WoW 122: On what happens in therapy, Psychotherapy Series, Part 1 [Words of Wisdom]

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WoW 122: On what happens in therapy, Psychotherapy Series, Part 1

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I have deep respect for my clients and for anyone who does psychotherapy. Why? They are embarking on an ​intentional​ path to grow in wisdom. Many never take such a courageous inward journey.

Yet when first starting out, it's​ not so obvious​ what actually happens in therapy. So I thought I'd share some high level thoughts that applies to psychotherapy no matter the treatment modality the therapist uses.

Here are a few of the elements and dynamics that take place in therapy to help you think about the process and how you might apply it in other domains.

Rigorous honesty – The best therapy occurs when you are ready to be rigorously honest and dare to look at yourself, your ​suffering​, your darkness, and your struggles in the eye. We are social creatures and will hit ceilings to our growth if we do not talk about our lives. The most amazing things can happen when you ​give words​ to something that you’ve never been able to speak before. Healing happens when you can speak out ​secrets​. You can gain unique perspective simply by talking. Through talking in an intentional, regular, and open way you will explore old and new territory, develop new language, create new narratives, and choose to be known.

Discovery – In therapy you will learn about yourself, others, and the truth. There are many ideas, frameworks, and skills that are part of healing and human flourishing. “Everything is grist for the mill”1 is a mindset good therapists hold where everything that occurs in a session is important and can be used to help the client. What is said, how it is said, what isn’t said, complaints or criticisms of the client towards the therapist, how a client starts or ends a session; anything can be used. Therapy can be seen as a microcosm of what is happening with the client out in the world. Helping the client uncover hidden dynamics that are affecting them and patterns of behavior that impact others is an important part of good therapy.

Feedback – Therapy is powerful when you receive actionable, wise, timely, and profound feedback. Feedback is critical because as a client, you don’t know what you don’t know, and there are plenty of things you know you don’t know and need perspective on. Part of the art of therapy is the timing of giving specific feedback, knowing when not to give feedback, and part of it is knowing how to give feedback in the form of questions.

Questions – One of the powerful dynamics of therapy is its bent towards therapists asking ​insightful questions​. Reflecting on powerful questions helps bring discovery like nothing else. Radical new insight can burst into being through a simple question. You can discover entirely new ways of seeing yourself, a loved one, or a perplexing situation by reflecting on a well crafted question.

Practice – Specific skills are learned through practice. It is one thing to show up to a therapy session and talk and learn during the session, but when you combine this with practicing specific skills in between sessions your growth can skyrocket because you will be intentionally applying what you are learning. Some of the feedback you receive in therapy will be specific, helping you take immediate action. This will help you practice growing in specific skills.

Applying the truth – We grow when we consistently take ​meaningful action​. We become more virtuous by practicing ​virtue​. We become more confident by taking courageous action, we become more honest by experiencing the benefits of confession, we become more responsible by owning our own behavior and taking initiative. By combining intentional practice of specific skills with talk therapy, clients can experience a radical transformation in a matter of months.

Virtuous – Growing in virtue is a ​power law. Investing in virtue gives you outsized positive returns in your life. Virtues are so significant because everything good in your life depends on your character. If you don't invest in growing in virtue, eventually it catches up to you. When your character grows, you grow in peace, contentment, joy, and hope. Regardless of if you have outward success in life, if you lack specific virtues, you will be miserable. Good therapy will help you become a more pure, loving, patient, gentle, courageous, worshipful, peaceful person.

Christian – Some therapists make the idealistic error that their worldview does not impact or influence their clients. This is impossible. I think it is helpful, and honest, for a therapist to be transparent about their worldview. Many will disagree with my worldview, and that is okay. Ideal therapy, in my biased opinion, is Christian in its foundational approach. Why? Because a Christian approach best values truth, trust, indomitable hope, and love.

The sacrificial love modeled by Christ is stunning and is the microcosm of human flourishing. This does not mean that as a Christian therapist I need my client to be a Christian or become a Christian. It means, in part, therapy is best when it helps you go all-in and identify and seek to surrender your strongholds of selfishness, dishonesty, resentment, fear, and distorted thinking. Spiritual ​strongholds​ destroy you and create chaos in the war for your soul. Experiencing a loving, consistent, safe, and skilled relationship such as what happens in good therapy can help you grow spiritual fruit of love, joy, peace, patience, kindness, goodness, gentleness, and self control2 .

Loving presence – The best therapists genuinely love and respect their clients. The client is seen as the acorn, and the therapist is part of the soil that will help the acorn become the oak tree3. That healthy soil, that loving presence shows up through the smallest kindness, specific encouragement and affirmation, and giving what we call unconditional positive regard4. A loving relationship is fundamental to a safe and welcoming environment for the courageous work of therapy. If the therapist doesn’t genuinely love and respect their client their desire to want the client to change or to be a certain way will poison the essential ground of having a loving, caring, and supportive environment. If the therapist does love the client right where they are they can authentically engage with and encourage the client in a powerful way.

Quotes

“The curious paradox is that when I accept myself just as I am, then I can change.”

Carl Rogers, ​On Becoming a Person: A Therapist's View of Psychotherapy​

“I am very often asked why, at the age of eighty-five, I continue to practice [psychotherapy]...my work with patients enriches my life in that it provides meaning in life. Rarely do I hear therapists complain of a lack of meaning. We live lives of service in which we fix our gaze on the needs of others. We take pleasure not only in helping our patients change, but also in hoping their changes will ripple beyond them toward others. We are also privileged by our role as cradlers of secrets. Every day patients grace us with their secrets, often never before shared. The secrets provide a backstage view of the human condition without social frills, role-playing, bravado, or stage posturing. Being entrusted with such secrets is a privilege given to very few. Sometimes the secrets scorch me and I go home and hold my wife and count my blessings. Moreover, our work provides the opportunity to transcend ourselves and to envision the true and tragic knowledge of the human condition. But we are offered even more. We become explorers immersed in the grandest of pursuits—the development and maintenance of the human mind. Hand in hand with patients, we savor the pleasure of discovery—the 'aha' experience when disparate ideational fragments suddenly slide smoothly together into a coherent whole."

Irving Yalom, ​Becoming Myself: A Psychiatrist's Memoir​

Questions

Are there any important areas in life where you are struggling to say no? How does your struggle to say no impact your life? What lies are you believing or stories are you telling yourself that empower your struggle to say no?

What question might you be avoiding asking yourself?

(Use these questions as a journal prompt and to guide your prayers this week)

Endnote

Whether you do psychotherapy or not, seeking integrity, being in relationships that help you reflect, and practicing a curious and compassionate self inquiry is essential for your ability to become more whole.

Live wisely,

Josh

Footnotes

1 - Irving Yalom, The Gift of Therapy

2 - Galatians 5

3 - Karen Horney, Neurosis and Human Growth

4 - Carl Rogers, On Personal Power

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