People wonder what therapy is like. The Hollywood image of therapy is a troubled person sitting and talking with a quirky therapist in a cluttered office until “the epiphany.” The client has such a realization he or she breaks down crying, gets a hug from the therapist, and walks out “cured;” ready to engage in life again. Cue “the end,“ credits and heartwarming music.

Therapy can look very different depending on the therapist and client’s needs. Some need counseling to increase skills for managing a problem. Others need longer-term work to examine how thoughts and feelings impact daily functioning. And others choose to examine the past and its impact on the present.

It took me years in my own therapy of impatiently waiting for THE epiphany to finally dawn on me that deep changes were not caused by cataclysmic tsunamis of emotion and insight. But the constant drip, drip, drip of weekly sessions examining the small disappointments is where I began to notice small shifts in my perspective. I had been waiting for my big breakthrough when all would be clear, as seen in so many great movies. But that is a myth.

There are breakthroughs of insight in therapy. But it is not the breakthroughs that change our lives. The changes happen over time through incremental shifts in our reactions and behavior. The slight shifts in our perspectives lead to greater changes than the big “aha.”

The work done outside the therapist’s office is more important than the work done inside the office. Only part of the change can occur in the 45 – 50 minutes a week in the safe and secure therapist’s office. The bulk of change occurs in real life as one applies new strategies, communication skills, and makes changes to old patterns that were discussed in the therapist’s office. Change happens when putting those new skills and approaches in practice at work, home or with friends.

The work with the therapist is important. It is an opportunity to work with an empathetic person, build trust in a relationship and heal old emotional wounds. The ultimate goal is to transfer this new found trust and healing to relationships in your real world. This can be slow work.

Many people see a therapist for short-term work to navigate some type of crisis. Others see a therapist for strictly goal-oriented work such as learning skills to manage anger, improve communication in relationships, discipline children… Learn and practice some skills in therapy and be on your way. (Insurance companies love these!)

The therapy that can combine skill building and rapport development between client and therapist leads to deep, lasting work on how the client relates to others in a more positive manner is very powerful. But it is not fast and rarely builds to the crescendo of sudden monumental insight. Your experience in therapy may not be as dramatic as seen in the movies but if you use the experience to work through issues – even conflict with your therapist – there will be change and growth that noticeably improves your life.