I do not know what the mechanism is but there is research that shows how the neurons in our brain change when in therapy. It is physical. I was bulimic for 20 years, suicidal, self harming and after 1.5 years of therapy with my current therapist I just cope better. I stopped resorting to all the maladaptive coping behaviors to deal with heavy emotions. I do not even react the way I used to to situations. Not sure why it all changed but something we do in that session room has caused the change.