If you find yourself skeptical of psychotherapy, you are not alone. The history of psychotherapy has a less than stellar reputation, and the field itself has changed dramatically over the last 50 years. Movies and tv shows usually don’t do a great job at conveying what it is actually like to be in psychotherapy, and, in some cultures, there still exists the sentiment that if you’re in therapy, you must be pretty messed up.

Is therapy going to help me?

The short answer is… I’m not sure, but I’m hopeful. Therapy is a complex process that requires participation, collaboration, and motivation from both parties. There is no one-size fits all. Recent research studies indicate that the most influential factor in the effectiveness of psychotherapy has to do with the goodness-of-fit between the client and therapist. Not where your therapist went to school, or how long they have been practicing, but if you feel there is a “click” between the two of you – you feel known and understood, and you and your therapist can collaborate on your treatment.

How long is it going to take?

Another short answer here… it depends. Some therapies are very short, only a few sessions. Others are years, even decades. Much of it depends on the presenting issues, motivation, finances/means, and what one wants to get out of their treatment. Some people come to therapy for relief from suffering; others come for personal growth, or often a combination of the two. Sometimes it is hard to tell from the beginning how long a psychotherapy relationship will last. If one has a long history of suffering, it usually means there is not going to be a simple straightforward solution. Healing and change take time and hard work.

So, how exactly does change take place?

This is where a therapist’s orientation or philosophy informs their answer. There are many different perspectives, so it may be important that you learn about your therapist’s orientation before choosing with whom you will work.

I generally hold to a psychodynamic (or psychoanalytic) perspective. In brief, this means I believe one’s developmental experiences and early relationships have substantial influence on how one experiences oneself, others, and the world. It is through a combination of processing and understanding these early experiences and relationships and making intentional changes in one’s current ways of relating and being in the world that deep long-lasting change comes about.

I also believe that we are complex beings, and although we like the idea that we know why we do what we do, think what we think, or feel what we feel, often there is more to the story. Our minds have ways of helping us survive our environments by repressing, defending, and rationalizing parts of our experience. But then there comes a time when such survival tactics keep us from growing; we get stuck. It is through reworking these survival strategies that people often find freedom, peace, and a greater sense of wellbeing.