Dr. Wall Says

Speak up, listen up, bridge the gap

Why does therapy work?

Ever wonder why therapy works? Do therapists possess some kind of deep wisdom and knowledge that unlocks your inner soul and dismantles your fears? Is it science, is there a tried and true formula for healing and empowering people? Or is it all bullshit, a placebo effect of sorts? Does therapy work because you believe it will?

In my years as a psychologist I’ve certainly come across a fair number of people who believe the latter. As far as they’re concerned, all this talk therapy is nonsense, a self-indulgence for people who are too confused or gullible to figure things out on their own. The truth is therapy is a simple process, and its success hinges on a single, very basic principle.

Assuming you’re not sitting across from a quack, your therapist has spent years growing her knowledge, skill set, and craft. From graduate school to internships, fellowships and years of practice, it takes time and dedication to hone your trade and become a truly good therapist. Let’s be honest though, there are people out there without all the schooling who are just as effective as a psychologist of 20-years; what’s their secret? I’ll get to that in a bit.

Becoming you

When I started out as a therapist (this is before earning my Ph.D. and before a board of psychology “approved” my credentials) I thought the key to change was helping people understand why they did what they did. By my third year of graduate school, I found out I was wrong.  As I learned more about what it takes to shift insight into action, my approach and theory evolved.  I figured that success in therapy required more than insight, that specific skills and behaviors (that I, of course, was an expert in) helped my patients put their insight to practice, and thus change. Though I was closer to understanding why therapy works, I wasn’t there yet. It took me a few more years to get it.

Want to know the secret? Therapy is one of the few places people feel completely free to be themselves. It’s a safe environment where you’re allowed to figure out what you need, what you believe, who you are, and that is why people feel better.  Therapy works because it’s where you learn to speak up – to say what you mean and mean what you say.

It takes time to build the kind of trust needed to be yourself in front of someone else. The skills I picked-up in graduate school definitely help, but ultimately it comes from proving  that you have the patience and desire to get to know and understand another human being.

When people feel heard incredible things can happen. More importantly, when you speak up, when you finally figure out what you believe in, what you stand for, and you find the words to put that out into the world, you make incredible things happen.

Putting it out there

Whether I realized it at a conscious level or not, I intrinsically understood the importance of speaking up very early on in my career. From the start, I was relentless in my efforts to help women assert themselves, say what they really felt and meant. I watch my patients struggle with depression, anxiety, shame, guilt, anger and more often than not what keeps them stuck is their inability to speak up, to ask for their needs or their feelings to be addressed. I listen as women fret over not being good enough, worry about losing relationships, stress over disappointing bosses and allow their friendships and love affairs to slowly fall apart, all because they don’t know how to speak up. Our first victory is always getting them to realize that they have something to say. There’s something incredible about putting your thoughts and words out into the world, starting with our safe space. It’s not enough being yourself once a week for 45-60 minutes, so the next challenge is always figuring out how to speak these same words in front of the people who need to hear them the most.

Ultimately, good therapy is about teaching you to speak up, and success hinges on your therapist’s ability to build trust and connect with you. That’s what I mean when I say therapy is a simple process. It’s why there are people out there without my education who can have a profound impact on others, they listen, they create these safe spaces, they allow you to speak up.

Changing the world one conversation at a time

My passion for speaking up has grown with time. What started initially as a personal desire to help people be honest with themselves and others, has changed into a fundamental belief and understanding that speaking up is one of the most powerful things any one of us can do.

I still teach my patients to be assertive, to know themselves, and trust that what they have to say deserves to be heard. I also argue – very passionately – that speaking up is the only way to be a good friend or a good partner. If the people in your world trust that you will say what you mean, ask for what you need, and represent yourself truthfully and authentically, they will never have to waste a minute worrying about you.

Good business

In the past 5 years I’ve also come to realize that speaking up, or rather people’s inability to speak up, is costing companies and our economy billions of dollars every year. I know this because I’ve been working with incredible women who either self-censor or are dismissed and shutdown. These women struggle to make the impact they want to make, and because of that coming to work becomes more stressful, less engaging and sometimes downright dreadful. They feel undervalued, unheard and dismissed, so naturally they quit. Job hopping costs the economy $31.5 billion annually. Companies all around the globe are losing some of the most educated and passionate employees they have because they haven’t figured out how to empower and support them to speak up. If these women knew they could share their ideas,  argue as vehemently as the men on their teams, and  speak up openly, they would add so much more to the conversation and would feel engaged.

Good social move

In the past 5 months I’ve begun a personal (and very belated) journey into active feminism. Here again, I see speaking up, and our inability or unwillingness to do so, as a huge contributor to the gender gap, and discrimination or disenfranchisement from women by women within the feminist movement. There are men and women out there who want to speak up but don’t have the outlets to be heard. Then there are those who aren’t given the space to find their voice, and others yet whose voice gets silenced everyday.

I might not be able to change the way the world works, but I do have the power in sessions, through workshops, and in every single conversation I have to bridge the gap and help myself and others be heard. How about you? What do you have to say? Do you live/work in a space where you feel comfortable speaking up? Have you been in therapy, and do you agree with my analysis of why it works?

If you’ve got something to say, I’d love to hear it, just share your thoughts in the comment section or on any of my social media sites. If you need help speaking up, or if your company could use some help empowering it’s women to speak up and be hear, check out my workshops or contact me HERE.

As always… love it? Like it? Share it.

Share on:

Share on facebook
Share on twitter
Share on linkedin
Share on email

Hi! I'm Dr. Alessandra Wall

I help smart driven women and forward-thinking companies bridge the gap & build real conversations.

Here on the ‘Dr. Wall Says’, I share tools, tips, and insights about speaking up, getting heard and how women can take up space and thrive in the 21st century.



Free Resource

Unforgettable: How To Articulate Your Value With Clarity & Confidence


Building a career that allows you to show up at your best, doing what you love + are most skilled at.

Leadership Consulting

Creating systems & businesses that support your best and brightest.

Speaking & Training

Building strong, engaged and impactful teams.