Wednesday, March 9, 2011

Therapy? For Me?

There are many commonly held misconceptions about therapy that I'd really like to de-bunk, but I'm going to focus on the top 4 I hear most often. Put on your big girl panties and your big boy undies, if you plan to proceed:-)

1. Therapy is only for crazy people: This has to be THE most common misconception/untruth about therapy and is most often spoken by someone who really needs therapy. First of all, what do you mean by crazy? Aren't we all just a little crazy? There is no shame in going to a therapist for help or support. If you had a disease like diabetes, you would take your medication and go to your doctor appointments without shame. Similarly, if you have experienced unforeseen events in life that have crippled you emotionally, it is good to seek the help of a therapist. It is good to take care of yourself and be seen by a professional who is trained and experienced in walking people through their hard times. Many people are blessed with genetics that predispose them to mood disorders. Then life comes along and brings out the symptoms. We go to therapy because we cannot overcome and deal with much of our emotional baggage all on our own. A good therapist is mindful of the interplay happening between the two of you and is aware that it is this interplay that is essential in you getting better! Relationship is key to healing! I personally believe therapy is especially important if you are a therapist yourself. My mind and my psyche are my primary work tools and I want them to be clear and healthy. Otherwise, I'm bringing my own dysfunctional patterns, beliefs, and feelings into the therapy relationship and acting it out with my clients-- not good. And, yes, you are doing that if you are a therapist. You are human after all, not perfect! Remember, I did warn you to put on your big girl and big boy undies. :-)

2. I don't need therapy, I just take medicine for that: I hear so many people say this. There are many wonderful medications designed to treat mental illness. I am very glad for this. In fact, I hope and pray for even more effective medications to come on the market all the time. We are in need of medications to treat biochemical imbalances that can lead to depression, psychosis, and anxiety. I also see many clients for whom the medications are absolutely an essential part of their treatment, and I know they would experience severe regression without the meds. BUT (and you knew the BUT was coming) medication ONLY is nothing more than a good start for most people. It's highly unlikely that you are going to find a medication that is going to cure it all. I see clients who find a good medication that stops their anxiety attacks all together-- GREAT! These clients feel they are better now and no longer in need of therapy. They then go on to experience one dysfunctional relationship after another, spend themselves into great debt again and again, have constant conflict with co-workers or family, etc., etc. In my own experience as a therapist, I have never seen a client who experienced anxiety in a vacuum. This is to say, they are experiencing crippling anxiety for no apparent reason, with no history of trauma, or family dysfunction that hard-wired their brain to respond in this way. I am not saying these types of people don't exist. I'm just saying that in 10 years of doing therapy, I've personally never seen it! It is possible to live without potentially addictive medications and learn to manage anxiety. Let your medication serve as a springboard that allows you to participate in therapy at an even deeper level. Remain open to the fact that there are characterological and interpersonal issues impacting your life that medication will never resolve. If you're waiting on the right medicine to come along that will finally make you feel better, you might be waiting for a long time. Medication combined with talk therapy will get you there!

3. A good therapist will be able to fix me: Many people come to therapy believing that I hold the solutions to their problems. They believe I will give them a magical answer and POOF, things will be great. They are often sorely disappointed when I have to tell them, "Sorry, my magic wand is in the shop." Certainly, there are people who need information. There are many clients who need to know more about their diagnosis. They may need to know more about the common effects of childhood sexual abuse or being the child of an alcoholic parent. This information alone can be very healing and give a person direction in how they think about themselves and the world. There are times too, when a client simply needs guidance and it is good for a therapist to provide it. Most of the time, however, my role is NOT to sit with you for an hour telling what you what you should be doing if you want to feel better. If you have a therapist who does that with you, how good does that feel? I want to encourage clients to explore themselves, dig deep inside the stuff of themselves. Together we sort through the trash, how did the trash get there, what can we do with it, what part am I playing in all the drama that goes on in my life? Good therapy also means working patiently through the ups and downs of the therapeutic relationship. Therapy means for many people that they experience warmth and a non-judgmental attitude from another person, maybe for the first time in their lives. That goes a lot farther than a therapeutic lecture. Therapy is a process of you learning about yourself, being courageous and honest about yourself, and actively working toward change.

4. I don't have time for therapy: Honey, you don't have the time to skip it. For people who are experiencing extreme stress, anxiety, chronic conflict with others, depression, addictions, and various other dysfunctional patterns, you cannot afford to continue another day without gaining some therapeutic insight. Each day that you continue on in your life engaging in the same dysfunctional patterns, experiencing the same negative and unhelpful thoughts, going deeper into dangerous depression and addiction, you make it much harder to ever extract yourself from it. You're also very likely creating further damage within your relationships that will have to be addressed and healed later as well as re-creating dysfunctional patterns in your life that you are probably unaware you are even re-creating. Good therapy cannot be postponed. It is too essential to put off until you have more time, because life will catch up with you eventually. When life and our own brokenness forces us into therapy... well, that's just no fun. Make the time now.

Rant ended. :-)


  1. Then there is:
    5. Price. (see #8)
    6. No good therapist near. (see #8)
    7. Too stressful. (see #8)
    and I'm sure for many it would be...
    8. I'm afraid. (see #8 -- this is a spiral)
    9. I'm doing okay. OKAY?!?!

    Actually I would need a good therapist to work through why I wouldn't go to a therapist. :-)

  2. LOL! You're right! I'm fine. Why do I need a therapist?

  3. I have a question about one of your comments in this post:

    "In my own experience as a therapist, I have never seen a client who experienced anxiety in a vacuum. This is to say, they are experiencing crippling anxiety for no apparent reason, with no history of trauma, or family dysfunction that hard-wired their brain to respond in this way."

    Over the last few years I have experienced great loss in just about every area of my life. Also, as you imply, I realize my problems didn't just start with recent losses but have roots in childhood.

    I have been struggling with anxiety and depression. Finally this past month, I became unable to function in some ways, due to lack of motivation as much as anything.

    Based on my research, I don't want to try an SSRI. I went to my GP and got a prescription for bupropion, which is really helping me after just 2 weeks--especially for concentration and motivation--and I'm functioning again. Also, I don't want to kill myself anymore, so that's good. Surprisingly, it hasn't increased my anxiety and I think I'm actually sleeping better. I don't like to take medication so this was an act of desperation.

    I've been to a couple of therapists, but honestly, it hasn't helped much. I guess I don't understand what they're supposed to do for me. They can't change the circumstances in my life. I've gotten into negative thought patterns and now it is difficult to change--but I'm trying. I also need to forgive, forgive, forgive, and move on--not because forgiveness is "deserved", but to free myself. This also is not easy.

    You obviously care about your clients a great deal and you are helping people. So I guess my for you question is, what am I missing? How is therapy supposed to help me?

  4. Anonymous, I am so grateful for your question. I am very glad that the bupropion is helping you. That's a good psychotropic that I've seen have wonderful benefits for my clients. I do care very much about the people I work with and hold tremendous respect for the courage I know it took them to come to me the FIRST time and to return again and again. Depending on your primary mood symptoms, there are varying and specific types of treatment geared toward those symptoms. For myself personally as well as the many people I've worked with over the years, I know that seeing results from therapy takes time. It took many years for us to get into bad shape and it will take awhile to get out too! We have to be patient and continue to bravely examine ourselves. How therapy will help you will depend on the type of therapy you're getting. I can speak for myself, here is how I expect therapy to help someone struggling with depression and anxiety: 1. They should learn new strategies for managing the anxiety rather than relying on unhealthy habits 2. Gain insight about the "core issues" that are contributing to the depression, which often stem from years of valid feelings being denied 3. Use the therapy relationship to express the denied feelings and get emotional needs met (validation, encouragement, information, modeling of self-care, confidence in the new self emerging in therapy)
    4. perhaps cognitive behavioral work surround past trauma as well as EMDR sessions (Eye Movement Desensitization Reprocessing), I really love EMDR and found it to benefit clients sometimes as quickly as 1-3 sessions. The main thing that I hear again and again from my own clients is that they learned a lot about themselves and no longer feel shame for being who they are. I feel my clients learn WHY they became who they are and through a caring and non-judgmental relationship with me, they learned how to become caring and non-judgmental toward themselves. This makes me very happy. :-) I hope this helped to answer your question. Bravo to you for the hard work you've already done and continue to do!

  5. I posted earlier about resources for love addiction, shadow selves, ect and am wondering how I go about finding a good, Christian, affordable (on welfare) where I live, here in detroit?