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What is Therapy and How Does it Work

TERRY JORDAN, LCSW, DCSW

Q:     How does therapy work?

A:   Most, if not all of our trauma occurs in the context of interpersonal relationships.  Therefore, healing would naturally occur in the context of a trusting, safe, reliable relationship.  The building of this new relationship itself provides a “corrective emotional experience”.  A skilled therapist makes it safe for you to talk about those things you have either repressed and “forgotten” about, or are too scared or uncomfortable talking about with people in your life.  With the support and guidance of a good therapist, you will come to understand how your past has affected you in the present;  you will be able to resolve past traumas that continue to unconsciously play out in your life, and you will feel more content, stable, and generally function far better in all areas of your life.

Essentially, our job is to create safety and undo your sense of aloneness so you can free yourself to be yourself. Here is how it works:

When something bad happens and we feel powerless – powerless to control our environment or our future, we create psychological strategies to protect ourselves. These are called defenses. Defenses are not bad; without them we literally couldn't function.

The bad news is that defenses can interfere with your quality of life ... your ability to love and be loved, to pursue goals or experience self- worth. When that happens, our job is to help you work through or around these defenses. Many of these defenses developed outside of your conscious awareness during vulnerable times in childhood. They are no longer necessary and are depriving you of experiencing the life that you want. Gently, compassionately and tenaciously, we dissolve these defenses so that you can know and express your real nature.

We do this by helping you connect with yourself as deeply as you are capable. We also help you connect with us in an honest and deep way so that you can experience the essential safety and security you need in order to heal. As we work together, new restorative experiences associated with feeling loved and whole become available to you. Your life, and relationship to yourself and others starts to deepen and expand. Fear gives way to freedom and curiosity.  Anger gives way to acceptance. And sorrow eases, creating room for resilience, love and self- activation.

Q:  What are other benefits of therapy?

A:  With the help of a trained professional, you come to understand the core of your struggles and how they are connected with the difficulties in your life, work and relationships.  You will develop the tools to cope with and change behavioral patterns that don’t work for you.  Because we are largely unconscious beings, and are largely driven by what is unconscious, therapy is about making us more conscious so that we have more control over our lives, feelings and behaviors.  We stop making the same mistakes over and over.  We choose healthier people and develop a sense of empowerment.  Our relationships also become more intimate and satisfying.  Psychotherapy produces positive effects in 92% of participants.  The longer you stay in therapy, the better the results. People who are active in therapy do better than those that are passive. Those who actively engage by being open, asking questions, and following up do better.  For most psychological conditions, people in therapy alone do as well as people who have medication plus therapy.  Those who stay in therapy only as long as insurance coverage allows do worse than those who stay until their concerns are resolved.

Q:  How will I know you are the right therapist for me?

A:  You will know this very quickly.  While there are many skilled therapists out there, you can’t predict “chemistry” and whether the connection will feel right to you.  Very soon into your first few sessions you should feel understood, not only with regard to the content of what you are talking about, but on a much deeper level.  Your therapist should be able to make connections for you that you had never previously considered and give you some insights that should be helpful.  You should have a ‘gut’ feeling, and a sense of relief, when you leave the first session. 

You really need to meet a therapist face-to-face in order to get a good idea of what he/she is like as a person and as a professional. At your first meeting you should keep these questions in mind:

How easy is it to talk to him/her?

Does he/she seem like someone I could trust?

Is he/she really listening to me?

Does he/she seem to know what he/she is doing?

Does he/she seem confident and competent?

Do I feel comfortable with him/her?

Could I ever show this person the deepest, ugliest parts of myself?

Does he/she seem to have the capacity to handle me?

Q: I’m a very private person and it’s important to me that issues I talk about are confidential.  Is my confidentiality completely protected? 

A:  By law I am bound to protect your confidentiality. The exceptions to this are related to child or elder abuse, a threat to harm another person, or if you are in danger of self-harm.

Q:   What makes for a good therapist?

A:   A good therapist is one who is kind, well educated, experienced, insightful, empathic, has good boundaries, is reliable, ethical and professional;  one who has participated in their own therapy (although they may not reveal this to you), and is knowledgeable about various theories of practice (rather than just being trained in one modality, e.g., Cognitive Behavioral Therapy).

A good therapist is deeply and genuinely interested in their client as a person and will understand and relate to them according to that person’s particular needs. 

Q:  How long does therapy take?

A:  No one can answer this honestly.  It depends on many factors, including your goals, your history of trauma, your response to treatment, and your level of motivation.

Q:  What kinds of therapy work best?

A:  There really isn’t one type of therapy that is best.  Typically, what is most important is that the therapist is trained in a range of modalities.  There is not a “one size fits all” approach to therapy.  Someone who is comprehensively trained in approaches that target the body (e.g., EMDR, EFT or SE), the mind, i.e., Evidence Based Practices that address distorted thoughts and are more practical in nature, and that addresses the unconscious, e.g., Psychodynamic/Psychoanalytic Psychotherapy, are, in combination, highly effective in working with any and all issues that emerge. 

Q:  How will I know if therapy is helping?

A:  You should know rather quickly.  You will begin to feel better, view things differently, have more self-awareness, coping skills, and hope. 

Q:  Why would I want to talk about difficult or painful things?

A:  If it is locked inside you, it is causing symptoms.  Imagine you had an untreated medical condition.  You would develop symptoms, feel unwell, and it would affect all areas of your life.  The same is true about untreated psychological conditions.  We

don’t recognize the symptoms as problems because we justify them, rationalize them away, deny, minimize or even blame others.  But if we are honest with ourselves and think about the feedback we get from others, the patterns in our relationships, our moods and anxiety, etc., consider that there are significant reasons for these issues.  These are the tell-tale signs that there is something underlying that is unresolved and needs attention.  If we limp for a long time, we might need surgery, which will be painful in the short term, but in the long term, we get relief and are far more functional.  The same is true about emotional or psychological issues. 

Terry Jordan, LCSW, DCSW is a psychotherapist in private practice in West Los Angeles, an Adjunct Faculty professor at USC and a clinical supervisor of masters level clinicians.  She is certified in EMDR, has an advanced certification from the Southern California Psychoanalytic Institute, and her areas of expertise include grief and loss, particularly loss to suicide, trauma, LGBTQIA, couples therapy and relationships, depression and anxiety.  For more info, please visit my website.

TERRY JORDAN, LCSW, DCSW, 2001 S. Barrington Ave, # 202, Los Angeles, CA  90025

(310) 895-4848           terry@psychotherapyinla.com             https://www.psychotherapyinla.com

Why relationships are so hard

Have you ever wondered why you can meet someone and "know" instantly that you're attracted to them?  You feel your heart pound, butterflies in your stomach, and an intense desire to 'make something happen'.  This is the power of our unconscious.  Our unconscious drives us.  We are unable to say, in that moment, exactly what it is that draws us to that person.  It is overwhelming, an overpowering combination of sensations that have no words.

What is our unconscious?  It is a compilation of dynamics, processes, beliefs, attitudes, suppressed memories and feelings.  We don't have access to our unconscious (which is what makes it unconscious).  We are unable to think about our unconscious mind.  This is what makes it so difficult to understand our reactions, feelings and motivations, and attachments to those who hurt us. 

Childhood experiences provide the foundation for adult functioning, including selection of partners and the way in which these relationships play out.  For those lucky enough to have had emotionally and psychologically healthy parents who understood their own trauma histories and the effects those experiences had on their development, those parents are in a good position to be able to meet the needs of their developing child.  Sadly, many are unaware of the effects of their childhood; they either minimize, deny or rationalize their impacts.  Despite their best efforts, the behavioral manifestations of that lack of awareness and resolution of those wounds get projected onto their children.  Children, being entirely dependent on their parents to provide an accurate reflection of who they are, readily absorb these projections, which ultimately get internalized in the form of self-esteem and self-image.  As children continue to develop, these projections and internalizations continue, and become increasingly cemented over time.  The result is a set of beliefs, rules, expectations, perceptions, judgments, attitudes and feelings about the self and others.  This is all unconscious. 

At the outset of a romantic relationship, we are ecstatic, full of hope, desire and fantasy.  Fears and dread slowly emerge when we begin to see the 'other' as a real person.  All of those internalized expectations, rules (about how one should behave in any given situation) and judgments unfold, as does our anxiety and fear that we will be hurt.  This then is the current version of a very old experience of need, hope and longing, and dread of retraumatization (in the form of rejection,
abandonment and betrayal).  The past is now alive and well in the present.  However, given our lack of awareness of our unconscious processes, we become overwhelmed with feelings and thoughts that we recognize (hopefully), on some level, don't necessarily make sense.

This is where relationships can either be healing or retraumatizing.  Healing if both parties are interested in introspection, developing self-awareness, and are motivated to "own their 50%" and understand the reality of what is occurring in the present moment.  All too often, retraumatization occurs.  It comes in the form of projection and reactions to perceived criticism, judgment, and rejection.  Without awareness of how our early history has influenced our interpretation of behaviors, there is a great likelihood of a distorted perception and an over-determined response (a reaction based on an early traumatic experience that has been triggered in our unconscious).  One can see how this can easily result in a spiral of mutual accusations and/or retreat. 

The only way out of this mass of confusion and mutual wounding is to develop self-awareness, examine our childhood histories and the wounds they created, understand those defenses we have developed to cope and protect ourselves, build the "muscles" to tolerate our feelings, learn the language of effective communication and the skills for resolving relational conflict.  This process is empowering, liberating, and ultimately can result in the type of intimacy we long for. 



Terry Jordan, LCSW, DCSW is a psychotherapist in private practice in West Los Angeles.  As an adjunct faculty member at USC, she teaches child and adolescent development, Evidence Based Practices and clinical practice in a range of social service contexts.  She supervises Masters level clinicians, is certified in EMDR, has advanced certifications in psychoanalytic and psychodynamic psychotherapy, and addresses issues such as grief and loss, LGBTQ/gender dysphoria, trauma, depression, anxiety, stress management and substance abuse. 
  
https://psychotherapyinla.com                   310-895-4848                      terry@psychotherapyinla.com