How does psychotherapy work?

Someone who has never experienced psychotherapy may understandably have questions about what it is like, how it works, and why it works. While psychotherapy sessions are different for every person, tailored to a client’s needs, based on the person’s biography and the issues they present, there is nonetheless a general pattern that a series of sessions follows. This article sets out that pattern, intended as a guide for clients.

The general principles of therapy are set out, and we see what that might look like in practice with a fictitious client, Steve, whose relationship is on shaky ground because he repeatedly has arguments that don’t make any sense to himself or his partner.  

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The Drama Triangle: reinforcing the unresolved past

One of the roles of psychotherapy is to offer the client new ways to understand their emotional dilemma, with the aim of resolving the impasse. When someone keeps replicating the same pattern of discontent, a repeating carousel of unhappy relationships which reinforce the same fear of rejection, or sadness, or anger, it is a potential sign that the Drama Triangle is being enacted.

This article explains the origin of the Drama Triangle in childhood; its three positions – Rescuer, Victim, Persecutor; what the Drama Triangle looks like in practice; and how this can be worked through and resolved in the therapy room.

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Getting to know your deeper self: the left/right journal

A key task of psychotherapy is to help someone understand their own cognitive and emotional processes better. It is often the case that our own ways of thinking, feeling and behaving are so habitual that we take them for granted. Because we can’t see them clearly, or see them at all, we don’t question them.  

One to one, a psychotherapist has various ways of bringing those hidden or unrecognised processes into conscious awareness. Since we have no choice over something we can’t see, self-awareness is especially important when established ways of thinking or habitual emotional responses create an unhealthy and self-defeating cycle. Once our habitual responses are recognised, we have knowledge, insight, and therefore new choices.

This article is about one method of getting to know yourself better that can be done alone, outside the therapy room; a method that can also enhance what happens in psychotherapy sessions: the left/right journal.   

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The childhood blueprint

One of the key insights in psychotherapy is that an event in itself doesn’t have meaning: events gain meaning through the personal filter of the experiencing individual. Four people at the same event, because they have four different filters or expectations, will experience it in four different ways. Using the imaginary example of observers of a fight in a car park, this article explores personal filters and their role in making meaning. We conclude with an explanation of what this means for the process of emotional healing in psychotherapy. 

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Emotions: why they’re all useful, and the cycle of problems when emotions are blocked

The key task of counselling or psychotherapy is to raise a person’s awareness of their own processes, to help them become attentive to their habitual patterns of thoughts and emotions. Of the four basic emotions – happiness, sadness, fear and anger – it is often the case that a person has learned that one emotion is ‘bad’, that they aren’t allowed it, that they should resist feeling it.  

This article outlines the purpose of emotions; why some are blocked or ‘banned’ in some families; how an ‘approved’ emotion is used as a substitute; how the banning of an emotion can lead to a repeated cycle of unresolved feelings; and how psychotherapy can help.

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Love, attachment and intimacy. Part 3/4: disorganised or fearful attachment

This is the third of four articles about the way we form relationships, known as an attachment style. This article explores disorganised or fearful attachment. Taking early experiences with parents or carers as the blueprint, disorganised attachment originates in an abiding fear due to lack of safety, resulting in negative views about life, dissociation, and emotional disregulation. In adult life, this makes relationships problematic, as the primary concern of the fearfully attached is avoiding danger and, for that reason, emotions are either heightened or blocked and hypervigilance is the norm.

Each of these four articles about attachment includes music which exemplifies the attachment style. Disorganised or fearful attachment is illustrated by Björk’s Hyperballad. Finally, the role of psychotherapy is outlined, the process of helping someone with fearful attachment reach a place of emotional security and safety.  Read more