How Therapy Supports Change

People often come to therapy hoping to feel different. They want to feel less anxious, less overwhelmed, less depressed, less weighed down by self-doubt, or less stuck in patterns that seem to repeat themselves. But an important question sits beneath this: how does change actually happen?

Different approaches to therapy understand this process in different ways.

The way I understand therapy begins with the belief that our sense of ourselves, and of other people, is shaped throughout our lives in the context of our relationships and experiences.

Our earliest relationships with caregivers shape us in important ways. Through these early experiences, we learn whether our feelings are welcomed, whether our needs matter, whether it feels safe to depend on someone, and whether we can be ourselves without fear of rejection or criticism. These experiences become woven into how we see ourselves and how we expect relationships to be.

We are also shaped through other relationships and experiences in life, including peer relationships, experiences in school, education, or work, and romantic relationships. All of these can have a profound impact on how we come to understand ourselves, other people, and the world.

In addition to this, our sense of self is also shaped by wider social realities. Experiences of discrimination can become internalised over time and can shape how safe or unsafe it feels to take up space, be seen, or belong. These are often both historic and ongoing experiences.

And beyond this, there are wider political and environmental realities that shape how we experience life, such as structural inequality, the climate crisis and ecological breakdown. These are not distant influences, but part of the lived emotional reality many of us are carrying.

The ways we think, feel and relate are not signs that something is wrong with us, but ways of responding to and making sense of what we have lived through.

Some of these ways of being begin as creative adaptations to early relational experiences. Others develop in response to trauma, exclusion, or repeated experiences of not being seen or safe. And some are ongoing ways of responding to difficult realities in the present. Whatever their origin, they make sense in the context in which they developed or are occurring.

It is important to acknowledge that not everything we struggle with is only about the past. Some of our emotional responses are understandable reactions to what is happening in the present in the wider world. Experiences such as discrimination, injustice, uncertainty and climate anxiety can evoke very real and meaningful emotional responses. In this context, therapy is not about dismissing these experiences, or reducing them to internal patterns that need to be changed. It is about helping us stay in contact with them without becoming overwhelmed or turned against ourselves.

However, when we are working with patterns that come from earlier relational and developmental experiences, a different process is involved. In these cases, the ways we learned to cope in earlier relationships can continue long after the circumstances that gave rise to them have changed. What once helped us survive can begin to limit how we respond.

By approaching these patterns with curiosity and compassion, we can begin to understand what they have been protecting, what they have been helping us manage, and what they still need. Often, simply making sense of our experience in this way begins to loosen the grip of old beliefs and familiar ways of coping.

But understanding alone is not always enough. If our difficulties developed in relationship, then lasting change also happens through relationship.

The therapeutic relationship offers the opportunity to experience something different — to find yourself with someone who is interested in understanding your world rather than judging it, and who is willing to stay with your experience even when it feels confusing, painful, or difficult. Someone who welcomes the parts of you that may have learned to stay hidden.

Over time, these experiences can begin to change something much deeper than conscious thought. They can gradually reshape our expectations of ourselves and of other people. We may begin to discover that our feelings can be shared without being dismissed, that our needs can be recognised without being seen as too much, that we can disagree without losing connection, and that we can be fully ourselves without having to earn acceptance.

These changes rarely happen all at once. They emerge through many moments of being seen, understood and responded to in ways that may not have been possible before.

As this happens, old ways of coping often become less necessary. Not because they have been forced to change, but because the reasons they developed are no longer present in quite the same way. Over time, you may begin to notice more space in how you respond, less need to organise yourself around old expectations or fears, and a growing sense of flexibility in how you live and relate.

For me, this is the heart of therapeutic change. It involves creating the conditions in which long-standing relational patterns can begin to soften and reorganise through new relational experience, and in which you can develop a greater capacity to stay in contact with yourself, with others, and with the realities of your life as they are.