Everyone’s approach to attending therapy sessions is different: people’s needs, symptoms, and circumstances vary incredibly. People want and expect different things in session.

Clearly, there are specific, well-researched interventions that are likely to be effective with most people who experience a certain symptom or pattern of behavior. Some interventions can be practiced in a therapy session, and some interventions are good for a client to take home and practice on their own. I do have plenty of handouts to work on and books to recommend that you read!

But not every intervention is on a list of tips that I’m going to print out and give you outright, or on a sheet in a manual with steps 1, 2, and 3. In fact, nearly all of what we are doing while in session is an intervention, even if I do not formally announce it as such. That is to say, we are not just sitting here chatting, even if sometimes that’s what it appears to be.

When I’m asking about your week, or how you feel, if you’ve gotten over your flu, or how things are going with your family or job, for example, I’m actually assessing your anxiety, depression, hypomania, behavior patterns, physical well-being, environmental influences, sense of hopefulness, and any changes in how you are interacting…for starters.

But I’m not just gathering data. I’m also intentionally getting you to practice certain kinds of conversing, thinking, and interacting during session.

I’m getting you to practice speaking openly about things that may have felt “unspeakable,” uncomfortable, scary, or just awkward. I’m reframing or redirecting your thoughts as you speak them from “shoulds and musts” to “preferences and wants,” so that you can begin to change your internalized messages. I am giving you the chance to practice openly experiencing and expressing feelings in the presence of someone who will not censor or scold you for how “irrational” or “unacceptable” they are. I am often taking the role of defending you from your own inner critic! I am supporting you in developing an attachment that is not based in power and control or other unhealthy dynamics. I’m also simply being a trained witness to your life; checking in with you over time to see how you are changing and making sure you are okay.

Developing different patterns of thought and interaction takes time, and it’s a great deal more powerful if done with another person. That is why sessions are “booster shots” even for those who do a lot of internal work on their own. Humans are social creatures. Everyone, even introverts (like me!) must interact with others in order to process and develop emotionally.

And you know I can tell you’ve been making real progress when you stop yourself from saying “should” in session before I can give you the “shoulds” lecture yet again! ;D

So that is why–even if I didn’t give you a handout to take home or a list of suggested solutions to your situation–you made a LOT of progress in your session today.

Remember, “talk therapy” actually changes brain structure!

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