This is a fascinating and contentious subject, and not every therapist either works the same way, or has the same theory about why psychotherapy works.  I believe psychotherapy works, of course -   and the reason why is not mysterious.

Clearly, some people can be dismissive of therapy - saying ‘it’s just talking,’ or saying ‘people should be able to cope with their own problems.’ I think life is about sharing both happy experiences and problems - we are social animals, after all - and so I don't accept we must all cope alone. But is it all just talk?

Some therapists make it easier for clients to see it that way! - by either saying nothing to their clients, and sittng impassively - or by looking kindly at their clients and saying repeatedly ‘and how do you feel about that? 

In my view there much more than tea and sympthy going in psychotherapy. Not only are we social creatures, humans are also the only animals with sophisticated language. This means we use language to both understand and control our world. 

In therapy, we talk about our lived experiences both past and present, and in creating linguistc pictures of our lives, we simultaneosly change them. New narratives, or interpretations, interact wih our lived experience and immediately alter them.

For. example, imagine that, in couple therapy, we interpret at an angry exchange between the partners as a ‘parent-child’ transaction. This is, on one level, just an interpretaion (after all, it’s not ‘true’ or ‘false’: it's just a way of looking at a particular style of argument). However, in taking on board this way of seeing things, it is likely to affect the way the couple transact in future. It’s quite difficult to ‘tell someone off’ in a parental way again if both parties are aware of the interpretation.

There are of course many other ways in which therapy works, incuding the whole idea of a restorative relationship. And the idea of the ‘village elder’ goes way back in history.

Im my experience, clients who can engage with how therapy works, generally progress more quickly. The most important aspect of all, however - backed up by significant academic research - is that you find a therapist that suits you.