How Does Therapy Help? The Importance of the Therapeutic Relationship

I don’t believe therapy helps because the therapist has all the answers.

I don’t.

And I don’t believe my role as a therapist is to sit opposite someone and tell them how they should live their life, what decisions they should make or who they should become.

For me, therapy can be helpful for a very different reason.

It offers the possibility of experiencing a different kind of relationship.

A relationship in which you can be listened to without immediately being told what to do.

A relationship in which your feelings are not dismissed because they make somebody else uncomfortable.

A relationship in which you do not have to pretend that everything is fine.

A relationship where there is space for curiosity rather than judgement.

For some people, this may be very different from the relationships they have experienced before.

And I believe that difference can matter.

How Does Therapy Actually Help?

People often come to therapy looking for answers.

Why do I keep feeling this way?

Why do I react like this?

Why do I keep ending up in similar relationships?

Why can’t I just move on?

What is wrong with me?

These are understandable questions.

But therapy does not necessarily provide quick answers.

Sometimes the therapeutic process begins by creating enough safety and trust for us to become curious about those questions together.

Instead of asking:

“What is wrong with you?”

we might begin asking:

“What happened to you?”

“What have you learned about yourself through your relationships and experiences?”

“What helped you survive or cope in the past?”

“And is that still helping you today?”

This can create a very different way of understanding yourself.

The Therapeutic Relationship Can Be Part of the Therapy

The relationship between therapist and client is not simply something that exists around the therapy.

For me, the therapeutic relationship is an important part of the therapy itself.

Many of the ways we relate to ourselves and other people develop through relationships.

Perhaps you learned that expressing your needs caused conflict.

Perhaps being vulnerable resulted in rejection.

Perhaps you learned that being useful, successful, quiet or easy to manage was the safest way to maintain connection with other people.

Perhaps nobody asked how you were feeling.

Or perhaps you learned to pay close attention to everyone else's emotions while gradually losing contact with your own.

Those patterns can continue into adulthood.

You may find yourself saying yes when you want to say no.

You may worry constantly about disappointing people.

You may apologise for having needs.

You may find it difficult to trust others.

You may hide parts of yourself because you fear that if someone really knew you, they might leave.

Therapy can provide an opportunity to begin noticing these patterns within a relationship that is intentionally different.

What Can a Different Therapeutic Relationship Feel Like?

Imagine being able to say:

“I’m angry.”

And the other person doesn't withdraw.

Imagine saying:

“I don't agree with you.”

And the relationship remains intact.

Imagine becoming emotional without immediately feeling that you need to apologise.

Imagine saying:

“That hurt me.”

And instead of being told that you are too sensitive, somebody becomes curious about your experience.

Imagine not having to look after the person sitting opposite you.

For someone who has spent years adapting themselves to maintain relationships, experiences like these may feel unfamiliar.

Sometimes even uncomfortable.

But they can also create an opportunity to discover something new:

Perhaps I can be myself and still remain connected to another person.

Therapy Is Not About the Therapist Knowing Better

I am a therapist, but I am not the expert on somebody else's life.

My clients bring something into the therapy room that I can never obtain from a textbook or training course: their lived experience of being themselves.

They know what it was like to grow up in their family.

They know what their relationships have felt like.

They know the losses they have experienced.

They know what they have had to do to cope.

My role is not to take that knowledge away from them by assuming that I know better.

My role is to bring my therapeutic knowledge, experience, curiosity and attention into a relationship where we can try to understand their experience together.

That is very different from giving someone instructions for how to live.

Empathy Does Not Mean Agreeing With Everything

Being empathic does not mean that a therapist simply agrees with everything a client says.

A meaningful therapeutic relationship can also include challenge.

But I believe there is an important difference between challenging someone from a position of judgement and becoming curious with them from a position of respect.

A therapist might notice something that happens repeatedly.

A change in your voice.

A moment when you suddenly become quiet.

A tendency to dismiss your own feelings.

A joke that appears whenever the conversation becomes painful.

A pattern of immediately blaming yourself when discussing conflict.

Rather than saying, “You need to stop doing that,” we can become curious about it.

What happened just then?

What did you notice in yourself?

Does this feel familiar?

Sometimes those small moments can tell us a great deal.

What Happens When You Have Never Experienced a Safe Relationship?

For some people, words such as trust, safety and acceptance sound straightforward.

For others, they may not be straightforward at all.

If relationships have previously involved criticism, unpredictability, rejection, emotional absence or having to constantly monitor another person's mood, trusting somebody simply because they are a therapist may not be possible.

And I don't think it should be expected.

Trust is something that develops within a relationship.

It can take time.

You may spend the first few sessions wondering whether it is really safe to speak honestly.

You may worry about being judged.

You may tell your therapist something and then spend the following week regretting having said it.

You may even expect them to eventually respond in the same way other people have.

These experiences can themselves become part of the therapeutic work.

You Don't Have to Perform in Therapy

One of the things I hope therapy can offer is a space where you gradually feel less pressure to perform.

You don't have to be the strong one.

You don't have to make me feel comfortable.

You don't have to arrive with an interesting story.

You don't need to know exactly what you want to talk about.

And you don't have to be a “good client”.

You can arrive confused.

You can change your mind.

You can sit quietly.

You can laugh.

You can cry.

You can tell me that something I have said doesn't feel right.

All of this can become part of our work together.

So, Does Therapy Help?

I don't believe therapy helps because therapists possess a collection of answers that their clients don't have.

I believe therapy can help because it creates the possibility of understanding yourself within a relationship that may be different from relationships you have experienced before.

A relationship where somebody stays curious.

Where your experience matters.

Where difficult feelings can be explored rather than immediately removed.

Where patterns can be noticed without reducing you to those patterns.

And where, gradually, you may begin to relate to yourself differently too.

Perhaps one of the most important questions in therapy isn't:

“What should I do?”

Perhaps it is:

“What happens when I am finally given enough space to discover my own answer?”

Aga Detlaf, MBACP Integrative Therapist