I’m a big proponent of taking care of your mental health, which means that I have suggested therapy to a number of friends who have come to me with problems (only after listening to them and determining that their problems were way too big for me and I could not handle them). Oftentimes I hear the response “I tried that once and I didn’t like it. I don’t think it would help. I felt worse afterwards”.
Now of course everyone has the right to decide how to deal with their own health and well being, but I have to call bullshit on that response. Many people who have never done therapy seem to have an odd conception of what therapy is like. They think that it’s a way to feel better, as if it’s some sort of medicine that will turn off the bad feelings. Maybe they imagine it will be cathartic, or their therapist will solve their problems for them. Others imagine a Freudian style therapist asking “why do you feel that way?” or other probing questions to illuminate your true self.
Because therapy can be an extremely effective way of dealing with mental health problems, or even just a good support for those who are going through a tough time, I think it’s important that people have a realistic idea of what it is and what it’s there for. If you’re going to make informed decisions about whether something is a good idea for you, you need to know what the potential downsides are. I’m in a fairly good position to talk about what therapy is like. I’ve had many different therapists in individual and group settings, in college, in eating disorder clinics, in general clinics, and participated in therapist like DBT, CBT, EMDR, some psychoanalysis, and intensive talk therapy/exposure therapy. I have been in therapy for about 5 years continuously. I’ve got a good handle on this guys, I promise.
The first myth that I want to clear up is the idea that therapy exists to make you feel happy/good/better. In reality, therapy exists to help you become mentally healthier. This means reducing symptoms of mental illness, providing coping mechanisms for difficult situations, making sense of the patterns that exist in your thoughts, and helping you live more effectively. Different therapies have different specific goals, but generally they fall under the realm of helping be more effective at living the life you would like to live.
As examples, DBT asks you to set “life worth living goals” (things that will make your life worthwhile in your mind), and the whole purpose of the therapy is to be able to allow you to reach those goals. In contrast, something like exposure therapy might have as its goal the ability to function in the presence of something that was previously triggering. Oftentimes in order to reach these goals you have to do some incredibly difficult things.
Therapy is not enjoyable. It does not make you feel better. Oftentimes you feel a whole lot worse after you start therapy because you are asked to dismantle some of your old coping mechanisms, seriously look at your problems, and then build up real and good coping mechanisms. No one particularly likes to look at their problems, so this process hurts. It’s like rebreaking a bone that was never properly set. Oftentimes you will come out of a therapy session feeling raw, weak and vulnerable. Oftentimes you will feel as if you’re going crazy because your therapist has asked you to give up an unhealthy coping mechanism and hasn’t replaced it yet.
A therapist is not there to tell you how to fix all your problems. In fact if a therapist tells you straight out what to do, they’re likely not doing their job very well (with the exception of some clear symptom like, self-destructive behaviors like drinking or restricting food). What a therapist does do is help provide you with a set of tools to manage your mental health, your relationships, and your life. You still have to do all the managing yourself though, and that’s a lot of work, particularly when you’re first starting. Changing behaviors and thought patterns takes a lot of time and effort which no one but you can do.
In addition, depending on what problems you’re struggling with, it may take a very long time before things start to look up. A simple phobia is probably the quickest, and that still can take a couple of months. Something like an eating disorder, a personality disorder, or PTSD may take years of work before you feel you can manage your symptoms or call yourself “recovered”. Making it even more difficult is the fact that oftentimes you don’t notice progress because for many things progress is a lack of negative symptoms rather than a presence of feeling totally awesome.
Another difficult element of therapy is the fact that you and your therapist won’t click from day one. It takes work to find a therapist that you’re comfortable with, and once you’ve done that you have to spend time building a relationship with that person, just like you would with anyone else who you ask to help you and mentor you. This again takes time and means that often your sessions will not feel easy or smooth.
Now despite all of these difficulties, the fact that therapy really is not any fun at all, the fact that it takes lots of time to work, and requires a great deal of energy on the patient’s part, there are wonderful things you can get out of therapy. If nothing else, therapy should give you someone who is on your side, someone who will listen and provide feedback. When it works really well, therapy can give you a great deal of insight into why you do the things you do, how you can change the things that are hurting you, how to determine what you truly want out of life and what your values are, how to live in accordance with those values, and a wonderful relationship with someone who cares about you and will do their utmost to show you how to live the best possible life. It can make your life a whole lot easier when you have the tools to manage your emotions in a healthy way.
So next time you hear someone say “Oh I tried therapy once and it didn’t work for me” you can give them a big ol’ side eye because that is not how therapy works.