What really happens in therapy?
Thanks to the stigma surrounding psychotherapy that is still, to some extent, present in our society (although this is, fortunately, changing for the better), many people have never seen a therapist and are hesitant to do so, even if they could benefit from it. Add to that sometimes-inaccurate portrayal in the media, and it’s not a surprise why many people have a slightly distorted, or downright wrong picture of psychotherapy. This can discourage people from seeking help when they really need it, and further damage their mental health. Thus, it is important to talk openly about therapy and share accurate information. It can help combat reservations people may have about finding a therapist and getting the right kind of support.
If you’ve never been to therapy and you feel like something is holding you back, maybe it’s worth exploring if you believe some of the common misconceptions about therapy. Here are 8 common myths we’ve heard about psychotherapy (in no particular order), and truths that disprove them.
1. Therapy is for weak people
Maybe the most common myth about therapy is that seeking professional help means that you are somehow weak or flawed. Everyone goes through a rough patch from time to time; that’s part of life, and we don’t have to go through it alone.
But sometimes we try to do exactly that, afraid of what other people might say or what we would think of ourselves if we have chosen otherwise. The truth is that seeking therapy does not mean you are incapable of solving your own problems. Exactly the opposite! You are taking charge of your life by actively improving some parts of it with the help of a professional. You have enough self-awareness to realize that some things are not working the way you’d want them to. Instead of trying to prove yourself as tough, you are choosing to smartly and efficiently get where you want to be. You’re not letting fear hold you back. That pretty much sounds like the opposite of weak, doesn’t it?
2. You will be lying on a couch
Nowadays, this is very rare. Some psychoanalytically oriented therapists use this approach sometimes as a way to help the client speak more freely about their inner experience, but only if the client feels comfortable with it. Typically, a therapist’s office looks a lot like a living room, where you both sit at a comfortable distance, facing each other. Some therapists take notes during your visit (yes, as you’ve seen in movies :)), others leave that for after the session. It all depends on the therapist’s approach and style, and there are many different ones out there.
3. Therapy is mostly just you talking and the therapist listening. You can do that with a friend.
While support from friends and family is amazing, sometimes that is not enough to work through some challenges. Your therapist is a professional with years of training, educated to treat cognitive, behavioural, and emotional problems, and will use many different techniques to help you deal with them effectively. Because of their long training and experience, your therapist hears things differently than a non-therapist. For example, you may be upset about others not following the rules, and your therapist may hear a fear of lack of control. Or you may be upset that your partner is going out without you and making new friends, and your therapist may hear a fear of abandonment.
It may look like a casual conversation, but a good therapist is trained to ask intentional questions to help you have a better look at your experiences and emotions and link them together. Exploring deep parts of yourself in a safe, encouraging, non-judgmental environment with the guidance of a professional who is (or should be) unbiased is much different than talking to a friend.
Moreover, a therapeutic relationship is different from all the other relationships in your life. The most obvious difference is that the whole focus of the relationship is on you and your well-being Even when a therapist shares something from their personal experience, it’s you and your goals in mind. A therapeutic relationship is deeply psychologically intimate but also strictly professional. Usually, you can’t be friends outside of therapy (or, at least, not during the course of treatment).
4. You have to have a major mental health issue or be in a crisis to seek therapy
People come to therapy for various reasons. Indeed, some of these people battle serious mental health issues and might benefit from medication. However, the majority of issues people come with are what you’d call “everyday problems”. Examples include managing stress, navigating transition and change, dealing with grief, finding a work-life balance, overcoming fears, improving relationships, etc. Moreover, many people look for therapy as a preventative measure, or as a way to maintain their mental health.
5. You will have to talk about your childhood
Not necessarily, and not if you don’t want to. There is nothing in therapy you strictly HAVE to do. If you don’t feel ready, a good therapist will not pressure you to talk about your past. Learning about your childhood can help in understanding the patterns of thoughts, emotions, and behaviours you have now, the way you see the world, and the decisions you are making in the present. Our early experiences deeply and powerfully shape our beliefs about relationships, safety, and love. These beliefs further direct what we think we “have to do to earn” those things. Some of these beliefs and tactics serve us well, and some are inaccurate and unhelpful. Nonetheless, we carry them all into adulthood.
For example, if your caretakers encouraged you to “always put others first”, that being kind means accommodating other people’s needs, that saying “no” is rude and you earned punishment for that… you, as a child, quickly learned how to behave to gain their approval. Your nervous system shapes in a way that communicates: “putting others first=mom’s/dad’s approval=safety” and “boundaries and self-care=mom’s/dad’s disapproval=wrong, danger, abort!”. As an adult, you may tend to people-please, be an ‘overgiver’ in relationships, and struggle with setting boundaries. Even if you rationally understand that boundaries are important, your nervous system can still cling to the old patterns. This is why you may feel a knot in your stomach or your heart pounding when you are about to set some personal boundaries, even when you know it’s the right thing to do.
When you understand why you feel or behave a certain way in the present, where the root of the problem is, the path to change becomes clearer. You connect the dots, are more aware of unhelpful patterns in the present and are more able to replace them with more accurate, useful ones, that will serve you better right now.
6. Therapists have ready solutions for your problems and will tell you what to do
Although your therapist knows a lot about what is important for mental health in general, a path to good mental health can be different for different people. A therapist may be an expert in mental health, but the client is an expert in their own life. In therapy, they are two equals who bring their knowledge together to explore the issue and weigh options to find a solution that works well. A good therapist doesn’t work based on a ready-made formula, but tailors treatment around each client’s needs and goals. They won’t give you direct advice. Instead, they will empower you to identify and understand your blocks, and guide you toward finding what’s best for you and trusting your own decisions.
7. Therapy can solve problems in one or two sessions
Usually not. Just like you don’t get a six-pack after one or two sets of crunches, you most probably won’t completely solve the problem you came with after just one session. Therapy is a process. Sometimes it’s a short process, sometimes it’s a longer one, but worth the effort nonetheless.
8. You will always feel better after a therapy session
Many times, you will leave your therapist’s office relieved, hopeful, optimistic, joyful. Other times, uncovering your fears and insecurities, remembering your past, or facing your true emotions, can be a painful experience. Talking about something that has a high emotional impact can be stressful and leave you exhausted. Therapy encourages you to leave your comfort zone, and that is not always a pleasant experience. Sometimes, therapy is described as “a storm that leads into calm”. It is a process in which, at times, things become worse before they become better.
Thus, it is not surprising to, sometimes, leave your therapy session feeling drained. You need time to process and to let things you unpacked fall into their place. It’s part of the healing process. However, if after the majority of your sessions you feel worse, it’s important to raise this issue with your therapist.
Do any of these misconceptions sound familiar? What are some myths you’ve heard about psychotherapy? Please let us know in the comment section below.
Kottler, J. A., & Balkin, R. S. (2020). Myths, misconceptions, and invalid assumptions about counseling and psychotherapy. Oxford University Press, USA.
Wampold, B. E. (2019). The basics of psychotherapy: An introduction to theory and practice. American Psychological Association. Online HERE