Therapy Doesn’t Work

“Therapy doesn’t work.”

I hear it all the time. Well I am here to tell you that you are 1,000% correct. Therapy does not work.

It simply can’t work when you do not enter it with the right mindset and intentions.

Therapy is like every other relationship. It takes mutual reciprocity for it to blossom and create real change. Mutual reciprocity is more than just a good rapport. It is the willingness of both parties to put in the work to achieve the goal. The goal being recovery or healing of the client.

Why doesn’t therapy work? I think there are four main reasons that therapy fails.

#1 Too Many Barriers

A mindset can be a barrier.

I know a person who is by all definitions a triple addict. However, this person only acknowledges and seeks help for one. Drugs. They go to rehab, attend therapy sessions, get clean, get released, get knocked around by life, seeks alcohol as a release which leads to having copious amounts of sex, and eventually this person is using again. It is a vicious cycle. Why? They have a gigantic mental barrier that says, drugs are the only thing I abuse. I can control my urges for everything else. Treating the drug use only remedies a third of the problem, leaving this person only a third healed.

I know someone else who says therapy is just paying someone to be all in your business. Well. . . yes, but no. You pay the therapy to listen to your problems and give sound advice based on research and experience. This person admits to going to therapy to yammer about people who annoy them rather than dealing with their painful abandonment issues.

Then there is the magic pill barrier. Most people, at least in America, have the magic pill barrier. They believe a pill, or a few sessions will drastically change everything and make them shiny and new. This is a fallacy. Just like a few sit-ups hasn’t given me washboard abs, a few counseling sessions will not create lasting change.

The sit-up is one method of ab work that creates results in conjunction with a good diet and other exercises. Counseling is one method of mental work that creates results in conjunction with other exercises. Therapy is the starting point, but it takes a lot of hard work and dedication.

In fact, from now on, let’s start thinking of mental health professionals as personal trainers for your mind. You must do the work; they are just yelling (hopefully not literally) the instructions and giving you encouragement.

Therapy is not to ‘talk about’ things, but to change the person’s life, and to relieve suffering, such as depression, anxiety, or relationship problems. David D. Burns

#2 Just Not Ready

Some things are too painful to revisit. That is very human. Most of the time we heal by forgetting, or more accurately compartmentalizing, our pain. We put it in a box, label it, and place it on a mental shelf for later use.

Sometimes a person seeks therapy, either by mandate or actual need, and they are not ready. Sometimes they are not ready for therapy at all, and sometimes they are not ready to discuss certain traumatic events. Now this doesn’t mean the person isn’t fully participating. It just means that the real deep-rooted pains are never uncovered and dissected. They are left on the shelf.

The problem with past pains being shelved is that they have a tendency to become triggers or tools used for self-sabotage. I personally never discussed the fact that it took me years to stop blaming myself for my parents getting back together because my mother was pregnant with me. The adults in my life had made it seem like it like was my fault. And growing up, watching my father hurt my mother (even after they divorced), I believed it too. While I believe this is a resolved issue for me, I did not discuss it in therapy. It seemed unnecessary. I’m over it. It doesn’t directly affect my life right now, even if it colored my childhood and sense of self-worth back then. Even typing this, my clinical mind is cringing, wondering if I’ve just uncovered a long shelved personal conflict.

These types of issues are often ignored; forever shelved, yet never unpacked. Personally, I learned a few years ago, that “getting over it” is not the same as “healing from it.” Someone who is holding on to deep rooted pain either may not be ready or may not think a traumatic event is worth uprooting for the sake of therapy. Sometimes, the things we bury the deepest are the things that we need to hone in on and unpack to truly heal and flourish. The best time to unearth these past hurts is with a capable, compassionate licensed professional.

#3 Transference, projection, and attachment

Transference, projection, and attachment are all possible barriers that can arise in therapy. A person who is resistant to feedback/criticism or change may start to project, meaning attribute their own traits onto others. I know someone who finds everyone around them to be aggressive and says their attitude is to protect themselves from all the aggressive people in their circle. A therapist may find it difficult to reason with or get around the emotional walls erected around someone who uses projection as a defense mechanism as the response is typically, it’s them not me. While there are several definitions or types of transference it is the unconscious redirection of feelings and desires to a new object. Those feelings are typically ones related to childhood.

I liked my therapist. I felt like she truly got me. We were both middle sisters with deceased parents, and we were both in helping professions. I liked her. I liked her so much I started to not want to disappoint her. So, if she didn’t ask a specific question like, “how was your anxiety this week” or “did you have any panic attacks”, I didn’t tell her because I didn’t want her to know I didn’t show progression. If she started the session by asking me about work (because I came to her directly from work and it was a great source of my stress) I’d harp for the entire hour about the woes of work instead of discussing the argument I had at home, my loss of connection to those around me, or my desire to hibernate (for real this time).

Long story short, I became attached to her. She became a source of comfort and trust. In plain language I began to think of my therapist a sort of big sister/mentor. However, with that level of trust came all the boundaries I carry with my role as a sister, so I stopped seeking her professional expertise and started keeping our interactions surface level.

She’d correctly diagnosed me with delayed grief and depression, and as the weeks went by I started treating her like she was my support system. Like a sister or friend. Not like a paid licensed professional. And just like that, I began to reveal less and less of my true issues in order to maintain her good graces. Here’s the thing. I knew this was happening. I saw it. I even kicked myself after my sessions and lectured myself before my sessions to be honest about my actual thoughts and feelings. So, while I did recover from grief and depression, I didn’t really work on my anxiety or other pain-points because I prioritized my need to feel connection over true healing. Why did this happen? My support system is already small, but it was shrinking by the second with my best friends moving away and all of us having busy lives. The tenth anniversary of my mother’s death made me feel alone, but I’m too introverted to make new friends, and we had a lot in common, so I became attached.

Your therapist should be someone who pushes and challenges you in a nurturing and productive way. They shouldn’t let you get too comfortable, nor should they push too hard. If you being to feel too comfortable, familial or friendly, with your therapist, you may want to discuss it or seek another therapist.

I believe that a different therapy must be constructed for each patient because each has a unique story.  Irvin D. Yalom

#4 Not a good fit

If you have ever taken PSYC101 or Early Childhood Education, you’ve heard the term good fit. Good fit isn’t just about the classroom or parents, it actually affects every segment of our lives. You love your job but want to quit because you have a terrible boss. That’s a good fit issue.

Good fit, and consequently lack of, also occurs in therapy. A therapist can be world renowned and highly recommended, but completely bad for you. I know someone who had a great therapist, but she kept asking the client about prayer. This person was never religious or spiritual and had no interest in prayer. In fact, it’s frowned upon to pray away a narcissistic, unloving parent. They were able to come to an agreement, there was a bit of trust lost in that relationship.

Good fit is necessary for true progress. This is not a one-size-fits-all situation. In fact, one-size-fits-all is the great lie of the fashion industry. It doesn’t exist. I’ve been a size zero and a size ten, and the stupid thing never fits.

It is okay to acknowledge the mismatch and correct it. Your contract is not written in blood. And a true professional may be saddened by separation, but ultimately understands. Always take advantage of a phone or in-person consultation. That first meeting will go a long way to determining whether it is a good fit. If you are half way through your treatment and things feel off or you just do not feel you are progressing, discuss your issues. If the answers aren’t satisfactory, look for another therapist.

If you break your knee, you have therapy on your knee, and it’s the same for your heart.    Toni Braxton

In conclusion, therapy can work. For many it does work. There are a multitude of situations in which an honest chat or a switch may need to occur, but therapy is a useful, underutilized part of self-care and personal growth. For maximum effectiveness it should be embarked on with an open, or at least willing, heart and mind.

 

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