The Recipe for Therapy

Lily Boyar MHC

What makes therapy work? I get this question a lot. Is it the interventions the therapist uses? The level of experience they have? Their specialization or expertise? All are useful of course, but I would argue there are other main ingredients.

We know that successful therapeutic outcomes (i.e wanting to attend and continue with therapy sessions, feeling a sense of safety, and making progress toward goals) have everything to do with the relationship between the therapist and client. It sounds so simple I know, but this match informs the level of comfort the client feels in the room, empowering them to show up authentically and share what’s on their mind. This safety allows the therapist to point out useful patterns or information, knowing there is a solid foundation of rapport and trust. Therapy can be challenging. It can bring up uncomfortable feelings and old wounds. This is part of the growth process. However the connection between the client and therapist is what creates the support environment for this work. 

Once that relationship is built, I believe there is another secret ingredient in the recipe for successful therapy. One that isn’t as frequently discussed. 

Typically therapy begins by diving into the past and exploring the context for who we are. This gives us fundamental understanding. However, once we have a sense of the why behind our thoughts, feelings and behaviors, what happens next? What creates change? I believe it is the power of awareness.

Having awareness means being able to recognize and notice ourselves. It means making the unconscious conscious. When we develop a sense of awareness of our thoughts, feelings and behavioral patterns, we are able to catch them in action and witness ourselves in a new way. Suddenly, instead of acting on instinct, we’re able to pause, notice what is happening, and make a choice about how we’d like to proceed. This gives us the space to try a different approach or solution.

We often seek therapy when there is something in our lives that we want to change or perspective we’d like to have. 

Let’s say I wanted to understand and change how often I procrastinate. First, I would need to explore my past history and how this has impacted me. I might discuss what it was like to manage deadlines in school as a kid and what it felt like to scramble at the last minute. This is the helpful context. However, after this stage in therapy my clients often say, “so now that I know the problem, what happens next?” This is when awareness comes in. With my understanding of the problem, I could then start slowing down and paying attention to what happens in the moment when I feel like procrastinating. Instead of instinctively scrolling on my phone or hemming and hawing about completing a task, I might notice my desire to put it off. I might become aware of what it feels like in my body when I think about completing the task now instead of later. Maybe I’d become curious about what other activities I felt I wanted to pursue instead. This awareness would allow me to stop the process in action and reflect on what is happening. To gain information about what happens in real time, and eventually practice making a different choice, rather than to follow my initial instinct. 

A sense of awareness allows us to create distance from ourselves and our behavior, creating a sense of agency in how we choose to respond.