Episode #428
The Truth About Psychotherapy: What Actually Creates Change?
What actually makes psychotherapy work—and how does meaningful, lasting psychological change happen? In this episode of Inner Voice: A Heartfelt Chat with Dr. Foojan, Dr. Foojan Zeine speaks with Dr. Jeffrey Smith, psychiatrist, psychotherapist, author, educator, and Clinical Professor of Psychiatry at New York Medical College. Dr. Smith explains the science of psychotherapy, psychotherapy integration, psychological change, emotional healing, and the mechanisms that help people change deeply rooted patterns. Drawing from decades of clinical experience, he brings together insights from different psychotherapy approaches and explains how therapists can understand and facilitate meaningful change. The conversation explores inner parts, survival strategies, schemas, emotional memory, behavioral change, mindfulness, self-observation, acceptance, values, therapeutic relationships, and accurate empathy. A central theme is that lasting change is not simply about understanding the past. Psychotherapy can help activate old patterns while introducing new perspectives and experiences—creating opportunities to develop healthier ways of thinking, feeling, relating, and responding. In This Episode: • How psychotherapy actually works • What creates lasting psychological change • Psychotherapy integration and effective therapy • Inner parts and protective survival strategies • Schemas and emotional patterns • Emotional activation and new experiences • Disconfirming information and changing old beliefs • Behavioral change and self-observation • Mindfulness, acceptance, and psychological awareness • The role of values in psychotherapy • Therapeutic safety and accurate empathy • Why the therapeutic relationship matters Chapters: 00:00 Introduction: How Psychotherapy Works 01:39 Understanding the Inner Self 02:11 When Survival Strategies Become Outdated 05:10 How Does Psychotherapy Actually Work? 07:39 Meet Dr. Jeffrey Smith 11:21 The Foundation of Psychotherapy 12:25 Mechanisms of Psychological Change 13:14 Compassion and the Inner Self 16:35 Understanding Different Parts of the Self 18:58 Protective Parts and Survival Strategies 20:10 Acceptance and Healing 24:08 Schemas and Emotional Memory 25:13 Why Emotional Activation Matters 26:40 Disconfirming Information and Change 29:18 How Behavior Creates Change 31:13 Self-Observation and Awareness 34:54 Mindfulness and a New Perspective 36:02 A Practical Inner Parts Exercise 36:59 The Role of Values in Psychotherapy 40:05 Safety and the Therapeutic Relationship 41:05 Why Psychotherapy Is Interpersonal 42:01 Accurate Empathy in Therapy 44:17 Dr. Smith’s Book: How Psychotherapy Works 45:31 Where to Find Dr. Jeffrey Smith 46:08 Closing Thoughts About Dr. Jeffrey Smith: Dr. Jeffrey Smith is a psychiatrist, psychotherapist, author, educator, and Clinical Professor of Psychiatry at New York Medical College. He is a former President of the Society for the Exploration of Psychotherapy Integration (SEPI) and has devoted his career to understanding how psychotherapy creates meaningful change. Learn more about Dr. Jeffrey Smith and his work at HowTherapyWorks.com. About Inner Voice: Inner Voice: A Heartfelt Chat with Dr. Foojan explores psychology, psychotherapy, emotional wellbeing, relationships, self-awareness, personal growth, and the science of meaningful change. Explore the International Awareness Integration Institute and learn more about psychotherapy, coaching, Awareness Integration Theory (AIT), and integrative wellbeing at IAII.life.
