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What You Should Know About Therapy, Part 1: The Therapeutic Relationship

Updated: Jul 20, 2020

Many of us are hesitant to speak with a therapist. Why wouldn’t we be? Therapy is a thoroughly strange process. We go talk to a stranger (something we don’t usually do) about the most personal details of our lives (stuff we don’t usually share) in an attempt to change troublesome aspects of our lives. Also, we don’t necessarily know what to expect. Most of us have seen movies and TV shows that portray psychotherapy with varying degrees of accuracy, but the mechanisms through which talking to someone leads to feeling better aren’t immediately apparent. In this series of entries, I will demystify the therapeutic process by addressing some of the ways that therapy helps people and providing some suggestions as to how to get the most out of therapy.

The relationship between therapist and client is unique. While it is in some ways similar to the relationships we might have with other healthcare professionals (i.e., paying a fee to meet for a predetermined amount of time in which we receive specialized care) and in other ways similar to a friendship ( e.g., supportive, caring; built on trust and positive regard,) it is where therapy differs from these types of relationships that positive change can occur.

When we are speaking with friends and family, it is normal to give some consideration as to how we are perceived. In fact, we tend to act somewhat differently depending on who we’re engaging with. This is not a bad thing. People are multifaceted, and different social circumstances may bring out different aspects of ourselves. Additionally, in some situations, it may be necessary or appropriate to inhibit certain ways of being that we might otherwise embody. The therapeutic relationship, on the other hand, doesn’t call for that type of social performance. Our therapist’s office is a place where we can express and examine all aspects of ourselves, and in doing so, better identify our unfulfilled needs, self-defeating behaviors, and potential directions for growth. Additionally, the therapeutic relationship does not call for the conversational give-and-take characteristic of more informal relationships. The focus is fully on one person, which allows for a more thorough exploration of the topics of discussion. In that exploratory context, new insights and solutions may emerge.

Our relationships with our therapists are also going to be pretty different from the ones we have with our dentists or gastroenterologists. While it’s certainly important to be able to speak openly with any healthcare provider, client-clinician rapport is absolutely vital to psychotherapy. In fact, the quality of the therapeutic relationship is the most important factor in creating positive change. This makes sense if we consider the role of relationships in our personal development. Much of our way of doing and perceiving things arises from our social relationships (our culture, our family dynamics, the sensibilities of our peer groups, etc.) In many ways, we are defined by how we relate to others. When a therapeutic relationship is characterized by qualities such as empathy, patience, and authenticity, it allows us space and nurturance to grow and develop in positive directions.

The reparative nature of the therapeutic relationship is just one of several aspects of treatment. In the next entry, we will explore the more direct, and in some cases more immediate, ways therapy helps.

Thomas Shooman is a mental health counselor practicing at Resolution Psychotherapy in Poughkeepsie, New York. Thomas’ clients include individuals dealing with issues such as anxiety, grief, and obsessive thinking. He enjoys helping people navigate uncomfortable circumstances and find solutions that are in line with their personal style. Thomas is a member of the Association for Contextual Behavioral Science and the International OCD Foundation, and he is currently accepting new clients. For more information or to schedule a session with Thomas, please visit or e-mail

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