It’s a reasonable question: why would I pay good money to go talk to a therapist when I can talk for free to a friend or family member who already knows me? Sometimes people worry that seeing a therapist would be like paying someone to listen, to be a friend— and of course that doesn’t sit right.
In considering this question, it’s crucial to understand that “talking” in therapy is not the same as ordinary talking. And the kind of listening the well-trained therapist does is not the same thing as ordinary listening.
Much of our ordinary social engagement consists of helping each other to carry on in a habitual, often repetitive, relatively automatic fashion. We don’t want to do or say anything that will disrupt the status quo too much, make anyone uncomfortable, or change the easy familiarity of the way things are.
Friends and family may also have needs or expectations of us that make it impossible to freely talk about certain things. They may even be invested in us not growing or changing, as change upsets the norm, to which people are often quite attached. Sometimes, with good intentions, they want to tell us what to do, based on their ideas—not ours. And maybe our strong emotions are scary or overwhelming to them, so they react instead of responding.
Talking in therapy is not shooting the breeze, passing the time, analyzing ourselves or engaging in our usual ways of socializing. In therapy, we notice and put into words or images what we find under the surface of everyday chatter and the go-go-go quality of our minds and activities. And your therapist, if she is doing her work well, is going to be very interested in this deeper looking, and whatever it may lead to. She isn’t going to fall into step with business-as-usual conversation. This doesn’t mean that friendly, ordinary conversation doesn’t happen in therapy, but the attention is on making a space in which it’s okay to talk about and say anything.
Your therapist is attentive to hearing about what is important to you, and may ask questions to help bring out what is needing attention and healing, based on your own feelings and desires. He (hopefully) doesn’t have an agenda that you should be a particular way, or change, or become “better” or “healthier,”or even happier. While he is a person who (hopefully) has a lot of training and experience in the causes and conditions of human suffering and well-being, his primary work is to engage with you as you are, and with the things you want to talk about and work with.
Jon Kabat-Zinn defined mindfulness as: Paying attention in a particular way, on purpose, in the present moment, and non-judgmentally. This is also a good working definition of the kind of listening that happens in therapy. This way of listening may sound simple and rather unremarkable, but it’s actually a radical departure from our ordinary, more automatic mode of thinking and acting. And it’s much more difficult than it sounds. Much training and practice are required to cultivate an open, receptive state of mind that can track and contain internal and external feelings and experiences without reacting mindlessly and repeating business-as-usual exchanges.
A common misconception about “mindfulness” is that people practicing it are Buddha-robots, remaining calm about everything and not having vivid emotions or responses. But actual mindfulness is almost the opposite. When we’re mindful, it’s not that we don’t have vivid emotional responses to experiences— it’s that we can tolerate being mentally and physically present with them in real time, as they’re happening. We don’t fuel them, but neither do we push them away. If anything, when we’re mindful, we feel more. The difference is that with mindfulness we have enough presence of mind that we don’t need to react as reflexively. We have time to consider what’s happening, to speak honestly about it, care for the hurt parts of us, and to make choices about what we want to do, if anything.
This makes the therapist a mindful midwife of sorts, attending the delivery into conscious awareness of the less conscious thoughts and feelings that drive our moods and behaviors. Less conscious thoughts and feelings tend to be lost to us in ordinary talking, with its automaticity and pressure to maintain the status quo. In therapy, they can be put into words. A coherent story can then come together about what really happened to us, what is happening now beneath the surface, and what we want to have happen in the future.
The Body and the Heart Talk Too
Talking in therapy can make it easier for the body and the heart to communicate, as well as the mind. Stepping out of the current of everyday life makes it easier to slow down a little and pay attention, with support, to sensations in the body that tell us about our more unconscious feelings: Oh, that’s what that heaviness in my chest is about… Oh, that’s the underlying belief beneath my constantly clenched jaw…
When talking in therapy, we might notice the impulse to analyze and intellectualize, while keeping a safe distance from the deeper feelings that actually run the show from their location just out of conscious awareness. We notice this tendency, and get to investigate where and how and why we learned to try to get away from our feelings rather than tune into them to help us understand who we are and what we need.
Practicing the Pause
If something isn’t right, if we’re hurting in life— around friends and family, or even alone— pausing tends to be the last thing we do. If anything, we find more things to do, keep-busy experiences to have, to avoid our pain. Or we find ways to self-medicate, numb the pain temporarily— with food, drugs, alcohol, isolation, repetitive activities, denial. Avoidance can be an absolutely appropriate short-term coping strategy, but if sustained too long, it prevents what is hurt from ever getting addressed and cared for.
We often long for things to change in our lives, yet how oddly difficult it can be to pause and pay attention long enough to really see and come to terms with how it is now, how we came to be in the situation we’re in. A skilled therapist will practice this quality of the pause, and help set the tone for a therapeutic relationship that gives a lot of room for deeper thoughts and feelings to emerge and be safely explored. For many people, the therapy session might be one of the few or only times when they step out of the current of everyday life into a sheltered space to reflect on what is happening.
Therapy as a Practice Laboratory
Another crucial difference between talking in therapy and ordinary talking is that therapy is a laboratory where you can experiment with how you feel and interact in relationship. Profoundly relational creatures that we humans are, when our sense of self is injured, it’s almost always in the context of a relationship with someone else. Likewise, it is repaired in the context of a non-recapitulating relationship with another person. Feelings that typically come up for us when we encounter other people are likely to come up sitting with our therapist too. When the therapist doesn’t play a typical social role, but instead listens and responds in a non-reflexive, attuned way, those old feelings can be consciously explored and understood. In this way, harmful scripts we internalized somewhere along the line, probably quite early in life, begin to be interrupted and lose their grip.
In addition to difficulties we have in our relationships with others, many of the most painful or perplexing experiences we have comes from our relationship with ourselves. Messages we received, especially early in life, become internalized and play out in a repetitive, destructive way. For instance, there may be a highly critical internal voice (likely learned from an important outside figure) that is unrelenting in its harshness toward another part of us that is uncertain or afraid. Talking in therapy provides supportive and unconventional conversation that helps us to explore these internalized aspects of self and sort out what’s really me, and what is more of an installed program, or “introject.”
When we feel ready, we can experiment in therapy with coloring outside the lines of how we’ve been conditioned to behave— speaking our minds more honestly, finding our voice, expressing anger, disappointment, fear, excitement, joy, humor. Getting to express ourselves in a freer, more uncensored way is healing and creative. It opens worlds of possibility that weren’t there when we were bound by long-ago internalized scripts, mostly unconscious, about what’s okay to feel and say and what isn’t.
Interacting in therapy gives us the chance to lean into and practice communicating who we really are and what we really feel. Over time, this more genuine personal voice is integrated into our sense of self and helps us experience a more satisfying sense of connection with others.
Talking in therapy safely brings the unconscious into conscious awareness, and much of what is unconscious is relational and emotionally charged. Conscious awareness grows in the context of an emotionally alive therapeutic relationship, which provides a new relational experience that is “corrective” in that it’s not based on patterned scripts from the past, but on genuine interactions of today.
As unconscious aspects of ourselves are increasingly brought into conscious awareness and found to be workable, we feel more and more integrated and whole. This integration makes us feel more connected to self and others, and more empowered to shape our lives in ways that are satisfying to us.
The Training of a Psychotherapist
Hopefully, your therapist has dedicated him- or herself to listening and interacting in an attuned, mindful way, and to providing a sheltered space where you can reflect and receive support outside the automaticity of everyday life. He has also undergone his own therapy and has gained experience riding his own and others’ waves of intense thoughts and feelings without being reactive. Another quality that distinguishes the therapist from a friend or family member is the extensive educational and clinical training that a psychotherapist undergoes prior to and while practicing. (Note: if you do have a psychotherapist friend or family member, they have hopefully already let you know that it is neither possible nor advisable for them to work with you therapeutically. What’s been said so far in this article should give some idea as to why.)
Licensed psychotherapists have spent somewhere between $30,000 and $100,00+ for the professional training they’ve received. Most clinicians have undergone a minimum of two to three years of academic study of mental health and illness and effective treatment approaches. Most have had a minimum of a year-long internship practicing therapy in a supervised setting prior to provisional licensure, and once licensed, therapists are required to consult on their cases with more experienced clinicians for two or three years post-licensure. This intensive training and practical experience give plenty of opportunities to make mistakes and learn experientially from them. Many dedicated therapists continue to invest in the good practice of ongoing supervision throughout their entire careers.
As long as therapists are licensed, they are required to keep up with their field by taking at least 40 hours of continuing education courses each year. And many therapists who are passionate about their work take on much more academic and experiential training throughout their careers than is required by licensure, as it enhances and deepens their skills. Psychotherapy is part science and part art—a professional craft that takes years of training and practice to hone and mature.
Psychotherapy is as old as the human race
Psychotherapy is typically considered to have originated very recently, in the late 1800s, with the development of psychoanalysis by Freud and his colleagues. Yet humans have always sought out a special person in the community to talk to in times of pain, confusion or need for change. In other times and cultures, and still today, people in these special roles have been called different things, like medicine man or woman, shaman, elder, priest, healer, doctor. But it seems that across cultures and history, these roles have been carefully assigned, requiring apprenticeship, special training and demonstrated accomplishment. This person is typically somewhat outside the everyday world of community life to help preserve their ability to see through the limitations and illusions to which individuals and even whole cultures are susceptible. They tend the boundary between the everyday world of conditioned mind, and the wisdom and grace of the unconditioned.
With the advent of psychoanalysis, the psyche came under the influence of academic and scientific study. Since the early days of the field, a vast body of knowledge has developed and continues to grow. The burgeoning research in affective neuroscience and the interpersonal neurobiology of attachment relationships has helped provide evolutionary and biological insight into why we have emotions, how profound is our need for healthy attachment and belonging, how the mind gets hurt, how it survives trauma, and how it heals.
But indigenous cultures across time and geography have always had healers, medicine men and women, shamans, and the like, who understood full well that aspects of the psyche are out of the conscious awareness of the individual seeking help, and that the trouble the patient is in results largely from this dis-integration. There have always been indigenous methods for wooing back injured, disowned aspects of self, sometimes with the aid of psychoactive plants and/or intense ritual in which ordinary reality is altered and a profoundly new experience, usually assisted, and usually witnessed by the healer or even the larger community. The crucial necessity of a relationship for the healing process to be effective— a unique, therapeutic relationship—has been recognized for millennia.
So the practice of going to a person with specialized training in times of psychological distress is not a new, 21st century phenomenon of the service marketplace. And while today we use the currency of money in exchange for psychological help, I imagine healers in past times and other places around the world being valued and compensated for their work with some kind of currency—money, food, medicine, goods, services.
I hope this brief discussion gives some useful insight into the question: why would I pay good money to go talk to a therapist when I can talk for free to a friend or family member who already knows me? And I hope the skeptic is now moved to answer, “Well, there may be some good reasons.”