Individuals, couples, children, and adolescents who decide to get counseling or therapy usually realize, sometimes by intuition, that they have lost track of something in themselves that is causing them emotional distress, irrational behavior, or self defeating attitudes. They may feel worried, sad, nervous, or even depressed. They may think or know that their own behavior is working against them but they cannot, for some reason, make changes needed in their behavior by themselves or even with the help of spouses, friends, or relatives. In that sense, their desires, needs, motives, thoughts, and perceptions are happening outside of their conscious awareness or control.

Counseling and psychotherapy work by helping people become aware of patterns of thinking and behavior that exist more-or-less outside of their consciousness. A counselor does this by making suggestions and using educational efforts and specific learning experiences. A psychotherapist does this somewhat differently, primarily by helping a person with self-directed exploration, supported and guided by the therapist. Both approaches share a common goal of bringing increasing information about patterns and structures of behavior into the person’s awareness, where it can be examined, studied, and changed or dealt with more effectively. It has been said, with some measure of truth, that increasing the awareness of one’s of thoughts, feelings, and behaviors, decreases their power to influence life’s important decisions in ways that seem out of control.

Sometimes the self-defeating patterns that lead a person to a psychologist can be discerned in the memories of things that have affected the person in the past. Most often, however, the patterns show up over and over again in the events of the person’s present life, which the person understands only vaguely or incompletely. There are many reasons why self-defeating patterns manage to elude a person’s awareness. For most people, it is because the feelings are too painful or disruptive, so they are shoved aside for the sake of keeping life more pleasant. The mind does this naturally, and it is not unusual or abnormal. But it does mean that some hard work, and usually some trained and sensitive professional help, is needed to bring the information into focus and awareness.

Sometimes, people are concerned that counseling and therapy will get them bogged down in useless re-hashing of old memories that don’t seem to have much relevance. Old memories can help people understand why they think, feel, and behave in certain ways, but it is a misconception to believe that psychological treatment is focused mainly on memories. Rather, counseling and therapy are, and should be, relevant to the person’s life-experiences in the here-and-now – dealing with today’s self-defeating patterns, in which the individual is “stuck.” All forms of psychological treatment succeed by expanding awareness in the present moment, though they may differ in the methods of accomplishing this.

People often ask whether therapy will take a long time, or whether results will happen quickly. There is no simple answer to this question, because each person is unique and has individual differences and problems.

Sometimes people do experience a very sudden sense of relief after starting psychotherapy. Often, however, the relief is temporary and problems remain and re-surface.

Typically, counseling and therapy require a commitment of from several weeks to several months before lasting results are seen.

People sometimes ask how counseling and therapy are better than just paying a “friend” to listen to them. The deeper question is whether counseling and therapy are any more successful than simply leaning on the people around us, and going ahead with life as best we can. There are a couple of answers to this question. First, hundreds of reliable scientific studies, performed over many years, have shown that counseling and psychotherapy do produce beneficial results for the vast majority of people, even when the personal distress or difficulties do not amount to a diagnosable psychological condition. Second, scientific studies have shown that when the psychological difficulties are serious enough to require medication or medical support, counseling and therapy significantly increase the benefits of the treatment. Beyond these general answers, it would not serve any useful purpose to talk about the relative merits of specific psychological interventions for specific conditions because the interactions between specific forms of counseling, therapy, and medical treatments involve a great deal of complexity. It is best to address questions about such matters in a consultation that is relevant to each person’s needs.