Therapy, as currently practiced, is often a linguistically mediated enterprise. The client says certain things, and the therapist says things or asks questions in response. So, when considering how therapy works (or fails to), it is worth considering how language works (or fails to).
In the last century, linguistics and philosophers of language came to distinguish between semantics and pragmatics. The semantics of a sentence is, roughly, its literal content: The semantics of "Fido is hungry" are that there is a being denoted by "Fido" (a dog, say) and that it has a certain property, namely the property of being hungry or desiring food. The pragmatics of a sentence are what is, again roughly, what that sentence is used to communicate in a context. For example, if we have joint caretaking responsibilities for Fido, my purpose in uttering this sentence might be to alert you to the fact that it is your responsibility tonight to give Fido his dinner.
The distinction between semantics and pragmatics allows us to capture and reconcile two things that might be meant by "meaning." The first is that language is meaningful in the sense that it makes claims about the world that may be true or false and that the meanings of sentences are in some sense equivalent to the circumstances in which they might be true (their "truth conditions," in........