What Is TALK Therapy Anyway?

After coming across numerous misleading social media ads and posts from mental health and therapist platforms, I felt compelled to address them in this blog. These ads often claim that 'traditional talk therapy doesn’t work.' But what exactly is 'traditional talk therapy'? For one, It typically refers to psychoanalytic, psychodynamic, and depth-oriented psychotherapy. So, when I mention traditional talk therapy in this blog, I’m referring to these psychoanalytic-oriented schools of therapy.

In my attempt to enlighten you about talk therapy, I will stick with 3 main points about talk therapy: 1) What is talk therapy, 2) Why talk therapy might not work, and 3) Don’t buy into the social media hype.

Today, graduate schools are increasingly becoming an assembly line focused on numbers rather than quality and depth of education. This is not to blame educators, but the overall system led by governing boards, lawmakers, etc., has led us to this place. After being in this field for well over a decade, I can tell you with certainty that most psychotherapists coming out of graduate school do not know what traditional talk therapy is. So, let’s dive into what talk therapy is.

Traditional talk therapy is fundamentally about building a strong therapeutic relationship. This relationship is based on the client's and therapist's shared therapeutic goals and the belief that the therapist can guide the client toward achieving those goals. A recent meta-analysis study by the American Psychological Association confirmed the importance of this relationship in the success of treatment. John Norcross, PhD, ABPP, chair of the APA, stated, “The therapeutic relationship is as powerful, if not more powerful than the particular treatment method a therapist is using.” This tells us that in any form of psychotherapy, you will receive, one of the biggest tools for change is the relationship you will develop with your therapist. The act of talking is essential to establishing the therapeutic relationship that creates powerful change, as the APA study suggests.

Talking is the cornerstone of all human relationships. Communication is key, whether it's a parent-child bond, an intimate relationship, or a friendship. While all schools of psychotherapy involve talking and developing a healthy therapeutic relationship, psychoanalytic-oriented psychotherapy, or 'traditional talk therapy,' strongly emphasizes the therapeutic relationship as the primary facilitator for the desired change in our patients. 

The therapeutic relationship in traditional talk therapy is not based solely on whether a patient likes their therapist. It is not about feeling good or immediate symptom relief. It is not a quick process. In fact, in my experience, backed by long-term studies, real psychological change only begins to take shape around the one-year mark. A healthy therapeutic relationship gives room to discuss the uncomfortable and, at times, the darkest parts of ourselves and our life experiences. Furthermore, how the patient relates to the therapist often reflects how the patient relates to people and things outside of therapy. A genuine therapeutic relationship will allow this process to take shape. It will give clients a space to not just talk about these uncomfortable and dark places but to experience them differently, leading to change over time.

The therapeutic relationship can and will be challenging, but as I always tell my clients ad nauseam, you cannot grow without growing pains. On the flip side, a beautiful therapeutic alliance emerges, and this process helps the patient meet their goals and claim a new sense of agency that they have not experienced before. And this process can only take place when we start talking.

Now, these are just the cliff notes of dynamic or "talk therapy" psychotherapy, but I hope this clarifies what talk therapy is for you at least a little.

Briefly, I would like to share why talk therapy might not work.

1)    Fit: You want to find a therapist that is a good fit for you. Sometimes, that means shopping around and consulting with a few therapists first. It may mean giving therapy a shot for a few sessions to see if they are a good fit for you. I would recommend challenging yourself in this process. A good fit does not mean that you like the therapist as a person; it does not mean that they tell you what you want to hear, and a good fit can be a little uncomfortable. So, keep these things in mind when searching for a therapist.

2)    Inability to repair: Like any other relationship, the therapeutic relationship will have ruptures. That is to say, there will be rifts, letdowns, disagreements, etc. Like any healthy relationship, it needs to be able to repair itself when these things happen. The main tool of repair is talking about it. In therapy, we want to be able to share these feelings and thoughts with the therapist to work through them.

3)    Lack of patience: I will speak for myself when I say therapy is a process. Change does not happen overnight. Go into therapy with a goal in mind. If you are seeking symptom relief, make that known from the start, but know that symptom relief is just that—temporary symptom relief. Research shows that this approach will temporarily relieve unwanted symptoms or feelings, but they will inevitably come back. Long-term change requires time.

4)    Lack of trust: Any good psychotherapist, through the process of psychotherapy, is creating a case conceptualization and treatment plan. I will spare the long, boring explanations of these things, but the point I want to make is to trust the process! Trust is one of the things I see many patients struggle with. This is a good opportunity to experience what trust means. What can get in the way is coming in with your own preconceived ideas of what “type” of therapy you need. Sometimes, a patient can see something on social media or some other source about what type of psychotherapy works for a certain issue. I would say that if you already feel and think your therapist is a good fit, then trust the process. The key to change is often hidden within the patient, so start to talk, build the therapeutic alliance, and trust that change will take shape.

These are a few reasons talk therapy might not work for some people.

The last thing I want to address in this blog about talk therapy is that you should not believe the social media hype. When you hear things like “talk therapy does not work,” it is usually because they are trying to promote their own brand. Remember that most clinicians are not fully trained or have a deep understanding of talk therapy, so do not buy into these marketing campaigns. If you are truly interested in deep change and are committed to doing the work, consider traditional talk therapy an option. During your initial consultation and getting to know your therapist, ask about their knowledge of talk therapy so you can find someone who can do this deep work alongside you. The points in this blog scratch the surface of what talk therapy is and what it can do for you, but I hope it sparks more curiosity to explore this more on your own.

I want to leave you with this final quote, which sums up the concept and goals of talk therapy (in my opinion).

“We are born in relationship, we are wounded in relationship, and we can be healed in relationship.” – Harville Hendrix

-Dr. Mario Rocha, PsyD, LMFT

Licensed Marriage and Family Therapist #110095