What Your Job is in Therapy

Many people begin therapy unsure of what is expected of them.
They wonder whether they should come prepared, whether they should have specific goals in mind, or whether progress the therapist should be taking the lead. While most areas of life rely on preparation and efficiency, talk therapy asks for something different.

In psychoanalytic therapy, the client’s role is not passive and nor is it about being clever or knowing what to say in advance. The work depends less on having answers and more on a particular way of speaking, thinking, and noticing oneself in the presence of another person.

One of the clearest descriptions of this comes from Otto Kernberg, a prolific writer a teacher to many and one of the greatest living psychoanalysts. He outlines how he introduces the work at the very beginning of therapy.

“Let me explain the role that each of us will play in your therapy sessions. Your role is to attend sessions regularly and to speak as openly and freely as possible as you can when you are here, without relying on a prepared agenda, paying special attention to the difficulties that brought you to treatment.”

Put simply, therapy is a place to become curious about your internal world. Rather than organizing experience in advance or aiming for coherence, the work involves noticing how thoughts, feelings, images, and reactions arise—and how you relate to them as they do.

The invitation is simpler, and more demanding: to speak from where you are, rather than from where you think you should be.

Kernberg continues:

“I am asking you quite literally to try to say whatever goes through your mind and also to share with me whatever difficulty you may have doing so.”

This does not mean that everything said will feel important or coherent. Much of what initially comes to mind may feel trivial, repetitive, or beside the point. But therapy is not primarily concerned with surface relevance. It is concerned with how the mind organizes experience. In therapy you have no obligation to make sense.

“I am suggesting that we work in this way because it is the best way I know of to learn about the thoughts and feelings that, out of your awareness, are underlying your difficulties.”

From a psychoanalytic perspective, the most influential parts of our inner lives are often not immediately accessible. They show themselves indirectly—in the way we speak, hesitate, change topics, minimize, intellectualize, or fall silent. Therapy becomes a space where these patterns can be noticed, not judged, and gradually understood.

This is also why Kernberg explicitly encourages clients to share thoughts that might otherwise feel inappropriate to mention:

“At times you may find that the thoughts you have in session seem trivial or embarrassing, but I would encourage you to share them even so. Similarly, if you have thoughts or questions about me, I would encourage you to share them as well, even when they may not be the kind of thing one would share in an ordinary social relationship.”

This is where talking to a therapist and talking to a trusted confidante diverge greatly. In most relationships, we manage impressions carefully. We edit ourselves. We avoid saying things that might feel awkward, critical, needy, or exposing. Therapy asks you to experiment at your own pace with this particular social norm.

Thoughts or imagination about the therapist, reactions to what the therapist just said, feelings that arise before or after sessions are all central to the therapy.

Kernberg adds:

“Things you find yourself thinking about as you are coming to or leaving your sessions may also be helpful to explore, as can be dreams, daydreams, and fantasies that you are having between sessions.”

The key is understanding how your inner world works and understanding what rules typically govern it. Importantly, Kernberg also clarifies something that many clients feel but don’t know how to articulate:

“What I am asking you to do is not so easy, and you will find at times that you are not comfortable being open or do not know what to say. This shouldn’t be surprising; unless you’ve been in therapy before, you probably have never tried to communicate with someone in this way and for the express purpose of learning more about yourself.”

Not knowing what to say is not a failure of therapy. It is likely that you are getting in touch with something that wants to be named, and staying with it is the task. Therapy does not require that you overcome these moments quickly. It asks that you notice them, and, when possible, speak about them.

As Kernberg puts it:

“In fact, understanding whatever is interfering with your thinking and communicating freely and openly is an important part of the therapy and helps us to better understand how your mind works.”

From this perspective, the client’s “job” is not to produce insight on demand, but to stay engaged with experience as it unfolds. Especially when that experience feels unclear or uncomfortable.

Kernberg then describes the therapist’s role:

“When you find you do have difficulty, I will do what I can to help you understand what is getting in the way. Otherwise, my job is to listen attentively and to share my thoughts when I feel I have something to add that will help to deepen our understanding of the patterns of thinking, behavior, and fantasies that underlie your difficulties.”

Put simply, the patient is responsible for the content of the work (what is brought into the room)  while the therapist is responsible for the process (keeping a pule on what is happening and deepening it). This division of responsibility allows the work to remain both open and contained. Neither person has to do everything, and neither can do the other’s part.

“You will find that there will be times when I talk a fair amount, and other times when I will be relatively silent. You will also find that I may not always answer your questions.”

This can be surprising, and occasionally frustrating. When a therapist does not immediately answer a question, it is not meant as avoidance or dismissal. Often, the focus is on understanding what prompted the question—what feeling, concern, or wish is embedded within it.

Finally, Kernberg emphasizes something foundational:

“Finally, I want to stress that everything you tell me here is confidential.”

Confidentiality is what allows this kind of exploration to take place at all. It creates the conditions for honesty, uncertainty, and emotional risk.

Taken together, this description offers a concise idea of the client’s role in therapy. It is not about performing well, improving efficiently, or arriving with clarity already in hand. It is about showing up ready to engage in a very particular kind of conversation.

For many people, this becomes the first place where they are able to speak honestly about their inner lives without needing to think about the other person. In the quiet space of the therapy transformation can occur at its own pace.