Updated: Feb 10
3 truths and 3 misunderstandings about what it's actually like to go to therapy.
Written by a licensed psychotherapist, here are some common truths and misunderstandings about what actually happens if you decide to see a mental health therapist.
All too often as I've traveled around Asia, and especially here in Vietnam, one of the first reactions I get from people when I tell them I'm a psychotherapist is: 'oh, so you know what I'm thinking right now?' Of course the answer to that question is: 'no! I'm not a mind reader.' I still wonder how that became such a common belief. This is just one example of the different stigmas (negative beliefs) about counseling or psychotherapy. Another stigma in some parts of America, for example, is more about being embarrassed or ashamed of the idea of going to a stranger for help.
I hope at least part of what this article might help to do is bring some awareness to these populations about the realities of therapy. Let's break this down and take a look at what therapy is, and is not.
THERAPY IS NOT READING YOUR MIND:
1) Ok, this one is kind of obvious, but apparently needs to be said: Therapy is not about reading someone's mind. If you choose to go to therapy, the only things your therapist knows about you are the things that you have already shared. Your therapist is not trying to manipulate you or trick you in any way. Your therapist wants you to feel better and the relationship is transparent (open and honest). Once the relationship between you and your therapist develops, over time, your skilled and qualified therapist will begin to understand more clearly your values, why you make the choices that you do, and how these choices are impacting your relationships. One of the cool things about therapy is your therapist does gain access to your inner world, eventually understands you and your values, and can help you keep things in perspective when you feel lost. One thing you don't have to worry about is your therapist being somehow inside your head and knowing what you're thinking. If your therapist could read your mind, would this be such a terrible thing? Yes, ok, you're right, it would! Anyway, your therapist is on your side and wants what is best for you.
YOUR THERAPIST IS A REAL (FLAWED) PERSON:
1) A good therapist is authentic, real, and human. Your therapist may make mistakes. Your therapist won't know everything. Your therapist shouldn't hide behind a wall of diplomas. Your therapist should know how to say 'I don't know.' or 'let me think about this.' Your therapist should be very cautious about giving advice, because what they would do in a situation isn't necessarily what's best for you. A qualified therapist will have good intentions and acknowledge their limitations. They won't ask you to put yourself in a situation that might be harmful or dangerous, and there is always professional boundaries between the therapist and the client. So a therapist likely won't be attending your wedding (although exceptions are often made), or there won't be a therapy session over dinner and drinks. The relationship should feel like a professional partnership. Two people authentically navigating this crazy thing called life. Certainly, your therapist should never bargain with you for payment (offer therapy services in exchange for something you might provide), nor should a therapist ever suggest any type of more intimate relationship. If something like that should happen, the client should strongly consider terminating the relationship immediately. It seems like a no-brainer, but just like in any profession, there are some good therapists and some that are not. For example, in California, it is suggested at the beginning of therapy that the therapist give the client a pamphlet entitled 'Therapy Never Includes Sexual Behavior.' Crazy!
THERAPY IS NOT ELIMINATING YOUR PROBLEMS:
2) Therapy is not about eliminating a client's problems. For many therapists, there have been times a client has come to therapy and immediately stopped coming, even after only one session, because they leave the session and nothing has changed. Recently, a client of mine came into the first session and went through the list of things that are wrong, and when it became clear to the client that I had no ways of eliminating these problems, I received the surprised and bewildered look of a deer in the headlights. I can only imagine the client's inner dialogue in that moment: 'I'm paying this much money for this and he isn't going to fix these problems?!' A therapist doesn't have a magic potion or isn't able to snap their fingers and make your problems disappear. What they can do, is help you understand how you're interpreting these problems, what you're doing to manage them effectively (or ineffectively), and then help you acquire new perspectives, skills, and tools so you can start feeling better. Freud once said something like: 'The best possible outcome of therapy is normal human suffering.'
THERAPY IS A LIVING THING:
2) Therapy should feel alive. Sometimes the most helpful moments are ones that are highly charged (emotional), intense (strong feelings), or thought provoking (gaining insights) . If your therapy experience feels boring and shallow and you're just talking about your day, or even worse, talking about your therapist's day (haha), then that's a problem. A good therapist does much more than just listen with a blank face and ask 'how does that make you feel?' Although there is a time and a place for this question (for example, if a client is avoiding certain feelings), a therapist is often more concerned about how you're functioning than how you're feeling. In other words, what is at the heart of your relationship challenges? What is beneath your questionable choices? What is this experience bringing up in you? A good therapist should feel like a partner who collaborates with you on how to best deal with life's challenges. A therapist can be like a guide, offering a roadmap on how you might approach your difficulties. Therapy should feel authentic, raw, vulnerable, and alive!
THERAPY IS NOT EASY:
3) Therapy ain't easy bro! A skilled therapist will likely challenge you with difficult questions that require you to be brutally honest with yourself. In addition, therapy will probably bring up painful feelings and emotions that you would rather not deal with. It is learning how to work with these difficult feelings that is one of the biggest benefits of therapy. Therapy requires work. The therapist may give homework and suggestions that need to be practiced. If a client comes to therapy expecting the therapist to do to the work, the client will likely end therapy too soon and be disappointed in the result (or lack thereof). Some of the most helpful things we can do for ourselves are very simple in nature, but not easy. One of the most healing things that can be done is allowing oneself to be completely vulnerable in the presence of another. This brings up all kinds of things, not the least of which is feeling the vulnerability of intimacy and the fear of rejection. When we can practice acknowledging and learning about these fears and difficulties with a therapist, it allows us to gain the confidence and skill to do it with others.
THERAPY IS PARADOXICAL:
3) A paradox means the opposite of what we think to be true is actually true. In other words, a paradox is a statement (or assertion) that is true, even though it seems to be false. An example might be: to become whole, one must empty oneself (spiritual paradox). Or another example: The way out is through (psychological paradox), which means the way out of the pain is to allow it to move through you (turn towards the pain instead of avoid it). What we've learned so often in life is that so many things are out of our control. We try to control our conditions (find the right relationship, get the right house, and the right job), and then we still end up dealing with pain, dysfunction, and relationships that suck. We seek therapy to learn how to surrender to life as it unfolds, instead of clinging to how we think it should be. So it is often in surrender (this doesn't mean giving up), that we find freedom as opposed to control. Similarly, it is in turning toward difficulties instead of avoiding them that finally opens us up to the parts of us that need attention. Paradox can mean doing the opposite of what we initially think we should do. One of my favorite quotes about paradox is from Carl Rogers: ' The curious paradox is that when I accept myself just as I am, then I can change.'
I hope this article is of some use or benefit to you. I am a licensed psychotherapist in California and Vietnam. Please email me if you want to explore how psychotherapy might help you feel better.