Things You Should Know About Therapy, prt. 2

things you should know about therapy -- guy talking to psychiatrist

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Therapy may often feel ineffective

When you go to counseling, chances are good you will expect it to be something other than it is. Some people expect very little to happen. Others expect it to “fix” their problems. Many people think therapy is about getting “advice.”

But therapy is unique. It’s not like talking to your mother-in-law, or seeing a doctor who will fix you.

You go into therapy with certain beliefs about who you are and how the world works, or should work. Chances are good some of these beliefs are flawed, unreasonable, even downright wrong, and that is probably why the actions you take based on those beliefs doesn’t work. Faulty beliefs about yourself and the world lead to faulty emotions, which lead to faulty choices and actions, which have negative consequences. Those consequences are likely the reason you came to therapy in the first place.

Therapy can often feel ineffective because

A good therapist will often not address the symptom(s) directly,

but instead will help you identify the faulty patterns of thinking that have led to your discomfort.

If you are unable to see the connection between your faulty thought patterns and your discomfort (therapists call this “poor insight”), therapy may seem ineffective or pointless.

Therapy may feel ineffective if you expect the therapist to “fix you.”

A therapist’s job is to spend enough time with you that he/she can come to understand how you experience the world. If you don’t allow the process time to work, therapy will seem pointless to you.

A client in a bad marriage once said to me, “I’ll give you two minutes to tell me what’s wrong with this marriage and how to fix it. Ready? Go!”

I’m sure that client walked away convinced that therapy is a scam, though I made the reasonable point that no therapist can unravel in two minutes a mess the client has spent thirty years making. (His attitude gave me a pretty good idea of some of the things that might have been troubling his marriage.)

Ironically, therapy will often seem ineffective if you reflect on each session and try to nail down specifically what was “accomplished.”

Can you imagine doing this to your marriage every day, going over every detail to determine whether your marriage was “effective” that day? Of course not! Yet you are correct to presume your marriage is moving in some direction, one way or another.

Though intentional and frequent evaluation can be good for situations where you are attempting to solve a particular problem, it is generally not good if you are in a process where the therapist is trying to help you develop insight into your problem.

In that case, your difficulty seeing the problem clearly is your problem!

If you cannot clearly see the problem, you will be unable to judge whether any particular session was effective or ineffective.

What matters is your willingness to consider your therapist’s words and ideas, and allow them to influence, and slowly begin changing, your thinking.

This will always be imperceptible at first, but will become clearer and clearer as you progress.

This is why it is critical that you trust and respect your therapist.

He/she may have to lead you down paths that are unfamiliar, even scary, to you. If you don’t trust them, you will not venture forward, and no growth ever comes by standing in place.

A good therapist will always respect where you are in your ability to trust them and not demand that you constantly take steps that exceed your level of trust.

A final reason therapy may seem ineffective is because

Clients often do not know who the client is.

The client is always the one sitting in front of the therapist — not that person’s spouse, boss, child, etc.

If you seek counseling, prepare to focus on yourself, not someone else.

Another party may well be involved, and perhaps even substantially responsible for the problem, but a therapist can only work with the one sitting in the counseling office.

A few disclaimers:

1. All points in this series assume that the therapist is competent and effective. Granted, that is a fairly generous assumption, since good therapists can be hard to find.

2. Be aware that insurance companies generally don’t pay for therapists to help clients develop “insight.” They want a six-session “fix” to every problem and that is simply not possible. Insight is critical because it is often impossible to fix what one cannot see, and insurance companies do not acknowledge or understand this reality.

3. Finally, on insight, it is important for the client to realize that the problem that may be nearly impossible for the client to see may be glaringly obvious to the therapist and often others in the client’s life. I’m not necessarily talking about some deep, mysterious phenomenon knowable only to the therapist. Nearly every therapist has had a client who sits red-faced in the office, screaming “I AM NOT AN ANGRY PERSON!!!!” Though their problem is apparent to everyone around them, they are unable to see it.

Please note: I reserve the right to delete comments that are offensive or off-topic. A request for me to defend some of my comments does not obligate me to do so.

  • Mark Glubke

    Excellent work, David. I completely agree with you, and am really enjoying your blog.

    • Thank you, Mark. I appreciate your words, and would be so grateful for shares, links, and any other “evangelism” you can do on behalf of the blog.