How Does Therapy Work?

How Does Therapy Work?

by Dr Emma Gray - 24th October, 2014

Therapy, and by this we mean ‘talking therapy’ is currently the most effective way of treating a range of psychological, emotional, relationship and mental health problems including anxiety, depression, eating disorders (e.g. anorexia nervosa, bulimia nervosa, binge eating disorder), obsessive compulsive disorders (OCD), post traumatic stress disorder (PTSD), panic attacks, stress, sleep problems, relationship problems, anger problems and more.

It’s effectiveness over medication seems to be rooted in the fact that a talking therapy aims to resolve the origin of the problem rather than just trying to alleviate the presenting symptoms, ensuring that symptoms do not reoccur or represent in a different form.

In essence therapy (through talking) creates a safe space for the patient and their therapist to explore the problem, its origins, development and how it is maintained on a day to day basis. This exploration then allows patient and therapist to collaboratively devise a way of resolving their symptoms and by addressing what underlies them, ensuring that they do not return.

Therapists also endeavour to assist their patient to create a distance between themselves that their distress; it is this distance that allows the patient to think differently and therefore ultimately feel and behave differently.

It is sometimes hard describe a thing that, like therapy, has many dimension, the description often ends up being overly complex and as a result inaccessible to the uninitiated. For clarity, it can therefore be useful to use an analogy:

The River: An Analogy for Therapy
When people are struggling with a problem is it like they are being swept along by a fast flowing river and all their energy is taken up trying not to drown. Often people hope that their therapist will come along with a boat and rescue them, however, although this would bring them short term relief, they would still not be able to dictate the direction that they are travelling and when the therapist leaves they will undoubtedly take their boat and so the individual will find themselves back in the river again.

A good therapist/therapy aims to get their patient out of the river and on to the bank. From here they will be able to catch their breath, collect their thoughts and then see the other options that are available to them; take a pair of wellies and go for a paddle, cross the bridge and see what things look like from the other side, or buy their own boat.

By helping their patient to change their position and therefore their perspective, the therapist enables their patient to see things differently and things that they couldn’t see before i.e. when they were drowning in the river.

Although this goal is implicit to all therapies, Cognitive Behavioural Therapy (CBT) champions it by teaching a unique mix of practical and psychological technique and strategies, Cognitive Behavioural Therapy (CBT) teaches the patient to become their own therapist.


Dr Emma Gray

Dr Emma Gray

I am often the first person with whom my patients share significant and intimate thoughts and memories; I never take that privileged position for granted nor the opportunity to help someone to feel better about themselves and discover a more fulfilling life. One of my colleague once described me as natural psychologist; I guess she was alluding to the fact that I feel at ease being a therapist, I can empathise with people’s distress and discomfort but don’t feel overwhelmed by it, I can understand their problem and know how to help, it has always just felt like what I should be doing.


Read more about my approach to counselling here...


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