So the whole concept of paying for it seems odd, but at the same time it seems like maybe I fundamentally don't understand what a therapist actually does.
My understanding was that their role was to listen to your issues and recontextualize negative experiences, beliefs, and perceptions of things, people and relationships into more positive ways of viewing things in order to let go of maladaptive thought patterns and the associated emotions, so that one can make way for more positive beliefs and emotions and experiences in life. But it sounds like I am horribly off base here.
Nope, you do not understand how therapy works.
Granted, even most people who go to therapy don't understand how it actually works, so that's not a you thing, that's more an everyone thing.
I thought I knew how therapy worked when I decided to be a therapist. Then I started learning it and went "wait...what the fuck is this? I hate this!" and dropped out of my program because it wasn't what I wanted to do. Turns out I wanted, at the time, to do something more like coaching, which was more similar to the work I had been doing before, because I was extremely good at giving people advice, telling them what to do, and getting them to actually do it.
But then I had a few years of retirement behind me, did a lot of therapy to move on from my old career, and gradually doing actual therapy started appealing to me.
You can only talk about your experiences and feelings in ways that you consciously understand them. What therapy does is systematically, with very particular skills, get past all of your decades of beliefs and rationalizations and dig into the very basis of how and why you think and behave the way you do.
I've had beliefs about myself and ways of behaving that felt like core, fundamental parts of who I am, unchangeable, factual truths that were utterly demolished in one session of therapy where I realized that core chunks of my identity were founded on reactions to trauma and then reinforced throughout my entire life.
You talk over and over again about wanting to understand why you are the way you are, well therapy does exactly that. You're avoiding the one thing that can actually help you get the answers you want.
You've read the biopsych textbook, so you understand that the brain creates shorthands for everything, interpretations of what reality is based on limited information. Well, you do that about yourself too.
You *think* you know yourself, but what you really know is the series of shorthands that your mind has created to represent *you* and a bunch of that programming is faulty. "This happened to me, so I'm like this," "I've always been this way, it's who I am," "This is important to me, and here's why," ect, etc.
Therapy digs into the base coding of that programming and figures out the basis of all of those things. It also allows you to recode things.
I am fundamentally not the same person I was before I walked into the office of my first really effective therapist.
Nothing about the experience was positive, he was a fucking asshole, and I left the session, promptly went home, got shit faced drunk, and sat staring catatonic at the wall for hours until my spouse came home.
I explained, through snotty, messy tears what had been talked about in therapy and my spouse said "he's a fucking genius." It's not that that therapist knew more than others, it's that he was the exact right fit for me at the time and it felt like being so profoundly understood far better than I could have ever understood myself on my own.
It was like having someone peel away my own skin and muscles for me to see the organs underneath with my own eyes and go "oh, exactly that, right there is what creates this physical state that I've always felt and thought was normal."
Literally nothing was reframed positively, actually many things that I said about myself that I used to see positively, he reframed just fucking horribly. Understanding *why* I prioritized the things I did, and how a lot of that was driven by trauma...it was actually horrifying, hence the drunken catatonia and sobbing.
Let me compare therapy to a medical issue.
So self help, as you've described: self reflection, reading books, talking to friends. That's like me growing up with knee and back pain. I know I had a ski injury at 11 that hurt both knees and I know I had a spinal injury at 13 that hurt my back. Those were very logical explanations.
I then fell skating and hurt my knees again, further reason for having knee pain. I did a lot of body building when I was young and my spine got further injured. Further explanation of why my lower back always hurt.
I exquisitely understood my knee and back pain. I knew exactly what set them off, I knew how to make them feel better, I felt I understood them.
I also sought the care of a lot of doctors. This was like when I was seeing therapists who were a bad fit. They were definitely well trained experts, and when they looked at my knees and lower back, they couldn't find anything majorly wrong, so chalked it up to oversize issues, minor soft tissue damage. I was prescribed PT and advil.
Everyone involved felt like they understood the issue and handled it in ways that we all thought were appropriate. We all felt we understood the etiology of the feelings my body had.
Seeing my first really good fit therapist was like when a spinal expert MD diagnosed me with a rare genetic condition that makes me extremely prone to injuries. Suddenly my whole lifetime experience of pain and injuries made more sense. It was like my entire life got reframed through this lens of "oh. This is why my body feels this way and reacts this way, and no, it's not normal."
My whole identity as it related to my body changed.
Seeing my second amazing fit therapist after the first one died was like when I met my surgeon who was like "dude...your femurs are rotated in the wrong direction, that's why your knees and spine hurt so much. Combine that with the genetic predisposition for injury and it's a miracle you've ever walked as much as you did."
Again. The whole history of what I believed about myself and my body radically changed and was entirely reframed. One of the hallmark signs of my bone deformity is that you get easily fatigued while running. I could never run as a kid and always framed myself as just not an athletic kid, out of shape and weak compared to my peers.
N'ah. Just all the muscles involved in running were twisted so they fatigue super quickly because running for me was incredibly inefficient and took enormous amounts of energy, like someone else trying to run backwards full tilt for a long distance wearing two different high heeled shoes.
Talking to these two doctors completely rewrote my entire life history and my entire perspective of myself. Like I'm transported back to when I was an embarrassed child unable to keep up with my classmates in gym class and totally seeing that experience differently. Or my early 20s talking to one of the previous doctors basically telling me that I just have a low pain threshold with my knees and need to learn to toughen up because my knee injury is so minor.
Having this incredible self knowledge of why my body has *actually* felt this way for my entire life was like watching the all of the puzzle pieces of my life history change shape and fit together differently.
Therapy does the exact same thing.