What to Expect from Therapy: Common Misconceptions and How Real Change Happens
One of the most common questions I hear as a psychologist is, "Can you help make these feelings go away?"
Many people come to therapy carrying painful memories, overwhelming emotions, self-doubt, anxiety, sadness, or anger. Often, they have spent months or even years trying to push these experiences away, hoping there might be a technique, strategy, or breakthrough that will make them disappear forever.
While that expectation is understandable, it is also one of the biggest misconceptions about therapy.
The reality is that there is no special wand that can erase a memory or guarantee that an emotion will never return. Human emotions are part of being alive. Difficult experiences leave their mark on us, and painful thoughts and feelings can resurface from time to time.
Therapy is not about eliminating emotions. Instead, it is about changing the relationship you have with them.
Learning to Sit with Difficult Emotions: Acceptance and Commitment Therapy (ACT)
A key principle in Acceptance and Commitment Therapy (ACT), developed by Steven Hayes and colleagues, is learning how to make room for difficult emotions rather than fighting against them (Hayes et al., 2012).
Imagine holding a spiky ball in the palm of your hand.
The spiky ball represents a painful memory, an anxious thought, or a difficult emotion. If you simply allow it to rest in your hand, it may be uncomfortable, but it doesn't necessarily cause harm.
However, when we become overwhelmed and squeeze the ball tightly, the spikes dig into our skin. The harder we grip it, the more pain we experience.
This is often what happens when we struggle against our emotions. We replay memories repeatedly, argue with our thoughts, desperately try to suppress feelings, or become consumed by them. In doing so, the emotion often grows larger and more powerful. It begins to dominate our attention and can start to feel like our entire reality.
ACT teaches clients to develop psychological flexibility—the ability to experience thoughts and feelings without allowing them to dictate behaviour (Hayes et al., 2012).
The goal is not to get rid of the spiky ball. The goal is to stop squeezing it.
Over time, many people discover that the emotion loses much of its power when they stop fighting it.
Understanding the Stories We Tell Ourselves: Cognitive Behavioural Therapy (CBT)
Another common reason people seek therapy is because they find themselves trapped in negative patterns of thinking.
They may believe:
"Everyone thinks I'm terrible at my job."
"I'm not a good parent."
"I'm letting my partner down."
"Nothing ever goes right for me."
"Life always gives me the short straw."
These thoughts often feel completely true in the moment. However, our minds are not always objective reporters of reality.
As humans, we all fall into what psychologists call cognitive distortions, habitual ways of thinking that can skew how we interpret situations.
CBT, developed by Aaron Beck, helps us understand and work with these patterns (Beck, 1976).
Some examples include:
Mind Reading: Assuming we know what others are thinking about us.
Catastrophising: Expecting the worst possible outcome.
All-or-Nothing Thinking: Seeing situations as complete successes or complete failures.
Overgeneralisation: Taking one negative experience and applying it to every situation.
In CBT, we work together to identify these thinking patterns and examine whether they are truly accurate.
Therapy does not force people to think positively. Instead, it helps them think more realistically, flexibly, and compassionately.
Looking Beneath the Surface with Schema Therapy
Sometimes our struggles are not simply about a single thought or emotion. They can stem from deeply ingrained patterns that have developed over many years.
Schema Therapy was developed by Jeffrey Young as an extension of CBT to address longstanding emotional and interpersonal difficulties (Young et al., 2003).
Schemas are deeply held beliefs about ourselves, other people, and the world, often formed early in life.
For example, someone with an "I'm not good enough" schema may constantly seek reassurance or feel a strong inner critic, even in the presence of success.
Schema Therapy helps clients identify these long-standing patterns, understand their origins, and develop healthier ways of responding to emotional needs (Young et al., 2003).
The goal is not to blame the past. Rather, it is to understand how past experiences may still be influencing the present and to create new, healthier ways of moving forward.
Building Skills for Emotional Regulation: Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan, was designed to help individuals who experience emotions intensely and struggle with emotional regulation (Linehan, 1993).
DBT teaches practical skills in four key areas:
Mindfulness
Learning to stay present rather than becoming lost in worries or memories.
Distress Tolerance
Developing healthier ways to cope with difficult situations without making them worse.
Emotional Regulation
Understanding emotions and learning strategies to manage emotional intensity.
Interpersonal Effectiveness
Building stronger communication skills and healthier relationships.
DBT helps clients develop confidence in their ability to experience emotions without being overwhelmed by them.
Therapy Is About Growth, Not Perfection
Many people begin therapy hoping to remove pain from their lives entirely.
What they often discover instead is something far more valuable.
They learn how to understand themselves.
They learn why they react the way they do.
They learn how their thoughts influence their emotions.
They learn how old experiences continue to shape present-day challenges.
Most importantly, they learn that difficult emotions are not something to fear.
Therapy is not about becoming a person who never feels anxious, sad, angry, or hurt. It is about becoming someone who can experience those emotions without being controlled by them.
When that happens, people often find that they have more freedom, more resilience, and a deeper connection to the life they want to live.
Written by Victoria MulcahyProvisional Psychologist
References
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). New York: Guilford Press.
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema Therapy: A Practitioner's Guide. New York: Guilford Press
