What Therapy Isn’t

There are many myths involving what actually happens in a therapy session. I think that some people actually believe all that feel-good nonsense they see on daytime TV talk shows, and expect their visit to be an instant cure for whatever ails them. Well, it’s not quite that easy. Based on my experience, I’ve put together a Top Ten list of assumptions about therapy — all of them wrong:

1. Talking, regardless of what it’s about, is enough to solve problems. Sorry, not true. In counseling, the goal is to learn to think objectively about reality in order to solve problems. We call that ‘solution-focused.’ Talking about your feelings can be a good thing, but it shouldn’t be the main objective. To solve problems, you have to think.

2. A therapist is like a friend or a family member. On the contrary. Your relationship with friends and family members is generally a two-way street. When you talk to a friend or spouse about yourself, you usually expect the same in return. You should not expect that from a therapist or counselor. Quality therapists don’t talk about themselves. They exist to talk with you, about you.

3. A therapist can give a person a reason for living. No, only you can do that. If you’re looking for a goal or a focus in life, I recommend something that’s better than self-help books or daytime talk shows: Reading or watching biographies. It’s a great way to learn how others survive, thrive, make mistakes and sometimes conquer obstacles. These glimpses into other people’s lives can not only provide ideas, but may also inspire.

4. Talking about yourself will instantly reduce the symptoms of emotional distress. Wrong again. Anxiety or emotional problems cannot be permanently resolved without first working to discover the underlying causes. If the client and the therapist can successfully uncover those causes, relief can be virtually immediate. Stress reduction is always desirable, but in matters like self-esteem, relationships, career and life in general, it might take a while to get to the root causes. Frankly, this is true whether you go to a therapist or not.

5. A person can benefit from therapy without bothering to identify contradictory thoughts and desires. For example, ‘I never want to make Joey angry, but I also don’t want to give him money that I know he’ll use for drugs.’ Well, you can’t do both of those things. Another example: ‘I want to please everybody and be liked by everyone; but I also want to do what’s important to me.’ Sorry, these two needs will eventually conflict and you’ll have to make a choice. A major purpose of cognitive therapy is to help people identify (and hopefully correct) conflicting ideas. It’s not always easy, but logic and facts will work every time.

6. A therapist makes the client lie down on a couch. Y’know, I’ve been in this profession for twenty years, and I’ve never encountered such a thing other than on television and in the movies.

7. A therapist constantly takes notes during the session. Not all do. Personally, if I were the client, I wouldn’t want the therapist writing while I’m talking. I’d want him or her to listen, offer objective feedback and ask intelligent questions. To me, taking notes is not the same as listening. It implies that you’re writing a report to be filed somewhere. How can that cultivate a helping relationship? Of course, others might disagree.

8. A therapist is selfless and has no concern for anything material or worldly. Wrong again. Believe me, you don’t want a therapist who doesn’t have a life. An unhappy person can’t help you. That also applies to brain surgeons, eye doctors, accountants, real estate agents, postal clerks, janitors, airplane pilots — just about anyone from whose efforts and services you hope to gain. It’s probably more true for a therapist because you’ve actually hired him or her to help you achieve happiness.

9. A psychotherapist can prescribe medication. No, a therapist has earned either a Master’s degree or a Ph.D., but not necessarily an M.D., and as such does not write prescriptions. Psychiatrists have medical degrees, and prescribe medication for mental illness, stress, anxiety and depression. Prescribing medication is not psychotherapy.

10. A therapist can “talk” an irrational or self-defeating person “into” being well adjusted, even if that person doesn’t want to change. This is probably one of the biggest myths about mental health. Reason and persuasion are the only ways of convincing someone to do something by using their minds. But if somebody doesn’t want to be reasoned with or persuaded to think in a certain way (for example, where psychotherapy is ‘court ordered’), there’s no amount of talk, pills or magic that can convince them to change their thinking. Therapy isn’t something that’s done ‘to’ you, like an appendectomy. It’s a partnership between the therapist and client to help change and improve the client’s way of thinking.