A curious mind recently asked, “So how does therapy actually work?” I appreciate it when people ask those genuine questions. We all have questions about all sorts of things, but sometimes we doubt the legitimacy of asking. I replied, “thank you for asking!” and then explained specifically how I see counseling working in general – keep in mind therapy is contoured to each individual’s unique experience, concern, and goal. Here is an explanation of how I see counseling work in my practice.
Emotion, Behavior, Thoughts
I view people as complex systems where no one part can be isolated. Some therapy models focus just on cognition – or the way people think. Other therapy models focus both on thinking and behavior. Other models may be very specific to use just one particular intervention as a means to healing. I have always believed that thoughts, behavior, and emotion are all intertwined and each requires recognition. Memory, sensation, and other aspects are also important in counseling but for the brevity of this blog we’ll keep it focused on the main aspects. I will address emotion, behavior and thoughts in this article; but of course, there’s always a favorite! For me, emotion is king.
The way people feel: Emotions
Counseling addresses how people feel – often emotions felt at their peak incite people to seek a therapist. Perhaps you just experienced the heart wrenching sadness of a broken relationship, the betrayal of infidelity, or the death of a loved one. Unbearable emotions often draw people to seek the comfort and safety of another to guide them through. Did you know this phenomenon of drawing near to others in time of need is based in science? Oxytocin is known as the cuddle hormone and its effect is to compel you towards others for comfort.
Perhaps your emotion isn’t based in crisis; life feels pretty uneventful. Perhaps you don’t feel at all – and that’s got you or those around you concerned. Often when people experience depression they may have a lack of feeling. In fact, along with feeling numb those suffering depression also stop enjoying activities in their life they once enjoyed.
How emotions are addressed
So how does counseling address emotion? As a counselor trained in Emotionally Focused Therapy (EFT) I believe the best way to help heal emotional wounds it to process through the difficult emotion. Lots of people prefer to avoid these difficult feelings all together; but the reality is the only way to deal with it, is to go through it, not around it. This may seem like a dreadful idea, but honestly the pain is much shorter to deal with it directly than to suffer with it indefinitely.
If you need a more concrete example of this think about a physical wound. No one would live indefinitely with a wooden steak piercing through his or her arm (sorry to be graphic!). With a steak still intact, every little movement would create immense pain. The goal is to get the foreign object out of the body ASAP! And of course, to promote healing by cleaning and wrapping as directed. Unfortunately the invisible wounds of emotion are often ignored despite the immeasurable pain that remains. But we all know, enduring the pain of removing the foreign object is far better in the end than allowing it to remain.
The concept of processing through the emotion involves the training and artistry of the therapist. Every person’s concern and experience is unique and therefore a well-trained therapist will be able to contour treatment to your particular needs and goals. Processing through the emotion will likely involve significant talk therapy, but it may also entail using other interventions (given your openness) such as art, journaling, movement, or breathing techniques. Often interventions that are less cognitive and more experiential go deeper to the root of the concern and help foster healing in a more thorough and lasting manner.
The way people act: Behavior
Counseling also addresses how people behave or act. This is the doing aspect of human behavior that includes everything from what people say to each other (verbal communication), gestures, glances, silent nuances (non-verbal communication), to acts of aggression or passive-aggression. Keep in mind, behavior also includes the omission of action – not doing something is doing something!
Husband: “Why do you always do that?!!!”
Wife: “I’m not doing anything.”
I often view behavior through the lens of family dynamics or with couples as their “dance.” With this lens, people can look at not only their individual behavior, but also how their behavior precipitated from or is a reaction to others behavior. People don’t tend to operate in isolation; people tend to engage or respond to multiple cues at any given time. Unfortunately, the way people act and what they actually want often comes across in confusing ways.
It’s unfortunate how often couples find themselves in unsatisfying relationships or marriages where each individual’s behavior clearly points to relationship distress, frustration with the other, and perhaps an outright disgust for the other. However, once each person’s deepest longings are identified, they often say the same thing. Unfortunately their current means of acting towards one another, isn’t communicating this (as in the dialog above).
As an example, does your cry for intimacy end up sounding like a loud complaintive argument? Or maybe the other direction, do you go silent? You may feel so shut down and apprehensive in your relationship that safety means getting as far away from your partner as you can. Both scenarios deal with behavior or how you dance in your relationship.
When individuals don’t read cues well or when the message gets confused – perhaps the verbal and nonverbal is not matching up – conflict ensues. Naturally people have conflict and generally they are able to manage to work through their conflict. However, in cases where the conflict is not actually resolved, perhaps the conflict ensues day after day for a long period of time, a significant emotional injury is likely to develop. Ah, do you see how a behavioral concern just became an emotional one! That’s the deal; humans are a loop of systems all intertwined.
how behaviors are addressed
So another way that therapy works is by addressing behaviors. What is the dance? What are the dynamics? Given the knowledge of the behaviors how has this impacted the emotion? And the loop cycles back to the top of this article! Again, as therapist trained in Emotionally Focused Therapy, my goal is to address behavior through the emotion where the heart of the issue lies. When emotion is addressed behaviors work themselves out naturally.
How people make sense of the world & Themselves: thoughts
Finally, counseling addresses how people think. Let me ask, if you constantly think, “life sucks” how do you think life is actually going to be? If you constantly think, “I’m no good” how great is your potential? These are not trite thoughts. I understand how powerful and ingrained negative thoughts become. Negative thoughts literally RUN people’s lives.
And, negative thinking is not limited to detrimental phrases about oneself. Negative thinking also tends to become much more pervasive in the sense of how one views the world. Based on repeated experience people come to believe specific ideals about other people in their life, themselves, and the world at large.
I tend to think of negative thinking – to whatever capacity it may reveal itself – as a cap on the potential of your life. When people continue to limit themselves by being stuck with negative views, perceptions or beliefs they limit their ability to be more productive, more successful, more fulfilled.
a complete cycle
Negative thoughts result in behaviors such as never attempting to go to college, denying oneself the opportunity to love again, remaining obese or not caring for personal health. Negative thoughts also lend to substance abuse, other addictions, and self-harm. Imagine how this affects how your feelings about yourself to think negatively. Then, think about how the resulting behaviors further impact how you feel about yourself. When you maintain difficult feelings about yourself the negative thoughts repeat and reaffirm. It’s a very despairing and pervasive feedback loop. Notice again how thoughts link to behavior and above we saw behaviors link to emotion. The cycle is complete.
In my approach to therapy I address all three of the above, while placing the most emphasis on emotion. Emotion is primal; it’s the engine that runs human interaction. When we connect with emotion, the deepest parts of ourselves, we begin to gain insight and affect change within. As change begins within our emotion our thoughts become aligned in clarity. And outwardly, our behavior follows suit.