t have a friendship with you.

It’s the same reason I can’t be my friend’s therapist. It’s called a dual relationship, which basically means being two things at once to someone. In the case of therapy, if I were to have an outside relationship with you, I couldn’t be a productive or helpful (or ethical) therapist. Unlike a friendship where both people support each other, my only focus when we meet is you. My years of training, supervision, and experience are all focused on helping you.

8. I’m not perfect by any means.

I run late sometimes. I may miss an email or forget to return a phone call. This doesn’t happen often, but if it does, please let me know. In the case of running late, I will make up the time either at the current session or at a later time. If it bothers you, let’s talk about it. Again, nothing is off limits.

9. What you say to me stays with me, with two exceptions.

The exceptions are if I feel you are going to kill yourself or hurt someone else, or if I suspect there is child or elder abuse or neglect. This doesn’t mean if you say you wish you were dead I’ll call the police. But if you mention a plan or I feel like you are on the edge of suicide, I have to take action to ensure the safety of you and others.

10. When you’re ready to leave therapy, that’s great!

It’s something you might be thinking of or I may bring up. Please don’t just stop coming in. Let’s talk about it. If you abruptly leave without letting me know, I am likely to be both confused and concerned for your well-being. The preferred method of ending therapy is to have at least one session where we talk about what we’ve achieved and where to go from here. Closure is important for both of us. You are always welcome back—be it in a month, a year, or five years.

Again, welcome to therapy. I’m glad you’re here. Let’s start this journey together.

People come to psychotherapy because they want to feel better. A big part of a therapist’s ability to help a person feel better lies in their taking a loving stance toward that person. This stance starts with a therapist’s understanding that it takes courage for another person to come to them and their sense of feeling privileged by the trust that person invests in them. The rest of this article describes the other core ways in which therapy involves love and why this matters.

Faith and Compassion

Having faith in a person’s inherent goodness, as well as compassion for how that person’s life experiences have influenced them, is integral to helping them. This love stems in part from a therapist’s appreciation of the vulnerability inherent in being human. People are vulnerable to being hurt by others. When they are in contact with individuals, families, work environments, or even cultures that are filled with anger, criticism, premature loss, or emotional distance, it is almost inevitable they will start to internalize these experiences and develop corresponding psychological symptoms.

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Children are particularly vulnerable to this phenomenon due to their limited power to assert themselves, and they often have no recourse but to accept messages that are hurtful. When people have been hurt, they start to believe negative things about themselves (e.g. “I’m hopeless,” “I’m a failure”) as well as negative things about others (e.g., “People will hurt me if I trust them,” “No one will ever care about me”). Not surprisingly, they also experience feelings such as anxiety, anger, and shame that accompany these beliefs and tend to act reflexively on these emotions. These reflexive actions make it harder to connect with others and reinforce their negative beliefs about themselves and others.

Therapy helps people to break out of these negative cycles by allowing them to have a new kind of experience with their therapist that feels more positive and empowering. When a therapist approaches a person with a basic belief in their goodness, over time a person can feel a therapist’s faith in them and internalize it, which starts to shift what they believe about themselves. A therapist’s compassion for the person they work with also contributes to this change.

An internalized sense of being loved by one’s therapist can vastly change how a person experiences the world.

People are understandably concerned about being judged when they come to therapy. They may be afraid that a therapist is going to try to force them to change, or that a therapist will condemn them for some of the choices they make. Rather than criticizing or blaming a person for how they feel and behave, a compassionate therapist helps a person to understand how they are doing the best they can given what their experiences have taught them. They also help the person to think about new approaches to addressing their challenges that may help them feel better in the long run. This compassion is also internalized and helps people make sense of their lives in ways that are less focused on blaming themselves or others and leave more room for them to take positive steps toward change.

Patience and Humility

Therapy is inherently challenging. It is common in the course of many long-term therapies for there to be moments where a person feels stuck as well as moments where they feel disappointed or angry with their therapist. If a therapist tries to force a person to change before they are ready, or if they handle a person’s disappointment defensively, these impasses can be destructive.

Rather than blaming a person for feeling stuck or disappointed, a therapist coming from a place of love recognizes their own fallibility and tries to take ownership for any contributions they may be making to a person’s discontent. They also try to help that person see the role they may be playing in it. These moments become opportunities to build trust and for the person to gain greater self-understanding, rather than being harmful moments that reenact earlier painful experiences the person has had. Many people have been traumatically shamed and/or abandoned when expressing negative feelings toward others, and it can be a profound experience to have a therapist who does neither of these things and instead tries to patiently help them understand their pain and continues to care for them.

Conclusion

Just as people can be hurt in their relationships, they can also heal in them. Therapy is not just a set of techniques, it is a special type of relationship that is oriented toward helping people to heal from past experiences.

An internalized sense of being loved by one’s therapist can vastly change how a person experiences the world. In addition to symptoms diminishing, other people who once seemed threatening may become sources of connection and the future may seem more hopeful. Generosity and compassion flourish in those who have felt loved, leading them to touch the lives of others. Fittingly, many therapists have been touched by another person’s love in their own therapy and find it to be a deep privilege to be trusted and to pass on the gift.

References:

1. Harrist, R. S., Quintana, S. M., Strupp, H. H., & Henry, W. P. (1994). Internalization of interpersonal process in time-limited dynamic psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 31(1), 49.
2. McAdams, D. P., Reynolds, J., Lewis, M., Patten, A. H., & Bowman, P. J. (2001). When bad things turn good and good things turn bad: Sequences of redemption and contamination in life narrative and their relation to psychosocial adaptation in midlife adults and in students. Personality and Social Psychology Bulletin, 27(4), 474-485.
3. Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85-101.

Imagine you are in a long-term relationship that, like all relationships, has its rough patches, its areas that need improvement. You are motivated to address these difficulties in order to elicit change, grow, and bring your relationship to another level. Your partner, on the other hand, is unmotivated and unwilling to put forth the same effort.

There may be any number of reasons behind their lack of motivation: They may be facing personal struggles or mental health or emotional challenges. This may simply be who they are.

Whatever the case, you may face extreme disappointment when confronted with this reality. You may beg, plead, try any number of methods to encourage your partner to cooperate, all to no avail. Some people may take this as a sign that the relationship will not work out and end it there. Others may prefer to stay in the relationship, for any number of reasons, and decide to do their best with what they have.

If you are in this situation and are among those who have decided to stay, you may wish to seek support from friends, family, and even a trained therapist or counselor. You might also consider the six strategies below as possible ways to constructively address the situation in order to create optimal dynamics in your relationship. [fat_widget_relationships_right]

1. Take Care of Your Own Wants

Even the most ideal partner may not be able to provide everything you want. With an uncooperative partner, you may feel even less fulfilled. You might experience frustration and anger or develop the urge to try and change your partner, to push them to do what you want. However, these strategies usually are not helpful. Ultimately, it’s generally best to empower yourself to take care of your own needs and wants rather than relying on your partner to do so. Yes, it may be disappointing to engage with an inconsiderate partner, but by becoming proactive in doing whatever is in your power to fulfill your wants, you are taking control over your life. Rather than expecting or waiting for your partner to do things with you and becoming upset when they don’t, you become better able to proactively find your own solutions.

2. Create Fulfilling Venues

Many individuals enter into a long-term relationship expecting their partners to fulfill all of their needs. They may expect a partner to be a companion, a protector, a lover, an intellectual peer, and/or to share the same hobbies and interests. But what if your partner cannot fulfill all of these wants? My suggestion is to find new channels to satisfy yourself and create a more meaningful and fulfilling life, with or without the other person. You can go to the gym, join a book or a movie club, participate in a philosophy group, take a class, build friendships, an so on. By diversifying your interests and social circles, you may find multiple ways to be fulfilled. Indirectly, you are likely to feel less frustrated with your partner as you reduce your reliance on them.

3. Build a Support System

It is always a good idea to surround yourself with an environment that is conducive to your well-being and happiness. Your ideal environment might include family, friends, and/or social and professional networks, for example. Anyone can benefit from social and emotional support, and you can turn to these people in times of need in order to gain a better perspective, seek encouragement, and increase self-esteem. It is usually helpful to talk, reflect, analyze and brainstorm with others about challenges and issues. In addition, social support is considered a form of psychological support, and you may find it improves your quality of life while also creating a buffer against the shock of unpleasant situations. There may come a point in the relationship when you find that to continue in it requires giving up on certain goals, expectations, or visions you have cherished, and you may then face a difficult choice: Leave it, or live with it.

4. Set Boundaries

One key element of creating healthy and happy relationships is setting boundaries. It can be even more crucial to establish clear boundaries when engaging with partners who may try to manipulate, use, and take advantage of situations. Defining what you are willing to tolerate and communicating this to your partner is an effective strategy. By acting assertively, you can not only protect yourself but also empower your partner to take responsibility for their actions and needs. Be consistent and stick to your boundaries. Often, the discipline of boundaries will generate positive results in your lives. Yes, it can be challenging to set boundaries in relationships with partners who do not support limits. But it is absolutely possible and is necessary to your well-being.

5. Reinforce and Influence Your Partner

When you are the best partner you can be, you may be better able to influence your partner, who might eventually follow and provide you with the same attitude and support. When you offer support—perhaps by listening actively, asking clarifying questions, and otherwise behaving in a way that demonstrates positive and constructive intention—you send a clear message to your partner: “I am here to support you. We are facing this challenge together. You are welcome to participate.”  Make an effort to find ways to reinforce your partner and reward them.

6. Accept and Let Go

There may come a point in the relationship when you find that to continue in it requires giving up on certain goals, expectations, or visions you have cherished, and you may then face a difficult choice: Leave it, or live with it. Many people find their situations too painful and/or unrewarding and leave the relationship, choosing not to further compromise themselves. Others accept that the situation is unlikely to change but decide to stay nonetheless, continuing to pursue happiness and fulfillment by letting go of some of their desires and expectations or changing their perspective regarding them. Whether you let go of the relationship or let go of some of what you had hoped for, it is necessary to come to the realization that the other person is beyond your power. Trying to control what cannot be controlled requires large amounts of energy and resources that could possibly be used to achieve something better and more fulfilling in your life. Whether you choose to “leave it” or “live with it,” you regain the power of control and can focus on fulfilling your life rather than hoping for an uncooperative partner to do it for you.

It is generally believed that humans are meant for connection and relationships. Most of us desire to live a life that is not isolated but diverse and interconnected, shared with a variety of people who all contribute meaning in a variety of ways. You may wish to share everything, or at least most things, with a partner, but this may not always be feasible. Yes, it is normal to expect a partner to change and be more cooperative toward shared goals or the relationship itself. But you might wish to consider whether it is better to focus on making fulfilling changes for yourself rather than pushing your partner to change. Then, if you don’t get the outcome you want from your partner, you won’t have wasted your energy but will instead have experienced personal growth, perhaps creating a more fulfilling and meaningful life for yourself in the process.

Your personal growth provides the freedom to exist with other people, even uncooperative ones, in a new manner, one in which your happiness no longer depends on another person.

Pursuing psychotherapy is a brave endeavor indeed. Many people make this choice when they find themselves in a dark place and are unable to see any light ahead of them.

In order to even begin the process of finding a therapist, you may first have to confront societal and internal judgments (“I must be sick.” “What’s wrong with me that I need to do this?” and so on). After that, you then find yourself attempting to choose a complete stranger who you will entrust with your innermost thoughts. If you haven’t sought therapy before, you may feel overwhelmed and as if you are stepping into the unknown. You might feel anxious or afraid and be unsure of the best way to proceed.

If you are experiencing serious distress, you may have gone as far as you can by yourself, or with the support of friends and family, and done as much as possible in order to improve on your own. You may feel as if you have no further choice beyond therapy.

Whatever your reasons for choosing therapy, however you get to the therapy office, I have a tremendous faith in the psychotherapeutic process. When a therapist and the person seeking help can earnestly work together to explore the person’s inner world, utilizing the contact made between the two of them (the therapeutic relationship), greater insight and an increased ability to address and work through inner conflicts is likely, and maturation often follows.

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I don’t think that every therapy process is successful, however. A number of unconscious forces may be at work, in either the person seeking help or the therapist attempting to help them, and any of these might effectively derail therapy.

Keeping the following eight points in mind, from the time you begin therapy and throughout the process, may help you make the best of your choice to seek help—and get the most out of your therapy sessions.

1. Therapy starts when you decide to seek therapy.

Take your search for a therapist seriously. Try to get a few names of potential therapists you can then interview. Taking the time to be thorough and control your search better enables you to find the therapist who fits you best, not only with regard to the specific issues bringing you to therapy, but also with regard to your personality and identity.

Some mental health professionals offer a first consultation over the phone, free of charge. Take advantage of this, if possible. You may be able to get a feel for their manner and personality, and at the very least, rule out some who may not be ideal for you and your needs.

2. Allow yourself the time to assess the fit of your therapist.

If you are in distress, you may be anxious to begin therapy and alleviate some of what you are struggling with. This is a common feeling. You might want to just choose a therapist at random and fall right into the process of therapy. While this can work for some people, it is often best to consider the first few sessions as a mutual assessment and use them to get a felt sense of whether this therapist not only listens, but hears what you have to say, and if this is a helping professional you feel comfortable with. Doing so is likely to greatly increase the chances for a good therapeutic alliance and eventually, success with treatment.

That being said, listen to your gut. If something doesn’t feel right, it’s generally best to move on in your search.

3. Take some time in the beginning to think about your goals for therapy.

Although therapy can take unexpected twists and turns, you can establish a more definitive direction to continue to assess the therapy if you establish goals in the beginning and keep these in mind throughout your work with a therapist. Goals might include minimizing painful symptoms, gaining insight, or pursuing transformation, among others. Regardless of what goals look like for you, they can often serve as a guide when therapy seems aimless.

Regardless of the number of therapy sessions you attend each week, you can maximize the benefits of treatment if you take the time to reflect on what you talked about in the session and—even more importantly—what you felt during and after each session.

4. Share your doubts, fears, concerns, and hopes.

You might be surprised to learn many people don’t share their doubts, fears, concerns, or even hopes with their therapist, perhaps because doing so might feel scary. But I say it can be well worth the risk! These feelings are deep expressions of you, and they can help your therapist know your particular vulnerabilities and become more informed about what you need from your therapy.

If your therapist reacts negatively to these feelings, this is often a red flag they might not be a good fit for your needs.

5. Talk to others who are receiving or have received “good” therapies.

It can be helpful to talk to friends or family members who have had a positive therapy experience. It’s possible to discuss this without exchanging details that may be too personal or private. You might simply ask what helped them most in their experience, or what detail(s) made their therapist a good fit. Although every therapeutic relationship will be unique, there are some universal aspects of good therapy you can look for.

6. If you don’t like something your therapist says, tell them. If you really like something your therapist says, tell them.

It is very possible that, if you are suffering or experiencing distress as an adult, your injuries were originally sustained within the context of your early relationships with caretakers. Thus, opportunities for healing are often greatest within the context of a relationship. Because of this, it is important to share feelings of hurt, anger, or disappointment, along with more positive feelings, with your therapist. This feedback is helpful, and can be essential, as it helps your therapist get to know you better and gain greater understanding of what you need from therapy.

7. Try to reflect on each session in between sessions. Share those thoughts with your therapist.

Regardless of the number of therapy sessions you attend each week, you can maximize the benefits of treatment if you take the time to reflect on what you talked about in the session and—even more importantly—what you felt during and after each session. These feelings often communicate something important about what is happening on an unconscious level during the therapy process.

8. Reflect on your goals from time to time during the therapy.

Use your goals as signposts from time to time. Beyond simply keeping them in mind, take the time to really consider them. Checking in on how things are going, with yourself and with the therapist, can be helpful. Doing so can allow you to recalibrate with your therapist, if necessary, in order to stay on course.

Therapy can be a lengthy process. It may be difficult at times, but keeping these tips in mind can help you increase your chances of success and make it more likely you will find the challenge of seeking treatment to be a rewarding one. Therapy can work for you, as much as you work for it.

I wish you the best in your therapeutic endeavors.

Has it happened to you? A few months into therapy and you’re scratching your head wondering what you’re still doing here. Things started off so strong. You were exploring your relationships or talking about work issues, maybe even venturing into a little family history. Maybe things have been a little better since you started. Maybe things haven’t changed much. Perhaps they even seem a bit worse since you’ve been talking about all these difficult things you’d rather not think about.

But you’ve gone over all that material and you’re still coming in each week. You’re still paying hard-earned money. And you’re still not being told what you should do differently.

You spend the whole time traveling to your appointment trying to come up with something to talk about, some problem in your life, some point of conversation that will take you through 45 minutes before you return to work or head home.

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And you’ve come up with nothing.

And now you’re in a staring contest with your therapist, who doesn’t seem to be coming up with anything, either.

And you think to yourself, I’m bored.

So you skip an appointment and “take the week off.”

You may consider this boring feeling a signal you should move on.

You might text or email your therapist and say you’re done. You’ll call in a few weeks if you need anything.

When reflecting on this, you’ll say to someone, “You know, therapy just didn’t work for me.” There’s no hard feelings, just … it’s not for you.

As both a therapist and a person who has been in therapy, I can empathize. I’ve felt all of these things at one time or another. But I’ve come to understand something about “boredom”: I’m not convinced it really exists.

I like to talk about anger as often being a secondary emotion. It can be used, often unconsciously, to protect us from feeling (or showing) some of our more vulnerable emotions, such as fear, insecurity, and sadness.

But anger can be just pure anger. I’m not convinced boredom is, in and of itself, its own thing.

When I notice I’m feeling bored, I tend to get curious. What else is in there? What am I avoiding? What is the “boredom” protecting me from?

When I notice I’m feeling bored, I tend to get curious. What else is in there? What am I avoiding? What is the “boredom” protecting me from?

Back in my performing years, when I’d spend evenings in rehearsals for off-off-Broadway productions that didn’t pay and days in corporate offices as a temp, I remember spending hours doing mindless data entry. I became “bored” pretty quickly. But as I later came to realize, what I really felt was anger that I had to be there at all as opposed to making a living doing what I wanted to do.

I’ve even been to parties where I felt bored, but, upon further digging, I was feeling kind of insecure. Likewise, I have days when I’m at home and think I’m bored, but what I really want in those moments is to hang out with others. That is, I’m actually feeling lonely.

Boredom covers for all of these feelings. Because who wants to be angry at work, self-conscious at a party, or lonely at home?

When a person in therapy starts to talk about feeling “bored” in therapy, especially around the three-month mark, I’m psyched. I’m psyched because they said it and didn’t just fade away, as many do. They are creating an opportunity with their therapist to process the feelings beneath their “boredom.”

Some are upset because they’ve been coming week after week, spending a lot of money, and they want results! They want me to tell them what to do or what not to do. They want to know if there is going to be relief.

I may not have the answers to these questions. I may not be able to put their mind at ease with a timeline or guarantee, but I will provide the space for them to express what they usually squelch and speak about some new ways to handle it all. I’ll provide a space to let out the anger, the frustration, the sadness, the hopelessness, the whatever, and see that it’s not going to push me away. That it’s not going to destroy them.

Once the real feeling is expressed, therapy gets real. And it’s anything but boring.

People enter psychotherapy with the desire to feel better, but they are often unsure how therapy will help them accomplish this goal. A common refrain from people hesitant to enter therapy is, “How is talking going to help?” People are used to talking to other people to get practical solutions to problems, and while problem-solving does have a place in therapy, change also occurs on a much deeper and unconscious level. This process has to do with the way the human brain is programmed and cannot easily be mimicked outside of a relationship with a psychotherapist.

Our brains are always evolving unconsciously through our relationships. People who experienced painful relationships growing up have been trained to expect hurtful experiences with others. It takes a new type of relationship—in particular, a therapeutic relationship—to retrain the brain to expect more positive experiences, which is a big part of ultimately feeling better.

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Why Can’t a Therapist Just Tell Me What to Do?

To understand why the therapeutic relationship can be so valuable and cannot be mimicked by, for example, advice in a self-help book, it is instructive to look at how the human brain has evolved. Broadly, there are three parts of the human brain that represent different phases of evolution: There is the reptilian brain, which evolved first and is responsible for the automatic control of vital bodily functions such as breathing; the limbic brain, which evolved second and is responsible for the regulation of emotion and behavior; and the neocortex, which evolved last and is responsible for higher-order functions such as symbolic thought, language, and reasoning.

When a person asks their therapist or a friend what they should do about something, they are essentially asking for a neocorticol solution—something that is rational and can be consciously implemented. Often, however, their problems are a result of hurtful experiences in their earlier relationships that have caused changes in their limbic brain, and only a new type of relationship can alter their limbic brain to produce fewer negative emotions and more positive ones.

Brain Wiring in Our Youth: How Emotional Issues Begin

Our emotions are meant to help us survive in a world in which we need the help of others. Over time, our limbic brains evolved to automatically create emotions, such as anger and sadness, that are meant to help us navigate the social world. When someone mistreats us, evolution has programmed us to become angry to try and change their behavior. When someone rejects us, we feel sad so we can mourn the loss of what we wanted with them and move forward with our lives.

However, when we are young and particularly dependent on others for survival, whether our emotions actually help us navigate the world has a lot to do with how other people—our parents in particular—respond to them. A child who responds to unfair or disappointing experiences with anger and is further punished for doing so may, over time, come to unconsciously pair the expression of anger with pain. As this occurs, rather than directly experiencing anger at times of unfair treatment or disappointment, they may instead experience anxiety about having anger because their brain has been trained by their social environment to expect that anger will hurt rather than help. Their limbic system is in effect attempting to prevent further emotional pain in the form of being punished, but the cost is another type of emotional pain in the form of persistent anxiety. This can be particularly problematic when people enter into new relationships (friendships, romantic relationships) where there would not be the same costs associated with the open expression of an emotion like anger, but earlier experiences still create anxiety and inhibit its expression.

Retraining the Brain with Psychotherapy

A psychotherapy relationship allows a person to essentially retrain their limbic system to no longer expect negative reactions to the expression of certain emotional experiences, and in doing so can alleviate the anxiety and unconscious emotional suppression their earlier experiences programmed into them. The therapeutic relationship does this in part because the parameters of psychotherapy recreate the type of relationship in which a person was first forced to suppress their emotions: one where they are dependent on another person to meet their needs.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships.

Just as a parent has a daunting task in meeting all of a child’s needs, so too does a psychotherapist, especially since many people arrive to therapy wanting a conscious, rational solution to their problems when such a solution often does not exist. Therapy presents a unique opportunity to heal and feel better by the way the therapist solicits and responds to feelings such as disappointment, anger, and sadness that emerge over the course of treatment. Rather than punishing a person for having these emotional experiences in the same way that may have occurred when they were younger, a therapist can actively solicit, explore, and normalize their feelings. This helps to retrain a person’s limbic system to no longer pair the expression of those emotions with punishment. As this de-coupling unconsciously occurs, the person becomes more easily able to tolerate the experience and expression of emotions.

Thriving in Adulthood

This shift in tolerance for emotions naturally causes a person’s anxiety level to diminish because their mind is no longer fighting to ward off their innate emotional impulses. In addition to symptom relief, the beautiful part of this process is it restores a person’s ability to constructively access their emotions for their original purpose—as a way of helping to navigate the social world. It is hard to thrive in relationships when we have been programmed to believe we must accept the mistreatment of others or that we cannot show others when we are hurting and in need of care. As adults, this is often no longer the case, but our early experiences may make such underlying beliefs unconsciously feel true.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships. The result can be genuinely transformative, and studies suggest people who have been through therapy show less activity in the areas of the brain responsible for creating negative emotions. Talking, it turns out, can help quite a bit when the person you are talking to is a skilled and compassionate therapist.

If you’re struggling, reach out to a therapist in your area for help.

References:

1. Bowlby, J. (2005). A secure base: Clinical applications of attachment theory (Vol. 393). UK: Taylor & Francis.
2. Cozolino, L. (2010). The neuroscience of psychotherapy: Healing the social brain. New York, NY: W.W. Norton & Company.
3. Damasio, A. R. (2006). Descartes’ error. New York, NY: Random House.
4. Grecucci, A., Theuninck, A., Frederickson, J., & Job, R. (2015). Mechanisms of social emotion regulation: From neuroscience to psychotherapy. In Emotion regulation: Processes, cognitive effects and social consequences, pp.57-84.
5. Karlsson, H. (2011). How psychotherapy changes the brain: Understanding the mechanisms. Psychiatric Times, 21.
6. Lewis, T., Amini, F., & Lannon, R. (2007). A general theory of love. New York, NY: Vintage.
7. MacLean, P. D. (1990). The triune brain in evolution: Role in paleocerebral functions. Berlin: Springer Science & Business Media.

When you decide to seek help from a therapist or counselor, chances are you’re struggling. Maybe you’re feeling lost in your life, or maybe you’re experiencing painful disconnection from others. Sometimes what brings people to therapy is a need for help brainstorming new solutions to old (or new!) problems.

One of the most important functions of good therapy is to help reveal new perspectives. A new perspective provides a new angle from which to view what is happening (or what has happened) and provides a new stance from which to make healthy choices for the future.

Sometimes, your therapist will help you find perspective by helping you step outside of the immediate details to see the bigger picture or context of the problem. You know the phrase about not losing sight of the forest for the trees? Therapists can help you look beyond the specifics of your situation to discover patterns or connections to a larger context.

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Other times, you therapist will help you find perspective by helping you dig deep inside yourself to uncover the emotions or fears underlying the problem. When you keep too much distance between your situation and how you think or feel about it, you lose important data from what renowned therapist Dr. Peter Levine calls your felt sense. Therapists can help you shift your awareness from the greater, external world to your intimate, internal landscape.

A metaphor I often use with people in therapy when describing the power of a new perspective is one about being in a dance hall:

Imagine you’ve just stepped into the dance hall. You can hear the music playing and see people moving around you. To your left is a flight of stairs up to a balcony that overlooks the dance floor, and to your right is a door that leads straight to the dance floor itself.

A new perspective provides a new angle from which to view what is happening (or what has happened), and provides a new stance from which to make healthy choices for the future.

The Perspective from the Balcony

From the height of the balcony, you can see the dance floor below. Your gaze takes in the whole scene and you can begin to notice patterns and differences among what you see is happening: a group of people are dancing in a circle, a line is forming at the bar, and there is a couple engaged in animated conversation in a corner of the room. You also notice what isn’t happening: although people are dancing close to one another, no bodies are touching and there isn’t a line for the bathrooms.

From the “balcony” perspective, you are able to notice patterns and learn from others. Over time, you’ll be able to notice and integrate all the different parts of your experience, how they interact and influence one another, and make decisions based on a broad look at your situation.

The Perspective from the Dance Floor

From your spot on the dance floor, your vision is limited to the space immediately around you—you can see only as far as the people dancing next to you. Your eyes close, you can feel the beat of the music pulse in your body, and you begin to notice the heat generated by your dancing. Your eyes open and you notice a new, attractive fellow dancer beside you.

From the “dance floor” perspective, you are able to access sensations, energy, and emotions. You have access to changing information moment to moment from all of your senses—from temperature, from color, from movement. Over time, this data will help you integrate your intuition with your surroundings and make decisions based on an intimate examination of your lived experience.

An important third part of this metaphor is the staircase that links the balcony to the dance floor, or being able to move freely and with intention back and forth between the bigger context of your problem and the underlying emotions. Sometimes, a short break from the action is helpful to gain knowledge and set goals. Other times, a short immersion into the depths of feeling is helpful to reconnect to your inner world. Finding balance in these perspectives can be one of the most powerful, positive outcomes of good therapy.

Therapists go on vacation. Therapists need time off for health reasons. Therapists have emergencies.

But what does it mean for you when your therapist needs a break?

It can be difficult to wait an extra week between appointments, let alone two or three. It’s a reminder your therapist has a life outside of the office. Often, we like to think of our therapist as ours and ours alone. Are you connected with the feelings that arise when your therapist tells you they’re going to be away?

Many people tell me they are “fine” with me not being around for a session or two. Depending on the person, I sometimes ask a few more questions about that. Not for personal reasons—I’m not trying to get a person in therapy to make me feel important and needed—but to help them bridge that feeling to other relationships in their lives.

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While you may know intellectually your therapist takes time off, just like you (hopefully!) do, that doesn’t mean you won’t feel a whole swath of feelings when it happens. Some common ones are abandonment, sadness, and anger, but also happiness and even relief!

Whatever you feel upon hearing your therapist will be away, it may be helpful to dig deep to see if there is a small spark of feeling that may be familiar. Once you connect to the part of you that is angry (even just a little), for example, you may be able to bridge that to another time in your life when someone left. This is a great opportunity: You get to use the therapy session to let the therapist know how you felt back then. You get to see you can say, “I’m angry you’re leaving” and know the therapist can take it. You can have what we call a “corrective emotional experience.”

“I’m angry you’re leaving. If you really cared about my well-being, you’d make yourself available.” That might sound confrontational, but it’s actually progress.

You can even go a step further: “I’m angry you’re leaving. If you really cared about my well-being, you’d make yourself available.” That might sound confrontational, but it’s actually progress. It’s being vulnerable with your therapist, which is both really, really difficult and incredibly important.

You’re not going to change your therapist’s plans, but you’re going to know what it’s like to say how you’re feeling. It opens the door to an exploration of hurts you’ve experienced in the past—but had nowhere to go with.

Boundaries and Safety

If the prospect of your therapist going away causes anxiety or worry, talk to them about what you can do in their absence. Some good questions are:

• “Can I call or email or text you?” You need to know your therapist’s boundaries. Some therapists take calls while on vacation; sometimes, only in special circumstances. Know before the therapist goes away.
• “Is there someone else I can talk to in the meantime?” Some therapists provide the name and contact information of someone you can call if the therapist is unreachable. This is rarer, but it’s good information to have.
• “What do I do if I’m really stuck or thinking of harming myself?” If you’re struggling with thoughts of self-harm or suicide and your therapist is aware of this, you may already have a safety plan with your therapist. Go over it with them before they leave, and if you don’t have one, create one together. No matter the circumstances, if you are ever in crisis or concerned about hurting yourself, call 911 or go to your nearest emergency room.

Your therapist going away can open some old wounds and bring up surprising feelings. Listen to those feelings and bring them forward. They could lead to breakthroughs that serve you not only while your therapist is unavailable, but long after you’ve parted on your terms.