Self-Discovery in Therapy: What Actually Changes When You Do the Work

Most people enter therapy with a vague sense that something is not working. They feel stuck, low, anxious, or disconnected, and they want it to change. But when therapists talk about "self-discovery" and "the therapeutic process," what does that actually mean? What specific changes happen, and how do people experience them from the inside?

A 2025 study by Mortimer and colleagues provides unusually clear answers by interviewing participants about their experiences during a structured psychodynamic therapy program delivered entirely over the internet. Combined with research on self-esteem, impostor feelings, and psychodynamic group therapy, a picture emerges of what genuine psychological change looks like in practice.

The Five Changes That Matter

Mortimer\'s research team interviewed fifteen university students who completed a 10-week internet-delivered psychodynamic therapy (iPDT) program for low mood. Using reflexive thematic analysis, they identified several distinct experiences of change that align closely with psychodynamic theory\'s predictions about how therapy works:

1. Learning to observe yourself. Participants described developing what therapists call "self-observing capacity," the ability to notice your own thoughts, feelings, and patterns while they are happening rather than being completely absorbed by them. This was not mindfulness in the popular sense. It was specifically about recognizing recurring emotional patterns and understanding them as patterns rather than just reactions to immediate circumstances.

2. Feeling difficult emotions directly. A consistent finding was that participants learned to sit with uncomfortable feelings rather than immediately deflecting or suppressing them. Several described a shift from intellectualizing their emotions (talking about sadness without feeling it) to actually experiencing them. This was uncomfortable but consistently described as necessary for change.

3. Recognizing your defenses. Participants began to see their own defensive strategies clearly, things like withdrawing from intimacy, intellectualizing emotions, people-pleasing, or avoiding conflict. The key shift was not just identifying these patterns but understanding that they had originally developed for good reasons (usually self-protection in childhood) while recognizing that they were no longer serving them well.

4. Connecting the past to the present. Many participants described moments of insight where they linked current emotional patterns to early experiences with caregivers. These connections were not forced or prescribed by the therapy program. They emerged organically as participants reflected on their histories and noticed parallels with their present behavior.

5. Experimenting with new ways of relating. Perhaps the most practically significant change was that participants began trying new interpersonal behaviors: setting boundaries, expressing needs directly, tolerating vulnerability in relationships. This was not described as automatic. It required deliberate effort and felt risky. But participants who engaged in this experimentation reported the most meaningful shifts in their daily lives.

The journey was described by many as empowering yet challenging. Self-discovery was not a comfortable process. It required facing things about themselves that they had previously avoided.

The Impostor Problem

A related finding from Taskiran and colleagues (2025) illuminates why self-discovery is so difficult for many people. Studying 376 employees at a Turkish bank, they found that the impostor phenomenon, the persistent feeling of being a fraud despite objective evidence of competence, has a significant negative effect on career satisfaction and is strongly predicted by low self-esteem.

What makes this relevant to therapy? The impostor experience is essentially a failure of self-knowledge. People who feel like impostors cannot accurately assess their own competence. They attribute successes to external factors like luck or timing and attribute failures to their inherent inadequacy. This is precisely the kind of distorted self-perception that psychodynamic therapy aims to address.

Interestingly, Taskiran\'s study found that proactive personality moderated this effect. People with proactive tendencies (those who take initiative and create change in their environment) were less damaged by impostor feelings. This suggests that self-discovery is not purely an internal process. It also requires testing your insights against reality by taking action and observing the results.

When the Work Gets Harder

Not all self-discovery happens in tidy, progressive stages. A 2026 study by Onsori and colleagues examined psychodynamic group therapy for patients with schizophrenia during the COVID-19 pandemic. Their qualitative analysis of therapy session transcripts revealed four themes that capture the existential challenges of psychological growth under pressure:

• Loss of something meaningful: Participants grappled with existential fears that intensified during the crisis, reflecting the universal human struggle with impermanence.
• Paranoia and distrust: External stress amplified suspicion toward institutions and other people, making the therapeutic work of building trust more difficult.
• Oscillation between autonomy and dependence: Participants swung between wanting to manage everything themselves and wanting someone else to take over entirely, a core conflict that psychodynamic theory identifies as central to psychological development.
• Closeness and distance in relationships: The enforced isolation of the pandemic made the fundamental human dilemma of intimacy versus independence unavoidable, giving therapists and patients something concrete to work with.

The researchers framed these themes within Mentzos\' psychodynamic theory of psychosis, which describes psychotic symptoms as attempts to resolve existential dilemmas around proximity and distance. Even for people without psychosis, these dilemmas are recognizable: how close is too close? How much independence is too much? Where is the line between healthy self-reliance and destructive isolation?

What Actually Helps People Change

Across these studies, several principles emerge about what makes therapeutic self-discovery effective:

• Structure helps. The internet-delivered therapy in Mortimer\'s study was structured with weekly modules, reflective exercises, and therapist feedback. Participants valued having a framework that guided their self-exploration rather than leaving them to figure everything out alone.
• Feeling matters more than thinking. Intellectual understanding without emotional engagement produced limited change. The participants who described the most significant shifts were those who allowed themselves to feel what they were learning about.
• Action is part of insight. Self-discovery that stays internal is incomplete. Testing new behaviors in real relationships was what turned insight into lasting change.
• The format is more flexible than we thought. Internet-delivered psychodynamic therapy produced genuine self-discovery experiences comparable to what traditional in-person therapy describes. The therapeutic ingredients appear to be the reflective process and the relational connection, not the physical setting.

Explore Your Patterns

Understanding your personality type can provide a structured starting point for the kind of self-discovery these studies describe. Take the free Enneagram test to explore your core motivations, fears, and defensive patterns. If you are ready for deeper work, booking a session with a therapist can help you move from insight to action.