What Actually Happens in Therapy?
It’s not like other conversations
People often imagine therapy as being held — emotionally, maybe even physically. A place to feel deeply understood and reassured. And sometimes, it is. But therapy isn’t always soothing in the ways people expect.
It can also be disorienting, frustrating, or quiet. There are moments of warmth, and moments that unsettle. This isn’t because therapists are cold — but because something real is being listened to. Not the social surface, but the undercurrent. It’s a space where what’s said, and how it’s said, begins to take shape differently.
We listen differently
Psychoanalytic psychotherapy is a conversation not like any other. The one fundamental instruction is simple: say whatever comes into your head, and try not to filter it.
It isn’t guided by polite reciprocity or small talk. The focus is on what you say — not what the therapist thinks you should say.
You bring what’s on your mind. Your therapist listens for patterns, for slips, for symbols, for silences. These aren’t interruptions to the work. They are the work.
Building towards an affect
A joke is funny not just because of its meaning, but because of something beyond its meaning. You can explain why a joke is funny — but that rarely makes anyone laugh. There’s always something that escapes words.
In psychoanalytic therapy, words and meaning can produce very real effects on the body. So we don’t dismiss meaning — we work through it, we dismantle it. But more importantly, we remain open to what can’t be fully articulated. The belly laugh. The knot in the stomach.
Like a good joke, therapy works to alter the effects of language on the body.
Meaning is important, but not everything
Therapy isn’t about interpreting everything to death. Some things land without a clean explanation. A phrase you didn’t expect to hear. A dream that nags. A pause that speaks. These can change the direction of the work more than any tidy insight ever could.
What happens? You speak. A therapist listens, interprets, directs. Something shifts.
Meet Our PsychotherapistsRecommended Reading:
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Jacques Lacan – The Direction of the Treatment and the Principles of Its Power.
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