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What Happens in Therapy?

The ten ways in which therapy changes us.

Key points

  • Therapy can seem mysterious and daunting, but it involves a process of change and learning.
  • Through therapy, a person can become more fluid and open to experience.
  • People become more willing to be open about who they are.

Psychotherapy can seem mysterious and unknown, daunting to people who think about it for the first time. What actually happens? How can sitting and talking about yourself make a difference?

It was the psychologist Carl Rogers, whose pioneering research involved listening to recordings of therapy sessions, who first helped us understand what happens during psychotherapy. He observed a general tendency for clients to change in 10 directions.

First, people move in a direction that is away from façades. No longer willing to put on a metaphorical mask, people become more willing to be open about who they are, what they think, and how they are feeling.

Second, no longer driven by oughts, people begin to live life as they see it rather than how they have been instructed by others on how they ought to be.

Third, no longer willing to do what others expect of them, people move away from living a life driven by the expectations of others.

Fourth, No longer willing to spend the day pleasing others, people begin doing what pleases them.

Fifth, people move towards self-direction. They begin to choose their own paths in life and their own goals.

Sixth, people become aware that they are not fixed in who they are, but that life is an ever-changing adventure, where things change in new and exciting ways, and where one is always learning.

Seventh, people’s eyes are opened to the complexities of the world and of themselves as part of it. No longer content with the old certainties, people begin to embrace the richness of life.

Eighth, people move towards openness to experience, seeking to learn and to change and enjoy the challenges ahead.

Ninth, people become more accepting of others. As they become more open to themselves, they become more open to others.

Finally, people become more trusting of themselves, daring to feel their own feelings and to trust their own sense of themselves and their uniqueness in the world.

In this way, Rogers’ view of good therapy was a process of learning and personality change that involved becoming less rigid in our perceptions and opening up to new experiences, and being more authentic and true to ourselves. This happens when we feel accepted for who we are and understood.

Psychotherapy takes courage, and a real desire to change. Our thoughts and feelings about ourselves, our beliefs and opinions about the world and our place in it, all of these make up who we are, and we must be ready to abandon all of them in favor of more realistic perceptions. The process Rogers described involves the change in who you are. However, the way people often talk about therapy makes it sound like we can change our lives without changing ourselves. Sometimes it seems like we think of ourselves as a little person at the steering wheel of a car. When we think about personal change, we think it is like getting a new car. We can trade in the old one with all its dents and scratches and drive out of the forecourt anew. But we imagine that we are still inside driving it just as we were. For Rogers, there is no little person inside, we can’t remain exactly the person we are right now and also change.

Excerpted from Think Like a Therapist. Six Life-changing Insights for Leading a Good Life. By Stephen Joseph.


Rogers, C. R. (1961). On Becoming a Person. Boston, MA: Houghton Mifflin.

Joseph, S. (2022). Think Like a Therapist. Six Life-Changing Insights for Leading a Good Life. London. Piatkus/Little,Brown.

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