People often wonder how “just talking” to a therapist can change a psychological disorder.  How can a friendly chat ease my depression or anxieties or raise my self-esteem? And, besides, why can’t I just talk to a trusted friend or relative?

Certainly, having a person in our lives that we can trust with our deepest secrets and emotions is a wonderful gift.  A friend or spouse may listen, comfort us or even offer some sincere words of advice.  However, talking with a well-trained therapist is very different and can be extremely helpful.  First, your therapist is trained to listen very carefully and thoughtfully.  She or he is listening for psychological patterns in your stories.  Are there emotional, behavioral or thinking styles that are unhealthy for you?  Your therapist uses his or her training in psychological theory to understand which patterns may be unhealthy, which ones are important and which ones are not.

Then, your therapist helps you gain insight into these patterns, their origins and how they may be hurting your life.  He or she is trying to help you understand the “causes and effects” of your life.  What events in your life may have caused the effects of unhealthy thoughts, behaviors or emotions that are harming your life?  This can be difficult and can take some time.  After all, it is natural to try to avoid pain, especially pain that has occurred in our past and feels too overwhelming to tolerate.  Your therapist can help you tolerate it.

Your therapist is trained in methods of questioning and communication that allow new or hidden information to emerge that you may not have been aware of.  He will paraphrase what you say to be sure he has it right.  She will validate your thoughts and feelings so you know they are accepted and that it is safe to keep talking about sensitive issues.  Your therapist can be objective about you and your life stories.  He can empathize and accept you as you are – not as someone else thinks you are supposed to be.  These qualities are important for therapy and are hard to find, even in a trusted relative or friend.

Most topics need to be explored on a deeper level than you can receive in a normal conversation. The counselor will ask more questions to help you go deeper into a topic.  Some people find this exhilarating and others find it very difficult and full of pressure.  Trust, that he or she is not trying to annoy you or cause you tension; but, is trying to help you both get a fuller understanding of the problem at hand.

Another crucial difference between talking to a friend and talking to your therapist is that the conversation is all about you – in a positive sense!  A therapy session is probably the only place in life where a person can get complete and undivided attention to anything and everything she or he has to say or feel.  The therapist does not get equal time to talk about his mother after you talk about yours. She should not be talking about her vacation or her kids.  He won’t be talking about his marital frustrations when you pause in talking about yours.  You are a team that is completely focused on your problems, needs and worries – past and present.  And the therapist is not judgmental about the things you say or have done.  Remember, the purpose of your self-disclosure is to understand your life better – not to criticize it or offer clichéd advice.  Your psychologist, counselor or therapist has “heard it all” and will not be shocked by anything you have to say.

Another difference between your friend and your therapist is that the therapist will not try to impose his or her values and beliefs onto you.  You are entitled to your beliefs and your values in life without criticism or pressure to think as someone else does.  The exceptions are when your beliefs may be part of the problem and you may be challenged to rethink what you believe or value – not to adopt the therapist’s; but, to help find beliefs that are healthier for you and acceptable to you.

You may talk about your religion and never know the religious beliefs of your counselor.  You may love or hate the president without your therapist promoting his or her political beliefs.  You may even express a dislike for a particular group of people without your therapist telling you that you are wrong or that you must think differently.

Finally, your therapist is trained in specific psychological techniques and interventions that are shown to be effective in helping people improve their lives.  Your best friend is unlikely to know how to properly use techniques like: cognitive restructuring, imagery, the empty chair, assertiveness training, mindfulness, relapse prevention, transference reactions, CBT, behavioral rehearsal and so on.  There are library shelves full of books on techniques like these and many others.  We practice them in graduate school and on internships until we can use them effectively with you.  We even practice them on each other during classes!  Those are some Kodak moments.

So, your therapist knows that therapy is not just about “talking” or “chit-chat”; but about using the right therapeutic techniques to help you gain deep insight about your problem areas.  Then, he or she will help you with the appropriate techniques that can lead to your improvement.  All of this occurs in the safe and accepting environment of the therapy room, a place very different from our living room, work room or bar room.

Take care of yourself – you deserve it.

Dr. Dave Borsos