I'm a Psychologist, and Here Are 5 Things I Often Think During Therapy

I'm a clinical psychologist specializing in evidence-based psychotherapies for anxiety, depression, and trauma in teens and adults. The nature of the therapeutic relationship differs from other types of social interactions in that we don't follow the usual rules of conversation. In a typical session, clients speak much more than I do. While the silence on your therapist's end may be unnerving, you don't need to worry that we're quietly judging you. Here are some common thoughts I have during therapy sessions that might surprise you.

1. I wish you could see yourself through my eyes, even briefly.

People are so quick to dismiss their strengths, but can easily peg their difficulties as personal failings. Part of a therapist's job is to help you embrace and tap into the strengths that are already there.

2. It's not enough to understand why you're struggling.

The people I see often know what caused or contributed to their anxiety or depression. For example, they know a job loss or breakup put them on this path. But clients can sometimes get stuck on unpacking that cause, as if better understanding it will suddenly lift the depression or ease their anxiety. While understanding where something came from is important, these insights usually won't be enough on their own to engender changes in behavior. In therapy, "What else is possible for me now that I know this?" is just as important a question as, "Why am I experiencing this?"

3. There's nothing you can say that will shock me.

I'm usually invited into someone's life to help them through their worst moments or most painful memories. People I see often experience shame and self-blame over traumatic experiences, and I know they sometimes worry I'll judge or blame them, too. But as therapists, we're simply working to see your experiences through your eyes, so we can help you put them in perspective. We have to understand before we can do that — and in that way, we need your help. So, share openly, without worrying what your therapist will think.

4. You don't need to apologize for crying.

We're often socialized against crying. That can make us feel like crying is a transgressive act, but it's usually a signal that we're talking about something that's important to you. I don't want to rush through that or cut it short, and neither does your therapist.

5. You'll need to take it from here.

Everything we do during therapy is in the service of your life outside of these sessions. You make your own decisions. You decide what you want to change and what you'd like to try. As therapists, we basically help guide you through that process. We can work super hard in session and if nothing happens between sessions, you likely won't see improvement. At the same time, behavioral change is difficult. There's an adage in Problem Solving Therapy that says, if it were easy, it would already be done. Because your therapist knows this, we're really excited when you put what you've learned into practice.