A question I am often asked is how does psychotherapy work? How can talking help me? It’s natural for those entering therapy to wonder about this process that seems a bit mysterious in nature. Here are some of my thoughts on how and why psychotherapy helps.
Beyond mere symptom relief, which in itself is wonderful, the word that most poignantly captures the outcome of good therapy is integration. Consistent therapy can contribute to the integration first of our sense of self, which then permits us to become interpersonally connected. What does integration of our sense of self mean? Jungian analyst James Hillman said that to become full human beings we have to claim the totality of our experience; we come to maturity by integrating not only the light but also the dark side of our story into our selfhood. Instead, we have the tendency to deny and suppress dark sides of life and ourselves, and naturally so because it’s difficult to endure the emotions that come with facing those darker aspects of ourselves. But disowning painful parts of ourselves comes at a high price. Rather than allowing for growth and maturity, it leads to disintegration. We section off those parts of ourselves that feel uncomfortable or scary so they can no longer be processed and integrated into the larger self. Although we may think we can store away those parts of ourselves without consequence, this simply isn’t true. When parts of the self are disintegrated (which they are at some level in all of us), they are expressed through such involuntary experiences as panic attacks, dissociation, somatic illness, a block in the flow of life and creativity. Disintegration also leads to the eventual inability to access deeper parts of ourselves and a lack of emotional flexibility. Considering all this, in psychotherapy we attempt to create an environment with enough safety and acceptance that allows patients to approach these darker aspects of self, embrace them, and invite them into a greater sense of identity.
In the service of integration, a basic tenet of therapy is that all emotional experiences are welcome and even necessary for negotiating life. The initial task within therapy is the allowance of all of our emotions and to begin to simply put thoughts and feelings into words (simple but not always so easy). Patients learn that they can tolerate painful emotions with support, and they don’t have to fear sitting in the presence of those emotions. There is actually value in feeling our full range of emotions. By permitting and listening to buried parts of ourselves, we have access to more of ourselves, including reservoirs of inner wisdom, and we learn we have the capacity to face life’s challenges. Nancy McWilliams wrote, “The experience of speaking from the heart and being taken seriously builds the psychic architecture that supports the capacity to bear life.” We learn to be open to life as it unfolds because we have the capacity to tolerate difficult experiences with resilience.
Another way to look at this same idea of integration is to consider what occurs neurologically as a result of good therapy. In response to an effective therapy experience, neural networks move from pockets of disintegration to become integrated within the brain, leaving less need for unwanted expression of those networks. The middle prefrontal cortex of the brain becomes neurologically integrated with the rest of the brain, particularly the limbic system, resulting in coherence. As a result of this kind of neural integration, we are better able to regulate our bodies and emotions, respond to situations with flexibility, modulate fear, experience insight and intuition, and connect with others (Siegel, 2007). Integration takes place in the body, the central nervous system, and the mind. That experience is often described as feeling more whole or an overall sense of well-being. There’s so much information available within the body and mind that now becomes available to us in the form of intuition.
Of course, psychotherapy does not change the realities of life. We are still faced with all the same relational and existential difficulties that accompany being alive, but what can change is the capacity to engage these difficulties. Integration means blocks are removed and we can access more resources within ourselves that make it possible to engage in life in a profoundly new way.