What do People Look for When They Come to therapy?

People have a variety of different experiences and serotypes of what takes place within the therapy hour. An ubiquitous, and perhaps the most dated idea of therapy, is a version of a clinician sitting behind a patient in his or her chair with a note pad and asking, “how does that make you feel?” In my years of clinical practice I can tell you that is often a gross misrepresentation of what mental health professionals do. There are many different types of theoretical approaches and ways to treat one’s mental health condition, but all of these approaches mean nothing if the therapist cannot understand the subjective experience of the person sitting in front of them. Several meta-analysis find that the underlying common factor of successful treatment is not the interventions used, the type of degrees one holds, or where one went to school. The common factor for successful treatment is the bond or therapeutic alliance that is created in the dyad between the patient and the therapist. In summary, the bond between the two people in the room together is the catalyst for healing and feeling understood.

When I think of my therapy experiences and the patients I have worked with over the years, it was not the most evidenced based intervention that alleviated one’s depression or anxiety nor was it making sure I used the most empirically validated treatment, but it was the connection I had with the person sitting across from me and making sure that they felt safe and listened to. This may sound overly simple, but to truly listen to someone is an art that takes years, perhaps decades, to master. It is not what they say but how they say it; it is not what they are told in regards to what happened but how they remember it. One’s subjective reality is their truth and one of the most fundamental jobs of a therapist is to be a witness to a patient’s lived experience.

So back to the originally question of this blog, why do people come to therapy and what are they looking for? I often find the answer to this question is constantly changing just like an rubix cube. Once you find a way to decrease your depression or learn how to communicate better with your partner, other parts of your life have shifted and evolved. So why do people come to therapy? They come to feel understood, to learn, to know that their experience matters and that at the very least one person genuinely cares about their life on such an authentic level without judgment.

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