Why Trust Takes Time in Therapy

Justin Bieber

I was- I was literally looking at this, uh, this old jacket yesterday, right? And the, the, the zipper is completely, like, shredded. And I'm thinking, do I take this to the guy down the street who doesn't know me, or do I just keep wearing it broken because... I don't know, explaining how I ripped it feels like... it feels like too much. It's like, why- why is it so exhausting to hand your stuff over to a stranger? Like, even just a piece of clothing, you know? But then you think about, like, real life. Like, when you have to hand over your actual, actual life to a new caretaker or a new therapist. It's like... it's like trying to explain the entire history of the world to a newborn baby. You're just sitting there like, where do I even start, man?

Roxanne

Oh, my god, Justin, yes. The, the, the newborn baby thing is so real. Because when you- when you meet someone new, especially in a clinical setting, they have zero context. They don't know your, like, your quirks, your history, your... anything. And you feel this massive pull to just... pull away, right? Like, why- why should I tell this person my stuff?

Justin Bieber

Exactly! Like, in the audio we were listening to, they talk about this, like, thirty-two minutes and eleven seconds of audio. This incredibly private, raw file. And the question is, can you just hand that 32 minutes and 11 seconds over to a stranger? A new caretaker? And it's like, no way, man! Why- why would you? They're completely unfamiliar. They don't understand what you're seeking. It's like... it's like waiting for the summer rain in a song, just waiting for a stranger's hand that doesn't even know you.

Roxanne

Well, and- and what's fascinating is that, clinically, that hesitation? It's actually incredibly smart. Like, we- we tend to beat ourselves up for not opening up instantly, but the data shows that the actual... the bond, what we call the therapeutic alliance, is everything. There was this massive, massive meta-analysis... I think it looked at like 295 separate studies on this.

Justin Bieber

Whoa, 295? That's a lot of, like, therapy sessions.

Roxanne

Right! And they found that the therapeutic alliance accounts for approximately 7.5% of outcome variance in therapy. Now, that might sound like a small number, but in clinical research, that is- it's huge. It's actually significantly more powerful than any specific technical style or method the therapist uses. Like, whether they're doing CBT or psychodynamic or whatever... that 7.5% variance from just the alliance is what actually moves the needle. So if you don't have that trust yet, forcing yourself to hand over your... your 32 minutes and 11 seconds? It's literally counterproductive.

Justin Bieber

See! That makes so much sense. Because you get this, like, pressure. Like, "Oh, you gotta be tough. Just hand it over, prove you're ready to heal." But that's a total trap. If you hand it over before you're ready, before you've got that bond with... like, they mentioned Duncan, the trusted therapist... if you do it without that, you just end up feeling ungodly intimidated. And intimidation is, like, the absolute enemy of exposure therapy. You can't heal if you're scared shitless of the person who's supposed to be helping you.

Roxanne

Exactly, Justin. Exposure therapy isn't about, like, throwing yourself off a cliff to prove you're brave. It has to be structured. You need to always visit- like, come back to your therapist, your coach, your mentor, before you step into... into completely unpredictable territory. Otherwise, you're just traumatizing yourself. You have to decide what you're going to do with this "newborn baby" caretaker at your own pace. You don't just fork it over to show you're a tough man.

Justin Bieber

Yeah, because, like, what are you trying to get out of that anyway? A medal? It's not realistic. And- and then you factor in how much energy it takes just to exist sometimes. Like, if you're spending, say, three hours in a chat room, but you can't spend three hours with a caretaker because... man, explaining yourself is just... it's exhausting, you know? Your mind is trying to protect its battery. When you have high anxiety, you spend a lot of time by yourself because the social atmosphere... it just drains you.

Roxanne

It really does. The cognitive load of constantly translating your internal world for someone who doesn't get it... it's a massive tax. And if you're trying to force a spontaneous relationship with a caretaker who doesn't understand your, like, your chat room habits or your quiet time, you're just going to run on empty. We have to stop expecting this, like... this "magic" to happen instantly. There's no magic. It's just slow, daily pacing.

Justin Bieber

Man, yes. No magic. Because otherwise you wake up every day with that voice in your head telling you it's gonna be hard, you're gonna be crying... and then even when something good happens, you're skeptical of it. You're like, "Is this too good to be true?" You don't even trust the joy because the hard stuff carries so much weight. But, like... you don't have to do it alone, and you don't have to do it with a stranger. You go back to Duncan. You use the support you already have.

Roxanne

Right, you rely on the established connection while you slowly, gradually build the new one. You don't have to jump into the deep end on day one. Just keep the boundaries firm and let the alliance build. It's the only way that actually works.

Justin Bieber

Yeah. Keep it simple, keep it safe. Alright, I think that's... that's a pretty good place to stop. Good chatting, Roxanne.

Roxanne

Yeah, good talk, Justin. Catch you next time.