What do you do in Counseling? ll By Lauren Black

About a year ago on a hike with my sister, she asked me, “What do you do in counseling?” As someone who has benefited immensely from twenty years of off and on personal therapy, I have always wanted to be able to explain how it works to my friends and family. Here was an opportunity! But I couldn’t find the words and I clumsily shut the conversation down. If, however, there is anything to be learned from this experience — and I believe there is — it’s that I have been able to reflect on what I would say about therapy to others who remain skeptical about how it could help. 

What I wish I had said is this. 

Ideally, what happens in counseling is that for perhaps the first time in your life, you are treated with unconditional acceptance, and if you can trust this feeling of being accepted, even just a little bit, you might start to realize that who you are is really okay. That you are a human among humans, not worth more or less than anyone else, and that you don’t need to do or buy anything more to finally be “good enough.” A therapist provides the conditions that nurture the seed of “good enough” that no one and nothing can take away. Slowly that seed grows into a distinct sense of “liking” yourself, a feeling of pleasure at being you and a wish to continue to get to know yourself better. This feeling of enjoying being you is what fills life with joy and meaning and playfulness and allows you to embrace even the painful and disappointing parts of life. 

So why should anyone go to a perfect stranger and tell them their most well-kept secrets? Why would anyone share their shame, their despair, their loneliness, their deepest fears with someone who gets paid from this arrangement? 

Unconditional positive regard, that’s why. 

Unconditional positive regard is a concept introduced by Carl Rogers, the psychologist who developed Person-Centered Therapy. It is the full acceptance for people as we are, and with full respect for our autonomy and basic goodness. While not all behaviors humans choose are acceptable, we possess inherent worth no matter what we do or say. Rogers believed that feeling accepted and understood is a key component of change and that therapists oriented in this direction create the conditions that allow their clients to move in a positive direction chosen by the clients themselves rather than imposed by the therapist. Research has shown this to be true and Rogers’ core conditions are taught to therapists in training as necessary conditions for a therapeutic relationship.

I experienced unconditional positive regard in almost every therapeutic relationship I’ve had over the past twenty years. For many years of my life, I have suffered with near constant anxiety and shame whenever in the company of others. Because I had no idea how to “be”, I often blushed, sweated, and stammered, or else I stayed silent to avoid the embarrassment of showing my insecurities. Finally in my 20s, I sought professional help and I’d like to tell you my anxiety resolved quickly. It didn’t; I had a long way to go, and I still do. But what started as a relationship with a therapist who accepted me and even liked me, for no good reason that I could see, eventually grew to include more people. I started to reveal myself and tell the truth to important people and I began to show up without a “mask” when I met new people, facing my fears of judgment and rejection. Over time, I was able to recognize when and with whom I didn’t feel accepted and I learned to choose my friends and relationships carefully. I developed a thicker skin (stronger boundaries) to protect myself when I couldn’t avoid judgment or embarrassment. Ultimately, I began to take better care of myself and began to treat myself with more respect and compassion. This, of course, is ongoing work, the work of a lifetime. 

Can’t friends give friends unconditional positive regard? 

Of course. If you have friends and family who can genuinely set aside their own judgments and evaluations in order to accept your full autonomy and responsibility for your own choices, that’s wonderful! But therapists are not friends or family, and friends and family–even if they are therapists– are not your therapist. Your friends and family love and care for you, but healthy personal relationships persist because they are mutually beneficial. For several years in college, I dated a guy who was abusive. My roommate, a really close friend at the time, finally ran out of patience for comforting me through repeated breakups with this person, only to find I continued to get back together with him. Ultimately I lost the friendship because I asked something of her she couldn’t give. It hurt and exhausted her to watch me cycle through the same pattern over and over again, and in order to protect herself, she had to distance herself from me. I didn’t know about counseling back then, but a therapist would’ve been able to stay in relationship with me while I sorted out what kept me in this abusive relationship. Friends and family, well meaning as they are, may simply not have the experience handling the suffering of others, and using them for this purpose may burn out the relationship over time. Therapists have years of professional training and experience that allow them to sit with the pain clients share, so you can trust what you bring to your therapist will remain confidential* and that your therapist will be able to stay with you in your struggle rather than turn away or try to fix it. Therapists are trained to walk with you in your experience, nonjudgmentally and skillfully, so that you can come to accept and understand yourself and move forward in your life. 

Counseling offers so many benefits — new tools, new insights and perspectives, accountability — but when I try to boil it down to the most powerful factor for me personally, it is unconditional positive regard: the therapeutic assumption that each of us is fundamentally good, that we mean well and will naturally move in a positive direction given that we feel accepted, understood, and free to explore our experience with another human being. 

*There are some exceptions to confidentiality in the case of imminent risk of harm to self or others, abuse or neglect of a child or elder, and when there is a court order to release information. 

People are just as wonderful as sunsets if you let them be. When I look at a sunset, I don’t find myself saying, “Soften the orange a bit on the right hand corner.” I don’t try to control a sunset. I watch with awe as it unfolds. 

Carl R. Rogers, A Way of Being

Lauren Black Affordable Counseling Program Intern

I’ll never forget my high school math teacher who said, “choices have consequences; make good choices.” Easier said than done! If you’re finding yourself making choices that are moving you further from your goals, you are not alone. Therapy can help you uncover the thoughts, feelings, and behaviors that might be holding you back and discover your motivations for change. My own experiences in therapy led me to change careers; I earned my Master’s Degree in Counseling and have worked with people rebuilding their lives after consequences related to substance abuse and criminal charges. All issues and identities welcomed.

LaurenBlack@peoplehouse.org; 307-509-0642

Leave a Comment