Want to succeed in therapy? Use what allowed you to succeed in your other pursuits

Clients with whom I work typically tell me of success they have had in other endeavours such as their work or school, sports, music and a variety of other activities. When they begin working with me, I tell them that their success in those other endeavours will help them to address their issues in therapy. In the following sections, I will discuss why this is the case.

Success in therapy: It’s less dramatic than in the movies and television

Success in therapy is often depicted in movies and television in the form of grand insights which lead to breakthroughs. The scenes depicting these ‘TSN turning points’ are very dramatic, emotionally moving and entertaining.

The only problem with these dramatic portrayals is that they present a distorted view of what accounts for most of the success in therapy. By saying this, I don’t mean to imply that insight is unimportant in therapy success or that it rarely plays a role in client progress. However, coming to insights is primarily viewed as a first step on the road to progress.

In that regard, the founder of psychotherapy Sigmund Freud stated that having his patients in psychoanalysis come to insights was a preliminary step to the labourious and painstaking process he referred to as ‘working through’. It is the latter step which ultimately produced lasting positive change for his patients. And it is this process for which success in other activities bodes well for success in therapy.

Working through: Practicing skills until they become habits

Success in therapy is ultimately based on clients practicing skills until they become habits. This is not different in kind from practicing skills until they become habits to succeed in other endeavours. For example, if your goal were to succeed as a golfer you would practice various skills until they become habits such as driving, putting, chipping, and hitting the ball out of sand traps. If your goal were to become a successful piano player you would practice various skills until they become habits such as scales, triads, arpeggios, sight reading and ear training skills as well as practicing various pieces until you could play them proficiently.

To succeed in addressing issues in therapy, the skills which you practice are different from those in the examples I mentioned. That is, instead of practicing putting balls on a green or playing scales on a piano you practice skills to change your thinking and your behaviour to improve your emotional reactions and mental health. However, the process of becoming successful at these therapy skills is virtually identical to that which leads to success in becoming a successful golfer or pianist. That is, you need to practice therapy skills consistently until they become habits in order to successfully address your issues.

Examples of the value of practicing therapy skills: Depression and anxiety

The value of practicing therapy skills is demonstrated with both cognitive and behavioural skills. Cognitive skills focus on practicing ways of thinking which are balanced rather than negatively distorted and which, in turn, have a beneficial effect one’s emotional states. Behavioural skills involve taking action with the benefit of more positive emotional experiences.

Practicing the cognitive skill known as the thought record has been demonstrated to have significant positive effects on mood issues—particularly depression. When I work with clients on thought records, I encourage them to practice this skill regularly. I typically recommend that they do two or three thought records per week and keep a running tally until they have completed 40 thought records over time.

Addressing anxiety issues is facilitated by practicing doing behavioural experiments in which you gradually and consistently expose yourself to situations which lead to strong anxiety. This allows you to accumulate data which demonstrates that the outcomes you feared do not necessarily occur and that you are able to cope with the feared situation as well as perform effectively while experiencing your anxiety. This consistent exposure practice combined with regular behavioural experiments leads to a reduction in anxiety to manageable levels and an increased belief in one’s ability to cope. The key to achieving these benefits is consistent practice of these skills over time.

Achieving success inside and outside of therapy: It’s more boring than dramatic

To recap, what it takes to succeed in therapy is no different from what it takes to succeed in other activities. In all these endeavours, consistently learning and applying skills gets results.

Learning and applying these skills under the direction of a therapist, coach, teacher or other kind of mentor is often helpful. This person will help you to learn the skills effectively and practice them until they have become habits which will generate the results you are seeking.

This route to success may not be dramatic enough for movies and television. In fact, it may seem downright boring. But boring isn’t such a bad thing if it helps you to achieve your goals.

May you draw on your success in other activities to succeed in therapy,

Dr. Pat