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As mental health terminology goes, therapy has a lot of baggage. Long misrepresented in the media, the average person often has the idea that going to online therapy is for people who are weak, unable to function and/or completely unhinged.
Not so. Not so at all.
For all the cinematic intensity behind scenes you may be calling to mind, therapy is not some intimidating, confrontational experience reserved only for the worst people.
In fact, when used properly, it’s a tool that can help high functioning people function better, successful people enjoy the fruits of their labor and people who are struggling find some much needed clarity.
Demystifying therapy starts with getting the basics right, and a good place to start is by understanding talk therapy.
After all, it could be argued that talk therapy is the sturdy core of the therapy world — and the thing that could help literally every human being become a better version of themselves.
Let’s start with the basics.
Talk therapy is what you often see represented in TV and film — another name for it is psychotherapy.
Talk or psychotherapy is conversational communication between patients and therapists with the goal of helping the patient.
Specifically, it is designed to help people find relief from emotional distress and become less anxious, fearful or depressed.
Talk therapy can help patients address their issues in two ways:
The first is by learning to deal with negative feelings (disappointment, grief, family issues or career satisfaction).
The second is by modifying ways of thinking that prevent the patient from being productive or enjoying life and relationships.
Psychotherapy isn’t just about “talking out” problems, though — you could technically do that with a friend.
According to the American Psychological Association, there are three reasons talking to a professional is better than talking to a friend, mentor or loved one:
Friends may be willing to listen, but their advice is neither licensed nor based on specialized education and experience.
Psychotherapy is a relationship devoted to the patient’s welfare, whereas relationships tend to be mutual — meaning people take turns talking and listening.
The relative formality of a talk therapy relationship is a routine that fosters a different purpose, and is meant to serve the patient’s interests.
Typically, talk therapy begins with the patient discussing their background — who they are, how they describe themselves and the concerns or problems that have led them to therapy in the first place.
That’s considered an initial assessment, after which a therapist will make recommendations and come to an agreement on the type of treatment, the goals of treatment, procedures and the schedule for further meetings.
Typically, sessions will last between 30 and 50 minutes, and the average patient meets with a therapist once a week, but that can vary widely depending on an individual’s needs.
Talk therapy isn’t necessarily a solo activity. The American Psychiatric Association explains that therapy can be conducted with an individual, family, couple or even in a group setting. It’s also effective both for children and adults (though the techniques may differ).
You may be wondering how long therapy takes to “work,” and that’s a valid question.
Unfortunately, the answer is somewhat less simple, because every person’s needs and healing processes are different.
Therapy can take as little as a few sessions, or it can be a long-term thing that goes on for months or even years.
Because your goals are set mutually with your therapist, they’ll be able to give you a better idea of the scope of time you’ll need to commit based on what you’ve asked for help with.
Psychotherapy/talk therapy may also work in tandem with other treatments, including medications, animal-assisted or arts therapy, or things like meditation.
Talk therapy can be used to treat a variety of issues, conditions and disorders.
The National Institute of Mental Health lays out a fairly comprehensive list of reasons you might seek out talk therapy. They include:
Chronic overwhelming sadness or helplessness.
Unusual and extreme insomnia or over-sleeping.
Difficulty focusing on and carrying out everyday tasks and work.
Constant anxiety or worry.
Excess drinking or other harmful behaviors.
Major life transitions including divorce, deaths of close friends or family, career difficulties or children leaving home.
Behavioral problems in children that interfere with peers, family or school.
More serious conditions, like chronic depression (also called persistent depressive disorder, dysthymia or chronic major depression) may require long-term therapeutic treatment, and you may benefit from medication in addition to therapy.
Your therapy professional will be able to decide if that’s right for you.
Likewise, the same might be true for generalized anxiety disorder, which is characterized by a persistent or extended time spent feeling “excessive anxiety or worry.”
But whether you suspect you may have anxiety, depression, both or neither, if you’re experiencing any of the above problems, you should consult a therapy professional.
Once you’ve had an initial assessment, your particular talk therapy might take one of several forms.
Contrary to what you’ve seen in the movies, all talk therapy does not begin with a stodgy old man in a tartan blazer with elbow patches suggesting that you “tell me about your mother.”
While modern talk therapy may have some things in common with these Mad Men-era approaches, the modern forms are much more intentional in how and why they explore certain topics.
Here are a few examples of the more popular types of talk therapy currently in practice:
Perhaps the most popular type of therapy today, cognitive behavioral therapy (CBT) is effective because of its targeted and functional approach.
CBT is designed to help people recognize, identify and eventually change thinking and behavior patterns that are harmful or ineffective.
This is done by replacing them with more accurate thoughts and behaviors that are more productive or functional.
CBT is effective in treating many disorders — depression, anxiety, eating disorders and trauma-related issues — all by helping the patient recognize what keeps happening in their minds and their actions.
For more on this, you can read our guide to CBT for anxiety.
Eventually, the goal is for the patient to learn how to break the cycle and change for the better.
Interpersonal therapy helps patients understand harmful or troublesome interpersonal issues — things like unresolved grief or conflicts with significant others.
It’s designed to help people learn healthy ways to express their emotions and communicate, and is often used as a short-term treatment, and it’s typically used to treat depression.
Dialectical behavior therapy is a specific type of cognitive behavioral therapy that targets emotional issues.
Often, it is used to treat people with suicidal thoughts, borderline personality disorder or conditions like PTSD or eating disorders.
The focus of DBT is to empower the patient to take personal responsibility to change their behaviors.
Perhaps the closest thing to the silver screen psychotherapy you’ll see these days, psychodynamic therapy pursues the idea that your problems today are based on childhood experiences and inappropriate repetitive thoughts or unconscious feelings — sometimes called intrusive thoughts.
The point of psychodynamic therapy is to increase self-awareness so that negative thinking and behavioral patterns can be changed.
Additionally, there’s a more intense version of this type of therapy called psychoanalysis, which differs mostly in its frequency — it’s often conducted several times a week for the patient’s benefit.
Supportive therapy is less of a style of therapy in its own right and more of a self-guided approach to finding the right solutions.
In supportive therapy, the role of the therapist is to help patients find their own resources and develop their own skills for coping.
The goal, of course, being to lead to reduced anxiety and increased self-esteem, strengthened coping mechanisms, and even improved social functioning.
Hopefully, we’ve done a few things in this article. If you were wary of therapy, perhaps it feels a little less intimidating.
If you were unsure of how therapy works, hopefully it feels a little more straight forward.
If you’ve been wondering if therapy is right for you, hopefully we’ve convinced you that it’s for everyone.
If you’ve been feeling tired, anxious, chronically sad or just isolated, talking to someone — anyone — is a great next step.
You can read our guide on how to tell someone you're depressed if you need more advice.
Verbalizing how you’re feeling is a great way to take the power out of those emotions, by enlisting someone to validate your feelings, and perhaps give you some context.
However, while friends and family may be great in the short term, a therapy professional can do more for you.
If you don’t know where to get started, we might be able to help. Hers has a multitude of therapeutic resources available, including individual and group resources with the benefits of therapy we discussed earlier.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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