How Psychotherapy Works

How Psychotherapy Works

When one is in a bad place in one’s head,
the modern world offers three main sources of solace: psychiatric medication, CBT and
psychotherapy. Each has its own advantages and drawbacks. Medication can be exemplary
in a crisis, at points when the mind is so under siege from fear, anxiety or despair
that thinking things through cannot be an option. Correctly administered, without requiring
any conscious cooperation from us, pills play around with our brain chemistry in a way that
helps us get through to the next day – and the one after. We may get very sleepy, a bit
nauseous or rather foggy in the process, but at least we’re still around – and functioning,
more or less.Then there is Cognitive Behavioural Therapy (CBT), normally administered by psychologists
and psychiatrists in six to ten hour-long sessions which teach us techniques for arguing
rationally with, and with any luck at points controlling, the ghoulish certainties thrown
up by our internal persecutors: paranoia, low self-esteem, shame and panic. Lastly there
is psychotherapy, which from a distance looks like it has only drawbacks. It has a very
hard time showing its efficacy in scientific trials – and has to plead that its results
are too singular neatly to fit the models offered by statisticians. It takes up a large
amount of time, demanding perhaps two sessions a week for a couple of years – and is therefore
by far the most expensive option on the menu. Finally, it requires active engagement from
its patients and sustained emotional effort; one cannot simply allow chemistry to do the
work. And yet, psychotherapy is, in certain cases, a hugely effective choice, which properly
alleviates pain not by chance or magic, but for three solidly-founded reasons: – Our
unconscious feelings become conscious A founding idea of psychotherapy is that we get mentally
unwell, have a breakdown or develop phobias because we are not sufficiently aware of the
difficulties we have been through. Somewhere in the past, we have endured certain situations
that were so troubling or sad, they outstripped our rational faculties and had to be pushed
out of day-to-day awareness. For example, we can’t remember the real dynamics of our
relationship with a parent; we can’t see what we do every time someone tries to get
close to us, nor trace the origins of our self-sabotage or panic around sex. Victims
of our unconscious, we can’t grasp what we long for or are terrified by. In such cases,
we can’t be healed simply through rational discussion, as proponents of CBT implicitly
propose, because we can’t fathom what is powering our distress in the first place.
Therapy is a tool for correcting our self-ignorance in the most profound ways. It provides us
with a space in which we can, in safety, say whatever comes into our heads. The therapist
won’t be disgusted or surprised or bored. They have seen everything already. In their
company, we can feel acceptable and our secrets sympathetically unpacked. As a result, crucial
ideas and feelings bubble up from the unconscious and are healed through exposure, interpretation
and contextualisation. We cry about incidents we didn’t even know, before the session
started, we’d been through or felt so strongly about. The ghosts of the past are seen in
daylight and are laid to rest. There is a second reason psychotherapy can work so well:
– Transference: Transference is a technical term that describes the way, once therapy
develops, a patient will start to behave towards the therapist in ways that echo aspects of
their most important and most traumatic past relationships. A patient with a punitive parent
might – for example – develop a strong feeling that the therapist must find them
revolting, or boring. Or a patient who needed to keep a depressed parent cheerful when they
were small might feel compelled to put up a jokey facade whenever dangerously sad topics
come into view. We transfer like this outside therapy all the time, but there, what we’re
doing doesn’t get noticed or properly dealt with. However, therapy is a controlled experiment
that can teach us to observe what we’re up to, understand where our impulses come
from – and then adjust our behaviour in less unfortunate directions. The therapist
might gently ask the patient why they’re so convinced they must be disgusting. Or they
might lead them to see how their use of jokey sarcasm is covering up sadness and terror.
The patient starts to spot the distortions in their expectations set up by their history
– and develops less self-defeating ways of interacting with people in their lives
going forward. – The First Good Relationship We are, many of us, critically damaged by
the legacy of past bad relationships. When we were defenceless and small, we did not
have the luxury of experiencing people who were reliable, who listened to us, who set
the right boundaries and helped us to feel legitimate and worthy. Image result for Winnicott
child However, when things go well, the therapist is experienced as the first truly supportive
and reliable person we’ve yet encountered. They become the good parent we so needed and
never had. In their company, we can regress to stages of development that went wrong and
relive them with a better ending. Now we can express need, we can be properly angry and
entirely devastated and they will take it – thereby making good of years of pain.
One good relationship becomes the model for relationships outside the therapy room. The
therapist’s moderate, intelligent voice becomes part of our own inner dialogue. We
are cured through continuous, repeated exposure to sanity and kindness. Psychotherapy
won’t work for everyone; one has to be in the right place in one’s mind, one has to
stumble on a good therapist and be in a position to give the process due time and care. But
that said, with a fair wind, psychotherapy also has the chance to be the best thing we
ever get around to doing. If you are interested in trying psycotherapy, The School of Life offers a service in person in London, or by Skype around the world. Click on the link for further details.

100 Replies to “How Psychotherapy Works”

  1. Have you had positive experiences with psychotherapy? Would you encourage others to try it? Let us know in the comments below or we have a discussion going on right now on our app available free here:

  2. I absolutely love Therapy, I've been fortunate to have found a good therapist early on. Their insight and perspective is the exact thing I've been seeking. I've always felt like I've had to find and figure out everything on my own but with a therapist, I can finally talk it through, experiment scenarios, and gain tools in my efforts to better understand my feelings.

  3. Psychotherapy can be very effective if engaged in by a professional, who has had several years of experience. However if not properly engaged in the suggestions given to the patients may lead to false memories (confabulation).

  4. Why do you make CBT look like it is not a form of psychotherapy? If you want to talk about psychodynamic approaches, please use that term!

  5. I started psychotherapy last year and it was probably the best decision i've ever made in my life. It helped me get through some traumas, it even helped me get in touch with myself more and more. Nowadays I think more about my feelings, where they come from and I will always talk about them with my therapist. It's so good, and it's so true to say that they become the good parent that we needed <3

  6. The first line was the most important:
    "A bad place in you're head". 99% of our misery is in our head, which makes it challenging to fix without a professional.

  7. Correct me ifI am wrong but to me it seems psychoanalysis is a scam. I can see how it can help people who do not have someone to talk to. But I see many mental disorders that I cannot see psychoanalysis to heal.

  8. Psychotherapy has helped me understand how boarding school at a very youny age, bereavement and a rough childhood have all affected me negatively, and also how to turn negative experiences into positive ones.

    Boarding itself seems to have affected me. I had always seen bullying as being the problem. Now I realise being sent away before I was eight was a terrible idea, and that all the other boys were probably damaged by the experience.

    If you were a boarder yourself, I recommend watching "The Making of Them" which is available on Youtube.

  9. when things go well the therapists is experienced as a truly supportive reliable person. their intelligent voice becomes our inner voice. our relationship with the therapist becomes a model for new relationships. therapy works if you engage

  10. When are you going to add Spanish subtitles? I already uploaded my contribution and I want to share this with my friends, but not all of them will understand. ?

  11. Just my two cents, as someone who has been through psychotherapy (I acknowledge this might cause a shitstorm):

    If you are able to manage in life and function well, you don't need to dive deep into your past and open up closed wounds. I started psychotherapy earlier on this year, and after about 3 months I HAD TO take medication because I felt so uncomfortable and severely depressed overly analyzing every small aspect of my life that went wrong.

    You end up becoming like a woman who is constantly on her period. And the feeling lasts a while.

    So, don't do psychotherapy if your life is more or less ok! Therapists will always find a way to break you and then it's just fireworks from there.

  12. 6 years of psychotherapy have changed my life, or rather it has helped me to change my own life, because in the end you have to take up your own responsibility after you've gained certain insights and, foremost, learned to trust the therapist. Best decision I've ever made and will I ever make.

  13. Long story short: it doesn’t
    Not if there’s actually something wrong with you
    If you actually have a chemical imbalance then you need medicine. Yelling at a sinus infection doesn’t make it better, and neither does yelling at a machine that’s missing parts. You need to talk to a doctor and find out what parts your biological machine is missing so that you can begin to explore ways of gaining the pieces that you need to function more normally.

    Psychotherapy only works if you don’t actually have anything wrong with you, and if you don’t mind getting yelled at and threatened by a stranger who has power over you

  14. @theschooloflife – how this differs from a good friendship, except the transaction of wealth from one party to another?

  15. 3:08… (Re: psychotherapy) It provides us with a space where we can say whatever we have to say without fear (paraphrase). This is not always so, especially after my experience with my last counselor,…to the point of lasting trauma in the form of bitterness. Such a one, I refer to as in “anti-therapist”, meaning the opposite of therapy, that is, they do greater harm than good.

  16. See

  17. The only thing that I have found that is helpful for a mother to say about her male children, is that they sit around the home nearly all day long and don't to much of anything. Call it Foxtrot syndrome.

  18. Your voice does something to my ears if i listen to your videos on headphones lol.. its the weirdest feeling, almost painful, but not… Hmmmm.. lmao.. i realise i sound insane lol. But i love these videos so much :).

  19. Woody Allen wrote that after 20 years of psychoanalyses, the only thing his psychoanalyst had to say to him was, "Hey, lighten up!".

  20. Another related theory is that two core processes of psychotherapy are 1) by verbalizing half known aspects of one's thoughts and desires they become more fully known, and 2) we have inherently conflicting, irreconsilable desires and goals, the verbal recognition of which helps cope. This would be the Ambavalence Based Psychotherapy of Sandor Grau.

  21. CBT is a form of psychotherapy…. psychotherapy is a very broad term much like saying "counselling" that incorporates various forms/techniques of therapy ie CBT , REBT, logotherapy, psychoanalytical, psychodynamic and so on and so on… and also "psychotherapists" is another title that can do all three of these things

  22. A woody allen life of therapy is more than most can afford, i thought it was a waste of time…jungian therapy is not that good. It woukd work possibly with profound emotional problems because its about dreams artwork and symbols. Its takes years and even then theres no proof it makes you change. Hence the woody allens second guessing decisions and them checking with therapists to make sure.

  23. Man…. The shrinks I dealt with really suck. The first one Ive been to told me "I don't believe you have autism. I don't even need to use psychotherapy on you. You just need somebody you can have a normal conversation with, is what I can tell" meaning he charged me €50 each time for unhealthy conversations. And the second one I've been to, well.. We'd talk about whatever I feel limits me from perusing a career because I saw her through a support project that was meant to help me get employed, if you will. As a result, we had repetitive conversations always coming back to the question "have you thought about which career you'd like to pursuit?" which was never helpful to me because I had more urgent problems that needed tending to, which are the ones partly blocking me from perusing a happy life altogether. Now I'm seeing a creative therapist. We have no clear rules or boundaries on how to work towards the goals I want to achieve in therapy: she says she'll offer therapeutic practices if you will, but she'll adapt to the needs of her patients. Lately, I've been speaking to her about things I keep ruminating about. Desiring for her to act out as a shrink the way that other shrinks wouldn't act out for me before, as described in this video. But she advises me not to ruminate or talk about my rumination and focus on positive things instead. But I really need for somebody to act out as a shrink for me. I desperately need for somebody to know the horrible things I've been through and validate just how badly I've been mistreated. To help me figure out who I am. Whether I am who I once believed to be, whether I am who my abusers told me I am, or whether I am becoming a better version of myself by trying to heal myself. To help me recognize the truth from the lies… I guess I really need to talk about whether it's okay to continue the therapy sessions with her or whether I should find a good shrink instead… I also think I might've had an autistic miscommunication with her last time and I intend to try and clear that up as well.

  24. I started therapy. I have only seen my therapist twice so far and each time I leave I start crying in my car. I guess I cry because it feels good to be in that room saying what I want and know I am safe. No one can hurt me.

  25. For ones who have gathered here, I would like to recommend the impressionist Ghibli film: when Marnie was there. It is my first wholehearted exposure to a deliberate Psychotherapy, without knowing it in advance. It has made a much bigger effect on me compared to other escapism shows which are easier to watch but also provides a positive influence.

  26. Medication is not just a temporary solution or only for times of crisis. Some people just arent born with cooperative neurochemistry and medication can be a necessary means to balancing out an otherwise highly unideal brain situation. There is too much stigma around medication as it is. I love this channel but several respect points have been lost after this video's portrayal of psychiatric meds as just a person "more or less okay" passed out on the couch.

  27. This video is incredibly inaccurate about so many things. First there are more then 3 types of treatments for mental illnesses. CBT is not not mainly administered by psychologist and psychiatrist any licensed mental health professional can do it including LPC’s, LMFTs and LCSW’s ( depending on your state). Also the video is not describing psychotherapy it’s describing psychoanalysis. Both CBT and psychoanalysis are forms of psychotherapy. I have no idea who wrote this but this is not written by anyone who has any clinical training.

  28. Psychotherapy is one of the most corrupt industries in the world and is pseudomedicine. Worst of all, it has caused numerous harm to millions of people since the creation of pseudomedicine industries of psychology, psychiatry, philosophy, and has lead to deaths of people. It is on par with Scientology. Fortunately, survivors are coming forward to speak out against those industries.

  29. 6:36 "One has to stumble on a good therapist . . . " So very important. A lot of therapists can be the wrong match for you, or just aren't very good at it.

  30. The core statement – that psychotherapy aims to make unconscious conscious – seems correct. But the begining set up is incorrect. One cannot divide treatments accurately the way the speaker does. Way too much strwman statements. A less abstract recounting, with fewer theoretical constructs than is usual in psychoanalytic texts, is Sandor Grau's booklet [71 pages] "A Practirioner's Guide to What Works in Modern Psychotherapy". Many psychotherapies fail due to burden of theories, granted that no psychotherapy can exist without a theory. Try that to better understand.

  31. Does this garbage work? Cause I've had HORRIBLE experiences with "therapists"…Have seen 3, and so far it's 0/3.

  32. I always thought that Psychotherapy was the Whole Counseling field and that psychodynamic/psychoanalysis is the one that dealt with the unconcious part and CBT is another type of psychotherapy??

  33. Seeing my therapist has to be one of the greatest chances I have had to be genuine with another person. I knew I needed help, I knew I needed to be honest, and I knew I had to believe it would work. With that mindset and a great recommendation, I am starting to see success in my emotional maturity.

  34. Well, two days ago i was rushing to my first session of therapy (i was kinda late and it stressed me out and i was already stressed bc you know i needed therapy) and umm i got hit by a car on my way bc i was so focused on making it to there, so I guess i'll have to wait a bit longer for psychotherapy lol but i think it will eventually do good

  35. Psychotherapy need not be twice weekly. Psychoanalysis, as a TYPE of psychotherapy may require attendance twice weekly, but in general, psychotherapy can happen as often as the client needs it. Mostly, this is once a week, but some people need lots of time to integrate new insights and may only be able to attend once every two weeks. Some people are not ready for deep work and a therapist may require that the client first work on self-care skills before engaging in deeper work; the client might need to resource themselves sufficiently to be able to cope with the work of integrating difficult life experiences and trauma. As someone who has attended weekly for nearly 7 years, I have found therapy invaluable for freeing myself from meaninglessness and disconnection. It's the best money I ever spent.

  36. Psychotherapy is great to fill the pockets of Psychotherapists they have no reason to get you well people get to visit them all their life's and its not a scientific is the replacement for the confession in the church pure bullshit.

  37. Psychotherapy works quite effectively. CBT is not a different treatment, psychotherapy includes CBT too.

  38. This video is totally inaccurate and really bad. CBT is a form of psychotherapy. All major theoretical disciplines have plenty of scientific evidence showing their efficacy if not evidence for their theoretical concepts. What you’re calling ‘psychotherapy’ is psychodynamics or psychoanalysis.

  39. Psychotherapy (whether it's psychoanalytic or cognitive) has serious drawbacks. Instead, take some SSRI, learn how to meditate and dedicate daily time for meditation, especially if you're in depression. Be persistent & patient.

  40. I have been in psychotherapy for 10 weeks and I cannot believe how much good has come from it in such a short space of time. Sadly constraints financially mean I may not be able to continue

  41. I was first introduced to the practice reading M. Scott Peck's "The Road Less Traveled" when it was suggested during a health class in college a couple of years ago (actually, I got his self-narrated audiobook, which provided me with a "voice" like Alain speaks of 🙂 ). Peck says that choosing to see a psychotherapist can be one of the scariest and bravest things one may do in their lives.

  42. not all medication have to make you nauseous or sleepy or anything. i am wide awake if i wake up at night. that cozy, sleepy feeling of being able to fall asleep again easily after a quick bathroom break? i don't have it. my meds soothe my mind just about enough to have this cozy sleepy feeling, and to not wake up every day crying. i am a great supporter of psychotherapy or cbt accompanying medication, but if you suffer from anxiety and depression, don't be scared of medication. a good psychiatrist won't let you take something like temesta for long, as it really knocks you out. the goal isn't to knock you out forever. the goal is to get you through the toughest patch, before you can continue therapy. often we are sleep-deprived and exhausted from all the anxiety and panic and depression. those are very tiresome illnesses (and i speak only of the ones i personally am affected by). it's okay to need to take medication that's stronger to catch up on that rest at first. but also, not everyone has to be on these very strong medications. keep that in mind, and find a health care professional you trust. 🙂

  43. No, a good therapist gives you tools to cope in your environment and deal with past traumas as the video says. But, the therapist is not a surrogate parent as is suggested here.
    The reason is the patient should not become attached to the therapist or dependent on them on an ongoing basis. The goal of therapy is to get you out of therapy so you can face the world on your own feet.

  44. The archangel Gabrielle will try to visit you if you are in psychotherapy.  If you're therapist does not approve of visitations by good looking naked girls, it will not work.  In fact, the psychotherapy will not work.

  45. Bullshit.
    I had two psychiatrists, and two therapists, and Almost every single one of them just sucked my money, asked the same questions, there were just hours of silence, which made it all even worse, wasting my time and money by doing some useless breathing trainings that were supposed to take at most 25 minutes, but they extended that to full hour. And for that they were taking about 5% of regular monthly salary PER HOUR. I can only tell that the first one was fair, because he said that I can't be helped. 4 doctors later, few years of just worsening everything and he was right. It was because I want cure, not lies.
    Every single therapist will tell you that he can't help you and you have to handle it yourself, but in a way that will sound like it's part of your treatment. It's literally just placebo. They will give you feeling that if you will go there, you will be cured, after a while of no actual progress they will say that you are doing better, set up rarer visits, so you will have fake feeling that it's ok, until it comes back, and they will milk you from money again.
    There is no cure for depression. Therapists are only to incept into your mind the lie that there is one.

  46. Here's how it was in my experience with few different psychotherapists and psychiatrists:
    I said everything I could, dropped everything that was heavy on my heart, all the shit that makes my life miserable and pains me a lot. A minute of silence. He says something like "This had to be rough" XDDDDDDDDDDDD NO SHIT SHERLOCK HOW DID YOU KNEW?!
    Therapists are not here to help you, they have few replies and few hard learned solutions, and they may or may not help, if they don't, they don't care, they just want your money. It is ANYTHING but a relationship. Stop spreading lies.

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