What actually makes people feel better from therapy?

It’s a question worth sitting with, because the answer isn’t as straightforward as most people expect. If you ask clients what brings them in, the answer is usually relief. Less anxiety. Less depression. Something that has been heavy, made lighter. And that’s a completely reasonable thing to want.

But what actually creates that relief is often harder to name. After three decades of doing this work, the closest I can get to a one-word answer is this: relationship. Part of what makes that relationship therapeutic is the sustained quality of attention that develops between therapist and client, and the effect it has over time. 

How exactly that happens remains something of a mystery, even within the field itself. What neuroscience suggests is that the therapeutic relationship helps cultivate new patterns of connection, both toward others and toward ourselves. 

While some noticeable symptom relief can occur relatively quickly, change at this deeper level tends to take time. 

Are you based in California or New York and wondering whether depth-oriented therapy might be right for you? This post is here to help you figure that out.

What feeling better looks like in depth-oriented therapy

Feeling better might look like finally recognizing a hidden pattern that has shaped your life for years. Or it can come from a session where nothing dramatic happens, and yet something shifts that you cannot fully explain.

To give one example, a client recently settled in at the start of our session and said, a little apologetically, “I don’t have anything prepared for today.” At the time, she was carrying a great deal: a family in crisis, a major loss, work piling up, and beneath it all, depression and grief that had been building.

While some forms of therapy focus on tracking symptom reduction from session to session, depth-oriented therapy tends to follow what arises spontaneously, trusting that relief and insight can come from staying with what comes up.

In this instance, I let the client know she had already done the most difficult part in showing up. From there, we could get curious about her worry that somehow she hadn’t done enough. Much of her life outside of therapy was spent caring for others, and extended beyond her family into roles she felt pressured to take on because of her gender and cultural identities. Allowing time for herself, even if unfamiliar, became an important part of the work.

That’s what this kind of therapy—depth psychology—often looks like. Not a prepared agenda, just two people paying attention to what’s actually there.

Whether that kind of work is helpful depends, in part, on whether it’s the right match.

Therapy works best when it’s the right match

In my practice, I work with a wide range of people across cultures, races, genders, and stages of life, including many LGBTQ+ clients navigating identity, coming out, intimacy, and the residue of growing up in a world that was often misinformed and not always kind. I also work with couples, queer and straight alike.

What tends to matter here is a person’s openness to this kind of work and their readiness to engage it.

Most people come to therapy with a clear presenting problem. But depth-oriented work starts from the assumption that within that problem, there may be more to understand—something that can make a real difference. The work often involves coming back into contact with a kind of core spirit that may be obscured, but not lost.

Recently I was sitting with a married couple who had been together for thirty-five years, facing the possibility of divorce. What they needed wasn’t a solution handed to them. They needed a way of working that could help them stay in dialogue, listen more carefully to each other, and begin to see their conflict not as the end of something, but as a signal that something between them still wanted to be heard. Beneath the conflict was a truth in the relationship that had been clouded by years of misunderstanding. In practice, their love for each other was still present. Even their conflict helped each of them see something important about themselves. Something new, and perhaps connected to what first brought them together.

What matters most is a readiness to see the presenting problem not only as something to resolve, but as a doorway into deeper self-awareness—and, at times, something genuinely life-changing.

What depth-oriented therapy actually looks like

A supervisor once told me that I should sit with my clients as if we were both watching a stream running through the woods. I’ve carried those words with me ever since.

In practice, depth-oriented work, sometimes referred to as depth psychology, psychodynamic therapy, or insight-oriented therapy, involves learning to notice the flow of your life as it emerges during therapy. Together, we pay attention to patterns in how you relate to yourself and to others. What serves you, what may be getting in the way, where a pattern was learned, and whether it can be updated to better align with who you are now.

Let me give you an example of what this can look like. One time during a first session with a client, they told me they had an “anger problem” and wanted me to help them get rid of it—to become a less angry person. On the one hand, they were struggling with their anger. On the other hand, I wondered whether the wish to get rid of it was part of the problem. That anger was there for a reason.

In our work together, it gradually became clear that the anger was also a form of protest against a world that had felt loveless and judgmental from early on. In that light, the anger may have been protecting them from shutting down or feeling powerless. As its value became clearer, the anger itself became more manageable. If we had simply treated it as the problem to solve, I am less confident the work would have been as helpful.

It’s less about analyzing and more about noticing. Less about fixing and more about arriving at a fuller understanding of what has actually been going on.

A little about me and how I got here

I’m a queer Jewish depth psychologist. I’ve been doing this work since around 1996, when I first started working as a marriage and family therapist. I later earned a doctorate in depth psychology and became licensed as a clinical psychologist in 2014. 

I’ve never stopped learning and have been training in a number of other modalities, such as EMDR for trauma work, LGBTQ+ affirmative therapy, mindfulness-based approaches, and more recently in an integrative form of couple therapy. (For more information, see my approach page).

Before I was a therapist, I worked in theater as a director, helping bring to life classical and contemporary stories that reflected the times and invited people to see things through a new prism. In a different way, that creative work continues here. In therapy, you are authoring your own life story–one that unfolds over time through what comes up between us, and from within.

What I learned from looking for my own therapist

Years ago, when I was looking for my own therapist, I spoke with someone well respected in the field. He described the importance of a good fit by saying it was like getting a suit made at Brooks Brothers. The analogy stuck with me—and it told me something: I was looking for a flannel shirt, not a tailored suit. So I kept looking.

I’m sure he would have been a good therapist. But at that moment, something didn’t click, and I trusted that.

If something feels off early on, it’s worth naming. Sometimes that moment becomes part of the work itself, and I do welcome real-time conversations about how the therapy is going. Sometimes it means the fit genuinely isn’t there, and that’s okay too. Either way, you deserve to be somewhere that feels right.

Is depth-oriented therapy right for you?

Depth psychological work can be an excellent fit for some, and a less good fit for others. If you’re unsure, here are a few guidelines to consider.

Depth-oriented therapy might be a good fit if:

• You’ve been in therapy before and felt like something was missing
• You’re interested not only in managing symptoms, but in understanding what lies underneath them
• You’re drawn to self-reflection, even when it may mean facing something uncomfortable
• You want a therapist who will stay curious with you, rather than guide you through a set of steps

Depth-oriented therapy isn’t the right fit for everyone, and it’s important to be honest about that.

This might not be the right match if:

• You’re primarily looking for faster relief, rather than exploring underlying causes
• You prefer to be in a therapy that follows a more fixed, clearly spelled out structure
• You prefer a therapist who will be more directive and consistently offer advice
• You’re not especially interested in exploring deeper patterns, dreams, or childhood/cultural histories

Depth-oriented therapy asks you to slow down and pay attention to what’s actually there, even when what’s there is uncomfortable. It’s less linear and often less predictable than more structured approaches. In practice, this can be one of the harder things to ask of yourself. And yet, at times, the simple permission to drop expectations—even of the outcome—can bring its own kind of relief.

If you’re in a place where you need faster results and a clear behavioral endpoint—like “getting rid of anger”—there are good therapists who work that way.

If you’re willing to stay with what’s uncertain for a while, and to engage your experience at a deeper level, we are probably a good fit.

Where the conversation begins: is depth-oriented therapy right for you?

Depth-oriented therapy can also be a place to grieve life’s disappointments, including, at times, the therapy itself. We don’t get a second chance at childhood, or to undo what has already happened. That tension often enters the room: the wish that something might somehow make it all different.

And yet, learning to bear those conditions can open space for something else—often bittersweet—can begin to take shape.

Even now, in my sixties, I find myself continuing to repair a relationship with my late grandfather, who was an old-world homophobe. I still mourn what he could not offer me. At the same time, I am slowly learning to integrate that part of my ancestry.

I am making space for—and remembering—a different world, one in which queerness, including within Jewish life, is not only tolerated but celebrated. The fact is, I am becoming my grandfather’s age now, and the choice about how I want to live my life rests with me. That, too, is bittersweet.

If you’re looking for someone who is willing to stay with what is difficult—not to rush past it, but to see what might come from it—there is a good chance I am the right fit for you.

I work with clients online throughout California and New York. I offer a free consultation where we can begin the conversation and see if this feels like the right fit.