What Psychotherapy Is, Can Be, and What It's Not

Whenever a first-time psychotherapy client begins with asking, "how does psychotherapy work?”, I start to wonder. Why are they putting a question about how I can help them ahead of telling me what they need help with. Of course I point that out and ask about it, and we launch into a discussion about their expectations, concerns, therapy’s usefulness, and possibly their own interpretation of what going to a psychotherapist means about them. I don’t mind answering the question. But my answer is limited. There isn’t one reliable answer. Every therapy experience is as unique as is every therapist/client relationship. But there are a few things that I can say about what therapy is, what therapy can be, and to clarify what therapy is not.

Therapy IS a relationship.

The two most important variables in psychotherapy are the client and the therapist. And just as is true in any relationship, therapist and client need to “click” with one another in order to have a relationship that will be the foundation for the work. So the first thing that therapy is, is a relationship built on trust and stability.

It’s a relationship that incorporates deep understanding, caring, conflict, and resolution. Those ingredients are critical in any important relationship. But the therapy relationship has one unique component. It’s one-sided.

A therapy relationship IS one-sided.

For most adults who haven’t been to a therapist before, coming to accept the fact that they get all of the support and have nothing emotionally expected of them, can be an awkward adjustment. And for those who are used to having a lot expected of them, it can then be a relief. It can also seem strange to pay someone for something so personal. The question often gets raised, “Does paying my therapist mean that they don’t really care about me? That they only act that way so that I’ll pay them?” The clear answer is NO. Your therapist got into this business because it’s in their blood to care about people. Caring about you is the raw material with which your therapist can work creatively with your therapy relationship, the way a sculptor works with clay. And how much you glean from that process depends on how much you participate. While the focus of attention is one-sided, the therapy process requires team effort.

Therapy CAN BE a variable experience.

Over the course of time in therapy, there may be periods that seem like you’re in a holding pattern. You might think nothing is happening, and other times when change is coming at you faster than you know what to do with it. And every variable of experience in between is also possible. Make the best possible use of your therapy by talking as openly to your therapist about your frustration, boredom, or anger with the process, as you do about your new insights and decisions to take action on them. Know that ebbs and flows are as much a part of therapy as they are a part of life.

Therapy CAN BE surprising!

If you knew what your therapy experience would be, you’d just do it. Without hiring a therapist. So neither you nor your therapist knows how your process will unfold. At some point you may realize that you'd expected it to be a certain way, and it’s turning out to be completely different. You may be surprised to discover that you’re therapist recognizes ways that you struggle, that even you didn’t realize. You may be surprised that your therapist doesn’t tell you to go home and do X..Y..Z. You may only realize that you had expectations, whey you notice those expectations are not getting met.

Therapy CAN include techniques and homework

Sometimes it makes sense to implement “tools of the trade” when those tools offer possibilities for discovery. Some therapy clients are interested in working a particular way, and will seek out a therapist who offers a technique, such as CBT, Hakomi, EFT, Hypnotherapy and countless others. But whether or not the technique brought therapist and client together, there will be times for using techniques and times for riding the wave of experience. In much the same way, homework may be given to stimulate a new experience outside of the therapy office. Your therapist just might say “go home and do X..Y..Z.  But even if a concrete homework assignment isn’t given, you’re doing your homework whenever you reflect on your therapy, and integrate what you’re learning into other areas of your life.

Therapy IS NOT one-size-fits-all.

Techniques come and go in popularity, or in what insurance companies will pay for. There are good reasons for the popularity, and for the insurance company endorsement. But your therapist needs to take your unique circumstance into account. CBT can be very effective, and insurance companies often want depression to be treated with CBT. But a particular person may not be a good candidate for that technique. Once again I say that therapists get into this business because it’s in our blood to care about people. Your therapist’s first job is to know and respond to the one-of-a-kind person that you are.

Therapy IS NOT easy answers to hard questions.

You may be expecting your first session to end with pearls of wisdom equal in value to the $200 you paid for the hour. But instead you just walk out scratching your head. Big change happens over time. Not with one $200 pearl of wisdom. With time, consistent sessions, and a willingness to use the feedback you get from your therapist, you have the best possible chance for the most lasting change.

So do you wonder if your concerns can be helped in psychotherapy? Your the only one who can answer that question. And the best way to research your answer is with your own personal experience. You can only know when you initiate your own life change by jumping in and discovering a new way to explore the one-of-a-kind person that you are.

Fresh Starts In Daily Life

I have an elderly aunt who, at age 84, with alzheimer’s disease barking at her heels, decided she’d had enough of her stubborn, controlling, and verbally abusive husband. She got a divorce and made a fresh start. At her age, a fresh start meant moving to a progressive care facility. Family and friends who’d endured 30 years of watching her life go by while holding her breath, said, “It’s about time!"

Your fresh start is uniquely your own. You may be putting a loss behind you. You may have finished raising kids and sent them on their way. You may have achieved a long-planned retirement. Or you may feel the need to stir the pot and change things up. Start with reflecting on what you already know about how you live each day.


  • What’s that routine coffee drink you order every morning?
  • How do you respond to people asking for money on the street?
  • What’s that thing you always say to your spouse?
  • What do you always listen to in the car?
  • How do you always feel about to rush hour traffic?
  • What’s your routine response to the question “how are you today?"


Noticing a routine doesn’t necessarily translate to changing it. Just reassess what still works for you and what doesn’t.


  • Which routines contribute to your life.
  • Which routines deplete you, or make you feel bad about yourself.
  • Which routines are you choosing to keep?
  • Which routines are you choosing to discard or change?
  • Which routines are choosing to keep you?


That last question is a tough one, but an important one to consider if a fresh start always seems out of reach.

You may not know what to do with an activity, feeling, or response that seems to have you. But realizing that it’s there is actually doing something. When you recognize it, you’ve changed your relationship to it. You may feel discouraged when you notice it. But just noticing it is actually doing something with it. And each time you notice it, you’ve done something more with it. Stay with it. Talk to a friend about it. Give it a name like "Hop Along", “Alice”, or “Fred”. Make fun of it. All the while, notice how your feelings toward it change. Notice that by incorporating it, you’ve chosen it. And once you’ve chosen it, you’re in a better place to change it if you want to.

A fresh start can start with simple observations. Those observations may lead to bigger changes. But it’s in knowing the details that make up where you are right now, that you lay the foundation for bigger change.

Now that my aunt’s alzheimer’s disease is progressed, every day is a fresh start. While my sister and I visited her in the common room, a middle-aged man passed by to visit his father. A moment later my aunt asked if I remembered that nice young man we met. Confused at first, I racked my brain for someone from her youth. Then my sister chimed in, “Do you mean him?” pointing at the middle-aged man. And my aunt enjoyed seeing the nice young man all over again.

Fresh starts don’t have to be earth shattering. If your memory is working better than my aunt’s, you can build on those moment-to-moment fresh starts to grow toward bigger changes.

How do you say no to a second date? The answer can strengthen the relationship you later say yes to.

Be as careful with your dating resources as you are with your money. Just because "Person X" is nice doesn’t mean that you want to invest in them any more than you have. Money is one part of your package of dating resources. So is the precious little time you have for a social life. But the biggest resource in that package is your heart. That’s the critical component that makes or breaks the connection when you do fall in love.

Until you meet “the one”, dates are opportunities to refine your idea of a perfect match. They are also opportunities to try on having difficult discussions. If you can’t work with the minimal difficulty of saying “no thanks” to someone you barely know, how will you ever tell your significant other that you’ve changed your mind about having kids! Or whatever inevitable difficult discussion arises.

You may have concrete reasons for wanting to stop seeing Person X, or your gut instinct might be saying no. But in contemplating what doesn’t feel right about seeing them again, you might also notice your attention is focused on them, and not on yourself. When you put your focus on them, regardless of your own difficult feelings, you’re making yourself secondary to Person X. You can’t manage how they’ll feel about moving on from you or how they'll react. So you develop strategies for getting out of the situation, rather than resolving it, and you miss a chance to cultivate your heart as a dating resource.

The best known current strategies are the most brutal on your own heart. Ignoring their calls and texts, telling them you’re too busy, or continuing to date them against your better judgement are all great ways to make yourself feel resentful or even like a rotten person. But there’s a difference between being purposely cruel, and just not knowing how to skillfully approach a potentially painful topic. 

So here’s the trick. Compassion. Give yourself compassion for how difficult you're finding this. The fact that you’re reading this blog is evidence that you have compassion for others. You're looking for a way to be kind to Person X, even though you don’t want to date them. You can grease the path to kindness for others by being kind to yourself. When you recognize your own discomfort, and allow yourself to sit with that discomfort the same way you’d sit and listen to a friend in pain, you’re compassion for yourself is building the heart element of your dating resources. A recognized heart is a stronger heart. And hearts are easiest to see when they're having a hard time. So recognize the discomfort inside of you. Hang out with your disappointment that they didn’t turn out to be the one you wanted. Hear the thoughts you have about how it did turn out, and about needing to tell Person X that you know now that you aren’t right for each other. Are there unkind thoughts directed at yourself? Don’t push them away. Notice where those unkind thoughts come from. Compassion isn’t about cherry picking the feelings that seem like “compassionate feelings". It’s about recognizing whatever is right in front of you, and hanging out with it in friendship. 

A natural byproduct of having compassion for yourself is that you’ll have stronger and more stable compassion for others. If there were things you did enjoy about Person X, then as you contemplate your need to stop seeing them, those things you appreciate will rise to the top. Those thoughts aren't there to change your mind. Just to be noticed. And if they don’t rise up, then there may not be anything you enjoyed about Person X. That’s okay too! This is about staying with what’s true for you. You may feel sad that there’s nothing to appreciate about them. Voila! That’s compassion for Person X! Don’t worry that you're being self-absorbed. Showing up for yourself is the “how” behind showing up for others. A compassionate heart is a loving heart. And a loving heart makes your dating resources more valuable!

So now that you’ve sat with yourself, and listened to yourself, notice what parts of your thoughts you'd be willing to share with Person X. But keep in mind that just because it’s true, doesn’t mean that you have to say it. You hardly know this person, and you’re trying to NOT get any more involved with them. So be conservative with how much of yourself you want to share. Your reflections can ease and strengthen your own heart. So they’re only meant for you. 

Recognize that Person X has a package of dating resources too. And they were offering to spend their precious resources on you. Appreciate them for the implicit offer. And know that you don't owe them anything for it. Everyone who dates is taking chances with their dating resources.

You many choose to keep your words to a minimum. Say you're clear that the two of you are not a good fit for each other, thank them for the opportunity (to be offered their dating resources), and wish them best of luck in their search. That’s it! Did you appreciate their recommendation for a book or a website? How nice of you to remember and add a thanks for offering those suggestions. But don’t feel obliged to dig up something nice to say about them. Don’t make it harder by making up anything that isn’t true. Being untrue depletes your dating resources without having even had a date! If you don't waste money on useless stuff, then don’t waste your heart on lying. Lies are a useless drain on your precious heart resource.

If they ask why you’re saying "no" to a second date, it may be that they what to learn about themselves and grow from your feedback, or it may be a set-up to argue you into more dates. You've already considered what you're willing to share. So offering honest information without exposing more of your heart than you're comfortable with, is perfectly fine. And it may be received quite gracefully. It’s when the other person wants to argue against your reasons that you may feel frustrated. This was exactly what you didn’t want to deal with. Know that you don’t need to justify yourself. You can simply restate your truth. And if this person is pushing for justification, you get to push back.“I know what I’m looking for. And I need to move on.” If you've only had one or two dates, you’re not under any obligation to do anything other than name the boundary you’re setting. 

Your mode of communication is always a delicate choice for any planned discussion. While texts and emails have streamlined our communications, they’ve also cultivated a culture of less personal connection. It’s sad to hear of people in committed long-term relationships who get a text announcing a break-up. While that’s an entirely different situation from a one or two date relationship, it’s a symptom of how people have learned to lean on technology to avoid communication challenges.  With only one or two dates under your belt, it’s usually okay to say "thanks but no thanks" via technology. But it’s up to you to consider whether you want to lean into difficult discussions, and get good at them. If it makes sense, dhoose the phone or a live discussion over texting or email. It's also important to consider the particulars of your situation. Is she your sister’s best friend? It’s probably better to call her than to text her. The fact that she is likely still a part of your life means you’re already invested. Is he someone you met on-line, and you’ll never see him again? He probably won’t mind a text, and will appreciate knowing soon, that he’s free to move on. Do you live in a small town? Chances are you'll cross paths again. Choose wisely.

There are no hard and fast rules for choosing your mode of communication, any more than there’s any one best way to say no to a second date. Rules have nothing to do with human contact. Use your humanity by taking the time to direct some kindness toward yourself. When you take the time to know what does or doesn’t feel right or wrong, true or untrue, you’ll realize you have your own answers. Then you'll be able to bring a strong, communicative, unfettered heart into the loving relationship you really want.