By Liz Wallenstein, LMHC

Though many people know therapy exists, most don’t actually know how it works. Here’s a peek into the mechanics of a typical therapy session:

Therapy is a collaborative process where the therapist requires the active involvement of the client in order to help them. Giving advice or offering a solution does not help the client in the long term, and sets them up to be dependent on the therapist to live their life. Instead, the therapist trusts the client has the ability to help him or herself, and helps guide the client to that point.

Many therapists stay quiet at the start of the session, leaving the client to start the conversation. This is because it’s important that the client discuss what they need to discuss, so the therapist wants to be careful not to influence the conversation in a certain direction. For example, if a therapist starts off cheerful but the client came in feeling angry, it may divert the client from expressing or exploring their anger. If a therapist asks, “What happened this week?” but the client wanted to talk about a decision coming up, the client may not use their time for what they wanted. By saying nothing, the therapist leaves it open for the client to use the session as they need to.

The same goes for silences in the conversation. Moments of silence in therapy should not be feared or avoided, as they are constructive. If a client gets to a point where they are not sure what to say next, the therapist may not jump in to guide them, but rather sit patiently with them in the silence until they are ready to speak next. It helps the client to look deeper and get more authentic with their feelings and desires, in order to continue the conversation.

What a client brings into a therapy session becomes a jumping off point. The therapist may spend some time addressing it directly but will usually use it as a springboard to a deeper exploration of what it is the client is reacting to or experiencing. The therapist does this by asking the client questions and inviting them to respond to the therapist’s observations and insights. This is why many clients will find the conversation may not go as they expected it would before coming into session, but leave the session with a sense that it was more helpful then if it had.

Therapists also help clients identify their automatic thoughts, beliefs, and attitudes and examine which ones are serving them, and which ones are hurting them and would benefit from change. Therapists may also teach clients techniques for managing their thoughts and feelings so that they cause less of a disruption to their life, as they work to resolve their problem.

If you’re in the NY area and want to schedule a consultation session with me, Liz Wallenstein, to see if therapy could be helpful to you, please call me at 917-727-3549 or visit the Contact page of my website:

This article was written from the perspective of a psychodynamic therapist.

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 Liz Wallenstein, LMHC, is in private practice in Brooklyn, NY. To learn more about her approach to therapy, or to receive a free copy of her special report “How Therapy Can Change YOUR Life, for the Better!” visit