The Part of Therapy No One Explains—and Why You Keep Baking a Cake When You Need a Sandwich

Therapy has two parts - but our culture usually only talks about one of them.

The Consumer Part

The first is the consumer part. A person has a problem, seeks help, and wants relief. This part fits easily into medical and business models - diagnose, treat, improve. It’s familiar, structured, and culturally comfortable. This is the one we hear about.

The Relational Part

The second part is relational. And this is where therapy becomes harder to define—and harder to market. This is the one we don’t hear about.

Why Therapy Is Hard to Simplify

One reason therapy resists simple explanations is the sheer range of what shows up in the room. Therapy isn’t working with just one kind of problem. Even when someone feels a single symptom - like anxiety - that doesn’t mean the cause is singular or simple.

Good therapy is personalized. It works with personality patterns, attachment histories, developmental interruptions, single overwhelming events, repeated traumatizing experiences, and acute crises. Often, it’s working with several of these at once.

And they don’t exist in isolation.

Layered Problems, Not Either/Or

For example, developmental trauma can create a nervous system that is more vulnerable to being rocked by later events. This means a person can be impacted - or even traumatized - by experiences that might be merely stressful for someone else. Those later events often deepen the original coping patterns, creating a vicious cycle.

The work isn’t either/or. It’s layered.

Second-Hand vs First-Hand Knowledge

Most people are comfortable talking to their therapist about what happened between them and someone else outside the therapy room. That matters and is valuable - but it’s also second-hand knowledge. It’s memory filtered through time, interpretation, and self-protection.

Something different happens when people talk about what’s happening between them and the therapist. That’s first-hand knowledge. The reactions are live. The body responds. Old patterns don’t need to be reconstructed - they show up on their own.

This is why it can be valuable to name how the therapist is being experienced in the moment. Whether they seem bored, interested, distant, irritated, calming, perfect, or completely incompetent, those impressions often tell us less about accuracy and more about which old patterns are coming online. When they’re spoken out loud, they become something we can actually work with.

This isn’t being rude or oversharing. It’s allowing material that might feel culturally awkward to surface - material that, psychologically, is often where unconscious emotions and memories are trying to be seen and heard.

Why Old Patterns Feel So Real

Our brains are designed to keep us alive while using as little energy as possible. When we survive emotionally overwhelming moments - especially ones where fear, shame, anger, or grief couldn’t be fully expressed - the brain records what worked.

Not as a list of details from the event, but as a total recipe.

That recipe includes coping strategies, body responses, and beliefs about the self and others. Because it helped us survive, it gets coded as accurate and efficient. Later, when enough familiar ingredients show up in the present - tone of voice, closeness, authority, disappointment—the brain automatically pulls that recipe back online.

The problem is that memory doesn’t feel like memory.
It feels like now.

So we don’t realize we’re trying to bake a cake in a moment that actually calls for a sandwich. Both situations may include similar ingredients - salt and flour - but they require entirely different outcomes. The cake recipe once made sense. It kept us alive. But it was never meant to become permanent.

It was a survival solution that got stuck, leaving us less flexible when familiar ingredients appear again in the future.

Where Clinical Judgment Comes In

This is where therapy becomes more than technique.

Some incomplete self-protective responses are best worked through intrapersonally—with the therapist coaching from the outside as sensations, emotions, and impulses are noticed and allowed to complete.

Other patterns work best interpersonally—with a therapist who is both coaching and participating, a kind of player-coach.

The Therapist Is Part of the System

The therapist is not outside this process.

Imagine gently dipping your hand into the water along a riverbank. You’re not just observing the river—you’re interacting with it. The water is impacted by your hand and may react to that impact; it may get warmer or colder, or move faster or slower around your hand. That reaction holds information.

In therapy, the therapist’s internal responses matter in the same way. Feeling a sudden chill or warmth can signal a coded moment emerging. At the same time, a skilled therapist knows their own hands. They work to recognize what belongs to them and what belongs to the shared moment. This part, by human nature, is a little inefficient and messy.

However, this unavoidable interplay isn’t a flaw in therapy. It’s part of how therapy works.

Why Analog Holds Both Parts

There is no simple model that captures all of this. Medical, expert, and influencer models are easy to communicate - but they ignore the relational part. When that part is missing, disappointing outcomes collapse into blame: the clinician failed, or the client failed.

At Analog, we refuse to separate the two parts of therapy, even though holding them together is difficult and messy. We aim to be both player and coach - guiding the work while knowing we are part of it.

This is why integrating psychoanalytic therapy with Somatic Experiencing matters so much to us. One helps us understand patterns and meaning. The other helps the nervous system complete what was once interrupted—so old survival code can loosen and something more flexible can take its place.

It’s harder to explain.

And it’s why it works.

Beyond the Transaction: Reimagining Therapy in Modern America

In our fast-paced American society, where everything seems to have a price tag and a measurable outcome, therapy often finds itself awkwardly squeezed into existing frameworks that don't quite fit. As we explore this disconnect at Analog, we've noticed how our cultural imagination around therapy has become increasingly shaped by consumer expectations and medical metrics.

The Problem with Current Models

The medical model of therapy, while valuable in some contexts, often reduces the human experience to a series of symptoms and diagnoses. This approach, as noted by Jonathan Shedler (2010) in his influential paper on psychodynamic therapy, can miss the deeper, more nuanced aspects of human suffering and healing. When therapy is viewed primarily through a medical lens, it risks becoming what Mary Pipher (2003) calls "McDonald's therapy" – standardized, quick, and stripped of its essential relational elements.

Similarly, when therapy is forced into a corporate framework, it risks prioritizing profitability over therapeutic value. As James Hillman argued in his seminal work "We've Had a Hundred Years of Psychotherapy and the World's Getting Worse" (1992), the commercialization of therapy can lead to what he terms "therapeutic consumerism," where the focus shifts from transformation to transaction.

The Analog Approach

At Analog, we've crafted a different model that honors both the ancient wisdom of therapeutic traditions and contemporary neuroscientific insights. Our approach integrates:

- Somatic Experiencing, drawing on Peter Levine's (2010) groundbreaking work on trauma and bodily wisdom

- Psychoanalytic depth, influenced by contemporary relational theorists like Stephen Mitchell

- Psychotherapy that emphasizes the healing power of relationship, as validated by decades of attachment research

- Enneagram coaching that offers a map for personal growth and self-understanding

Why We're Different

Yes, we are a private-pay practice. Yes, our services require a significant investment. But unlike a quick-fix solution or a standardized treatment protocol, we offer something more profound: an opportunity for genuine transformation. Our approach aligns with what research consistently shows about effective therapy – that the therapeutic relationship itself is a crucial factor in healing (Wampold & Imel, 2015).

The Value Proposition

When you work with us, you're not just paying for a service – you're investing in a process that can fundamentally change how you experience yourself and your life. As van der Kolk (2014) emphasizes in "The Body Keeps the Score," genuine healing requires a holistic approach that honors both mind and body, past and present, individual and relationship.

References:

Hillman, J., & Ventura, M. (1992). We've had a hundred years of psychotherapy and the world's getting worse. HarperOne.

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.

Pipher, M. (2003). Letters to a young therapist. Basic Books.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.

van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.

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Our invitation is simple: Step into a therapeutic space that honors the complexity of human experience, where healing isn't measured in worksheets completed or symptoms checked off, but in the profound shifts that occur when we're truly seen and understood.

Ready to begin? Contact us to learn more about our approach and how we might work together.

How the brain and therapy work together

The Brain's Job: Keeping You Alive Through Predictions

Our brains are essentially prediction machines with one primary job: keeping us alive. To do this, they rely on past experiences to predict future events. This is all based on what we've encoded in our memory.

When we encounter danger in the past but only manage to cope with it instead of solving it, those coping mechanisms get stored in our memory. Then, when we face something similar in the future, our brain automatically uses those past coping strategies. It's like if you taste a delicious cake and later encounter ingredients like eggs, flour, and butter. Your brain might label the new dish as cake, even if it isn’t.

This automatic process helps the brain save energy. It's unconscious and hard to recognize, let alone slow down to evaluate whether the past is truly repeating itself.

The Hose and the Snake

Imagine seeing a hose coiled up on the floor and for a moment thinking it's a snake. Your brain uses the shape of the hose to make a quick judgment to protect you. After a second, you realize it’s just a hose, and you can go about your gardening.

In relationships, these automatic assumptions are harder to recognize. We often mistake our gut feelings for objective truth. For example, if you grew up with parents who couldn’t handle big emotions like sadness, anger, or fear, you might have learned to suppress these feelings to cope. This coping strategy gets encoded in your brain.

Coping vs. Solving

As an adult, when you feel sad, scared, or angry in a romantic relationship, you might automatically suppress these emotions. You might feel anxious, irritable, or distracted but not recognize the underlying sadness, fear, or anger. This can lead you to stay in unhealthy relationships because your emotions, which are meant to guide you, are being ignored.

The Role of Therapy

Describing this unconscious process is challenging because it's designed to be unnoticed. This is where therapy comes in. Good psychotherapy helps you recognize the core issues behind your behaviors, like difficulty focusing, irritability, numbness, or getting overly upset. Therapy guides you in creating new, healthier responses that truly solve your problems rather than just coping with them.

By working through these issues in therapy, you can update your brain's prediction models with new data that reflects actual solutions, allowing you to live a more fulfilling life.

How Our Brain Learns and Adapts: The Magic of Memory Reconsolidation

When we’re born, our brains aren’t fully developed; they’re like houses with just the framing up. So, in the beginning, we heavily rely on our lower brain areas and start interacting with the world through our core emotions. These primal interactions happen through instinctive reactions to our sensory experiences. The feedback from these experiences gets stored and helps us learn. Over time, with repetition, these experiences turn into long-term, non-declarative memories, creating implicit prediction models (see our easy to read post on implicit prediction models).

Our brains learn through a method called prediction error. If a prediction is wrong, we update it; if it’s right, we stick with it. This process, which Freud called the Reality Principle, helps us use energy efficiently while adapting to survive. Memories and predictions guide our actions, from our posture to social strategies and facial expressions. These non-declarative memories are (like Tinactin) quick-acting and long-lasting, making them reliable for forming automated prediction models, even though updating them can be tough.

However, these memories can be updated through a process called memory reconsolidation. When we recall and viscerally feel these implicit memories, they become destabilized and open to new information before consolidating again. The provides a potential to change deeply held connections between emotions, events, and self-protective behaviors if new, powerful experiences contradict old expectations. Thus, memory is a constructive process, piecing together bits of the past to predict the future. We are still learning how and where this can apply clinically but any good effective psychotherapy will harness this mechanism in the brain.

Our subcortical systems, memories, and prediction models support the brain’s higher functions, like thinking and feeling. The cortex, allows us to learn and adapt. Unlike our primary instincts, learning involves creating predictions about what is adaptive at the moment (instincts are built in, we don’t have to learn them). What we learn as adaptive may therefore differ from instinctive reactions.

Memory Reconsolidation: A Deeper Dive

Karin Nader and Oliver Hardt’s groundbreaking work revolutionized our understanding of memory. Before their research, it was believed that memories formed linearly, transitioning from short-term in the hippocampus to long-term storage elsewhere. They showed that recalling long-term memories makes them unstable and requires reconsolidation to remain long-term. This means memories can change each time they're recalled, making memory a dynamic process.

Their research indicates that after a memory is reactivated, it stays open to new learning for about six hours before reconsolidating. This process doesn’t damage the brain and is specific to individual memories. Memory reconsolidation has since influenced psychotherapy, such as Bruce Ecker’s Coherence Therapy, by showing that old memories can be updated with new emotional experiences, facilitating growth and reducing anxiety.

This concept aligns with Frank Alexander’s idea of the corrective emotional experience, suggesting that updating old memories with new, positive experiences can help resolve long-standing emotional issues. Interestingly, Nader and Hardt were students of neuroscientist Joseph LeDoux, who initially doubted their hypothesis but changed his stance after they proved it correct.

Understanding how our brains learn, adapt, and change through memory reconsolidation not only gives us insight into our own behaviors but also opens up new possibilities for personal growth and therapeutic techniques. Whether we’re dealing with past traumas or looking to improve our adaptive strategies, the dynamic nature of memory offers hope for lasting change.

What Counseling Isn’t: Clearing Up Common Misunderstandings

It might seem odd to write about what counseling isn’t, but there's a lot of confusion about effective therapy. So, let’s clear up some misconceptions.

Counseling is Not Giving Advice

A friend once mentioned they were unsure if their loved one’s therapist was giving good advice. This is a common misunderstanding. People often think therapy is about being told what to do. But, imagine a therapist as an archeologist. They dig in areas where they believe they might find significant artifacts. When they find something, they carefully uncover and study it to understand the bigger picture.

Similarly, therapists help you explore your thoughts, feelings, sensations, and memories. They work with you to understand these elements and how they fit into the bigger picture of your life, often uncovering connections to past traumas. The goal isn’t to give advice, but to help you understand yourself better and develop strategies to create meaningful change in your life.

Counseling is Not Quick or Easy

Many people are surprised by how long therapy can take, as well as the time, effort, and cost involved. Changing your brain and breaking old habits is a delicate, slow process. While there are aids like medication or alternative methods that can support therapy, the core work is often gradual and requires patience.

Counseling is Not a Regular Conversation or Relationship

Therapy conversations are unique. They aim to access parts of you that don't typically come up in everyday interactions. This means the topics and the way you talk about them are different. You might be encouraged to express your true feelings, which can be challenging and make you feel vulnerable. Therapists aren’t interested in being politically correct or sticking to societal norms—they focus on what truly is. There’s no right or wrong, just what exists.

Moreover, the therapist-client relationship is different from a regular friendship. It’s a unique bond with emotional intimacy, where the therapist knows a lot about you, but you know less about them. This imbalance, however, creates a powerful connection essential for making progress. You might feel younger, more empowered, or different in other ways compared to your daily relationships. As trust builds, you’ll become more open to feelings you’ve previously hidden, allowing them to surface and be addressed, whether they stem from developmental stages or trauma.

Understanding these distinctions helps in appreciating what therapy is truly about: a journey of self-discovery, healing, and growth, rather than a quick fix or a series of friendly chats.

Rethinking Mental Health: Embracing the "Choose Your Own Adventure" Metaphor

In my last post, I touched on how viewing mental health through a strict medical lens can hold back progress. The medical model labels things as healthy or unhealthy, good or bad, and this binary thinking just doesn’t fit when it comes to mental health. (And yes, even the term "mental health" has its issues, but let’s tackle one thing at a time.) Today, I want to introduce a different metaphor: think of mental health as a "choose your own adventure" story.

Everything Tells a Story

Everything we do, feel, and think carries meaning. It might be a small detail or something significant, but it all contributes to the story we're living. It can be exhausting to stay on top of everything, and it’s tempting to dismiss some things as meaningless. But here’s the good news: we’re not trying to write a story or determine its meaning; we’re here to listen to the story being told.

The words we use, the tension in our muscles, the way we look or avoid looking, the emotions we feel or suppress, the intensity of those emotions, our behaviors, our thoughts, our levels of engagement—they all tell a story. Often, the real story isn’t just what's on the surface. In therapy, we’re trained to listen to everything, not just the spoken narrative. We call this "process vs. content." For example, you might say one thing, but your hand gestures might reveal something different.

Moving Beyond the Medical Model

Using the medical model can increase the risk of shame. Why? Because getting curious about something can trigger a fear that we’ll find something "faulty" or "unhealthy." But if we approach it like a psychotherapy model—where we listen for the story without judgment and assume everything that surfaces is normal given the context—there is no right or wrong. This frees us to remain curious and keep listening.

In Somatic Experiencing work, this might lead to noticing imagery, movements, or sensations. In psychotherapy, it might bring greater insight and clarity.

The Therapist as a Curious Companion

This isn’t a “gotcha” approach. The therapist isn’t an expert who sees what you can’t. They are a curious companion who might notice something and wonder about it with you. By listening to the story your body-mind is telling, without trying to force it into a specific framework, we can follow the adventure your system chooses. This is what ultimately leads to feeling better.

So, let’s ditch the rigid medical model and embrace the idea that mental health is like a choose your own adventure story. By listening to our stories and staying curious, we open up the path to genuine understanding and healing.

Two Common Misconceptions About Mental Health and How to Overcome Them

Hey there! Let's talk about two common misconceptions about mental health that can really get in the way of making real progress:

Misconception 1: Treating Symptoms Instead of the Root Cause

We often mistake the symptoms of mental health issues for the problem itself. So, we end up trying to manage these symptoms—like negative thoughts, anxiety, or depression—instead of digging deeper to understand what they actually represent. For example, these symptoms might be rooted in traumatic memories that have shaped how we respond to situations in the present. If we only focus on managing the symptoms, we're not addressing the underlying issues that cause them.

Misconception 2: Using Medical Metaphors for Mental Health

Another big misunderstanding comes from how we talk about mental health. You’ve probably heard people say, "I have anxiety" or "I have depression," like it’s something they’ve caught, similar to "I have a cold" or "I have a broken bone." This medical language implies that these mental states are static and abnormal, but that’s not really the case. Anxiety and depression are important and natural states that everyone experiences to some extent, and they fluctuate over time.

Even chronic states of suffering often indicate that the nervous system is responding exactly as it should, based on past trauma. The system is on high alert or shut down because it's unconsciously using old, trauma-based information to navigate current situations, which might not be helpful unless that same historical trauma is happening again.

The Bigger Picture

Of course, mental health is complex, and there are exceptions to these ideas. But generally speaking, shifting our focus from just managing symptoms to understanding and addressing their root causes, and rethinking how we conceptualize mental health, can make a big difference in our approach to healing and change.

Counseling Reimagined: Fostering Connection and Healing

In today's counseling world, a transformative shift is reshaping our approach to mental health. Moving away from traditional, problem-centric methods, we're now embracing a more nurturing path that highlights and strengthens what's inherently right within individuals. This new direction challenges the outdated view of individuals as 'problems to be solved,' reminiscent of a broken vehicle in need of repair, and instead focuses on fostering personal growth and connection.

Our lives are a complex mosaic of relationships and emotions, each playing a crucial role in our mental health. Contrary to the notion of 'brokenness,' mental health challenges are our natural responses to life's stresses and perceived threats. They're rooted in our experiences and the protective strategies our minds deploy to navigate the world.

Take the example of someone struggling with anger, which strains their relationships and career. This anger often stems from deeper feelings of vulnerability and a subconscious search for security, which paradoxically leads to more instability and frustration. Traditional counseling methods, which typically focus on highlighting and correcting 'wrong' behaviors, may inadvertently deepen these feelings of vulnerability, pushing individuals into a defensive state.

In contrast, today's counseling embraces a compassionate, understanding approach that walks alongside individuals, acknowledging their feelings and experiences as rational responses to their life circumstances. This relational method emphasizes connection, shared vulnerabilities, and collaborative emotion management, fostering a deep sense of empathy and understanding. Ironically, when more traditional interventions and contemporary trauma therapy are introduced within this context of this empathetic relationship, counseling becomes more effective, promoting genuine and lasting transformation.

Thus, modern counseling is about more than just addressing problems; it's about understanding and supporting individuals within the rich tapestry of their lives and relationships, offering a path to healing characterized by compassion and effective support.

Recap:
- Counseling is evolving from focusing on problems to nurturing what's right within individuals, promoting personal growth and connection over fixing perceived 'brokenness.'
- Mental health challenges are seen as natural responses to life's stresses, rooted in our complex web of past relationships and emotions, moving away from the idea of individuals being 'broken.'
- Modern counseling prioritizes empathy, understanding, and collaboration, enhancing the effectiveness of both traditional and contemporary therapies when integrated by fostering a supportive, relational environment.

If we want Mental health we need a bigger imagination Than Medicine Gives Us