Many people have a perception of talk therapy that doesn't quite match up to reality. If you think therapy means lying on a couch with a box of tissues and paying top dollar to talk to someone who doesn't quite get it, or that it's only for people who are mentally ill, think again.
It turns out that most people could benefit from therapy -- but it takes work on your part, a therapist who meets your needs and really does understand you, and as much time as it takes -- at your convenience and within your budget -- to make a difference.
An expert psychologist and a psychiatrist explain the top 7 misunderstandings that people have about therapy -- with a dose of reality tossed in.
My childhood doesn’t matter.
Most people start therapy because they have an issue in their adult life that they want to talk about with a professional. Whether it’s job trouble, relationship turmoil, or struggles with children, it’s not today that needs fixing -- it’s the way you relate to your past.
“Your relationship with your parents and your childhood are immensely significant on your life today,” says Jenn Berman, PhD, a marriage, family, and child therapist in private practice in Beverly Hills, Calif. “Most people think that in order to have been affected by their childhood they needed to be abused in some way. But it’s never that black and white. ”
Sometimes, it’s the seemingly simple act of being misunderstood by your parents as a child that can have a tremendous impact on your adult life. And it's just not some people who need to dig up the past -- it’s everyone.
“One hundred percent of people who seek help in therapy have issues that relate to their childhood,” says Carole Leiberman, MD, a Beverly Hills, Calif., psychiatrist. “Certain expectations and behavior you have in your adult life come from childhood, and could cause a person to have to trouble today.”
All therapists are the same.
Not even close, Berman says. There are different types of therapists and different types of therapy -- such as cognitive therapy, which engages a patient to identify, challenge, and then change behavior that causes issues in his life; and psychoanalytic therapy, which deals more with how the subconscious influences behavior.
“Don’t think that whoever you meet with first will be the right fit for you,” says Berman, who hosts the Love and Sex Show with Dr. Jenn on Sirius/XM radio. “Shop around for the right person.”
Her advice is to talk to a half-dozen different therapists as a good benchmark and then pick the expert that best meets your needs.
Look for someone who is a licensed therapist, with expertise in the area in which you are seeking help -- whether it's marriage counseling, traumatic stress, or eating disorders, for instance -- and someone with whom you just have good chemistry and have a sense of comfort.
I don’t need therapy, just drugs.
“This is never the answer,” says Leiberman, host of Internet radio show Dr. Carole’s Couch. “If you need medication to treat your mental health issues, then you definitely need therapy as well.”
The medication, she says, is just a bandage. Without therapy as part of your treatment plan, you run the risk of just covering up your symptoms and not treating the underlying issue.
“Therapy is what gets to the root of the problem,” Leiberman says. “It’s talking about a person’s issues, learning more about where they stem from, and understanding and treating the cause.”
The real value to your mental health comes from uncovering your issues, gaining insight into what went wrong, and then starting to look for a better path forward, Leiberman says.
It’s not going to work.
Though almost anyone could benefit from a good dose of professional discussion about the state of their mental health, many people are doubtful it will do them any good.
“Lots of people have misinformation about therapy,” Berman says. “It’s not a passive experience in which you can come in, talk, leave, and get better. It only works if you work at it, and if you are an active participant in making a difference in your own life.”
Fear also plays a role in creating skepticism about the value of therapy for some people.
“When people are resistant to therapy, they are generally afraid,” Lieberman says. “They know there are issues they need to deal with and they are fearful of addressing them, which creates a barrier that comes through as, “It’s not going to work.”
But once a person overcomes the fear and starts to engage in the process, Lieberman says they’re headed in the right direction.
It’s too expensive.
You don’t have to always pay top dollar for expert help.
“Many universities and colleges with mental health programs are associated with clinics where their students train -- and don’t get paid for their time,” Berman says.
In order to be licensed, she says, the students have to do a minimum of 3,000 clinic hours under supervision. So it’s like getting two for the price of one, except it’s low-cost (or free) in some cases.
“They’re being graded and judged on how they treat you, and a licensed professional is guiding them in the background,” Berman says. “So the care you are getting is actually very good.”
Health insurance companies also provide some mental health coverage, but whether a therapist takes insurance varies. If they don’t, many offer sliding fee scales based on income for people who need help but can’t afford it.
“Most therapists are do-gooders,” Berman says. “They want to help people, so if someone needs care but can’t afford it, you can usually negotiate a fair fee.”
It’s going to send me over the edge.
Think talk therapy and rehashing the past is going to overwhelm you and push you over the edge? In all likelihood, that won't happen.
“Lots of people think that the pain of therapy will be so overwhelming they will lose it,” Lieberman says. “A good therapist knows how far each patient can go at a particular moment and when to pull back.”
Therapy isn’t an instant fix. It's done in spoon-sized pieces that are as much as a person can deal with at the moment.
“People are skittish because they sometimes think therapy is like walking around with an open wound,” Berman says. “But it’s important to remember that you are in charge of guiding how far you want to go, and when. And again, with the right therapist, you’ll work together to find an appropriate pace that meets your needs and makes you feel safe.”
I don’t have time.
In this day and age, this misunderstanding falls flat.
“These days, you can easily find a therapist who will see you on the weekends or during evening hours,” Berman says.
Therapists know that some patients are strapped for time, so off-hours are a must she says. And it’s not only flexible time that therapists offer; they leverage technology, too.
“If you can meet with a therapist face to face, and establish where you need to go, many will even have phone sessions, or talk over video on the Internet,” Berman says. “While in-person is ideal, we do what we have to do.”
