Over the years, attitudes about counseling as well as counseling itself have changed. While the stigma connected to counseling may have declined, many misconceptions about it still endure.
In addition, new research has significantly changed how we understand and treat emotional problems.
Today, I want to update your understanding and answer some common questions that many folks have about psychotherapy.
Common Threads in Counseling
While there are different counseling approaches, it’s helpful to understand the basic elements found in most talk therapies. Understanding psychotherapy and how it works
— Trust in the therapeutic relationship. The key to any successful therapy is the solid trust one has with their therapist. Over time, non-judgmental responses from a counselor create a sense of safety and trust. This safe space allows one to explore and discuss important but painful issues that may have been previously avoided.
Unlike most other interpersonal interactions in life, counselors are neutral. They seek to understand rather than judge or express a personal opinion. This experience creates a supportive bond that promotes emotional healing and growth.
— Expanding Self-Awareness Becoming mindful of the systemic influences of one’s environment and past experiences creates a wider perspective on one’s current problems. This enhanced perspective leads to greater understanding of one’s difficulties and opens up options for change.
— Advances in Counseling
Greater understanding results in correcting trauma-based distortions about how one sees oneself and others. Many psychological problems are the result of past trauma, which has created perceptual distortions in the way one views oneself and others.
Most commonly, the distortions result in a person’s not fully approaching their value and thus having low self-esteem.
PolyVagal Theory: A significant advance in our understanding of the polyvagal system has revolutionized our understanding of human psychology.
“Polyvagal theory in therapy, developed by Dr. Stephen Porges, is a neurobiological framework that explores how the autonomic nervous system (ANS) influences emotional states, social behavior, and responses to stress.” (from Google AI)
The major takeaway from this theory is an appreciation of how fragile our connection to reason is.
This awareness has added a new dimension to psychotherapy. Further, understanding how we become disconnected from the reasonable part of our brain changes our understanding of many psychological disorders and how to treat them.
— The Expanded Understanding of the Residual Effects of Trauma Research reveals that many more events are traumatic than previously recognized. Specifically, trauma disconnects a person from the human/rational part of their brain, the neo-cortex, leaving one at the mercy of their animal/ limbic brain. The limbic system is not rational. Its only concern is with survival and thus it has no concern for social interaction or getting along with others.
— Trauma’s impact on the amygdalae
Sadly, trauma corrupts the threat-alert system in our brain, the amygdala, and causes it to give off false alarms. When the amygdalae perceive threats, whether real or false, access to the reasonable cortex is greatly slowed or blocked. As a result, a person reacts without evaluating or reality-testing the threat with a fight-or-flight action.
— Somatic Awareness
Understanding of the impact of trauma on disrupting our connection to our neo-cortex expanded therapy to go beyond just understanding. It explains the necessity of addressing the somatic (physical) dimension of psychological disorders to provide successful relief and change.
Specifically, increased appreciation of physical symptoms of distress connects seemingly unrelated elements that can trigger irrational reactions caused by childhood trauma.
In addition to understanding, calming symptoms of physical panic is necessary to make significant and lasting change.
Conditions for which counseling is helpful
Mental health counseling can’t help all psychological disorders but here are some issues where it can:
— Grieving and Adjusting to recent loss, changes, or hardships. One of the most common types of emotional problems arises when a person experiences change. Since humans are creatures of habit who need reliable routines, any change causes anxiety.
Losses, like the death of a loved one or a job, are examples of common issues for which counseling can help. Talking with a therapist can calm anxious and depressed feelings and help individuals, couples, and families to solve problems and make needed adjustments.
— Healing from prior trauma. Corruptions in perception caused by trauma can last for many years after the experience. Another common source of emotional disturbance is previous trauma. Just as the notion of trauma has expanded, so too has the understanding of PTSD.
It is essential to understand that even though a person’s symptoms may not meet the criteria for a formal PTSD diagnosis, counseling can be very effective in relieving distressing emotional elements.
— Marital, family, or other relational conflicts. Interpersonal disagreements and arguments are a major source of individual distress. Whether with couples, families, or workmates, counseling can help folks learn practical communication skills and ways to deal with anger and conflicts constructively.
Learning how to communicate with I-statements and conflict resolution skills are just some of the powerful skills that folks learn in conjoint counseling that are useful in a variety of interpersonal situations.
— Ongoing environmental stress. Not all counseling involves a psychosocial disorder. Sometimes, life’s stress alone can overload a person’s ability to cope. Trouble at work, problems with finances, or health may not have immediate solutions.
Learning about things such as stress management and coping skills can help folks to endure and get through difficult times.
Spiritual and Existential Mysteries Apart from psychological disorders or painful circumstances, life itself poses spiritual or existential challenges. Pastoral counseling helps individuals, couples, and families come to terms with life mysteries.
Rather than offering advice or solutions, counseling helps clients to address rather than avoid important existential issues regarding one’s sense of purpose and an ultimate understanding of the meaning of life. Bursting some common myths about Pastoral Counselling | Pastoral Counseling Syracuse NY
Indicators to see a counselor
People often ask when they should see a counselor or how bad it has to be to get professional help. In the past, family doctors were the primary source of referrals to counseling. Today, however, individuals can decide for themselves if they want to see a counselor/
While there is no one-size-fits-all way to tell, here are some questions to think about to help you decide: How much is your problem interfering with your life?
Ultimately, only you can say when you need counseling. Asking yourself:
Is your problem getting in the way of your job?
Does your concern interfere with your relationships ?
Do people tell you that you have a problem
Is the emotional pain detracting from your personal happiness?
If the answer is yes to any of these, counseling can probably help. That said, if you are unsure, there is no harm in trying it out and seeing how it feels doing it.
Rev. Michael Heath, LMHC, Fellow A.A.P.C. 6/04/2025
