Is It Pointless And Inefficient To Explore Your Past In Therapy?
There's an argument that it's unnecessary and needlessly time consuming to focus on your past in counseling. You'll hear things like:
- "It's better to work on coping with your problems in the here and now."
- "The factors that kicked off your issues long ago, and what's keeping them going today are totally different."
- "Even if you uncover the root cause of your anxiety or depression, that insight won't magically cure anything. Dwelling on the past is pointless navel gazing."
- "Even if exploring your past could help, it would take way too long. You'd have to go to therapy twice a week for seven years or something. There are better ways to use your time."
- "Investigating the past is a relic of outdated types of therapy, like classic Freudian psychoanalysis. That's what counselors used to do when they didn't know any better. Sometime in the 1970's modern treatments came to the rescue, which are all about learning practical skills you can use going forward."
I don't think it's automatically a waste of time to work on your past in therapy. I'm not saying counseling should exclusively be about your childhood, and anything focused on the present or future is misguided. It's not that black or white. I just want to push back against the idea that considering the past is totally unnecessary.
There are effective therapies that delve into the past
There are established counseling methods that put a lot of focus on the past, and can get good results. It isn't only the realm of dusty old Freudian techniques.
- Therapy that helps clients emotionally process the traumatic or upsetting life experiences that contribute to their current issues. Often a client will know exactly what difficult events from their past fuel their present day problems, and it's a matter of getting to the hands-on processing work as soon as they're ready for it. At other times they won't be as in touch with what old events play a part in their current problems, and they can work with their therapist to figure that out.
- Therapy that helps clients uncover the unconscious motivations behind the self-sabotaging behaviors or emotions they can't seem to stop doing. Often these unconscious motivations comes from faulty "life lessons" they drew from experiences they had growing up.
If you can get some fairly quick relief through practical, present day coping strategies, it totally makes sense to focus on that first... but it doesn't always work
Some people say, "Sure, working on your past might help, but it's hard to say if or when it will pay off. It's better to learn some hands on ways to feel better day to day, or figure out how to change your behavior going forward. Once you're in a better place then you may not even need to poke around in your childhood."
That's a sensible point of view. If you're struggling with anxiety, learning some relaxation techniques or making some mood boosting lifestyle changes can have a big effect fairly quickly. If your nerves are mild that may be all you need to make them go away. If you have social insecurities you may be able to reduce them by spending a few months gradually facing the situations that make you uneasy. If someone feels awkward around their classmates they could learn some new conversation skills. If you're always procrastinating at your job, you may be able to turn things around by reading one good book on time management techniques. It's a good idea to try stuff like this before poking around in your life history.
Sometimes that all works. At other times you get a bit of relief from your problems, but not quite enough. Like your anxiety isn't as frequent or intense, and you're better at dealing with it when it pops up, but it's still there. It still limits you more than you'd like.
What can also happen is you try to put practical, here-and-now steps into place, but keep stalling out. Like you might try to slowly face your fears, but you can't get beyond the first few steps. It all feels too scary, no matter how much willpower or self-compassion you try to muster, or how often you tinker with your exposure hierarchy. Or you could try a dozen different productivity systems, but some mysterious inner force makes you keep putting everything off until the last second.
By all means, try to implement some non-past oriented solutions to your issues, but if you've maxed out on them and still feel like they're not helping enough, then it can be useful to figure out what's really at the heart of things. If some scar from your childhood is producing a steady stream of anxiety, just trying to cope with the symptoms may not be enough.
If traumatic experiences from the past are clearly feeding your current distressing moods, you may have to emotionally process those events to get full relief from them, but that work can be difficult. Trauma therapists help their clients learn hands-on coping methods first, so they have the tools to handle the upsetting emotions the processing stage may bring up.
It's true that dry, intellectual insights often aren't that helpful
There's this idea that when you explore your past in therapy the goal is to arrive at insights about why you are the way you are. Supposedly just having these insights will instantly rearrange your mind and make your problems disappear. Critics disagree with that premise and say insights alone won't fix anything, so spending years looking for them isn't a good use of your time or money.
Yes, abstract, intellectual insights usually won't change much. Say someone's been feeling depressed their whole life and you tell them, "Well it's because your parents were decent people, but a bit emotionally checked out, and as a kid you interpreted that to mean you don't matter." They may disagree, but if they're open to the idea they'll probably say something like, "Yeah... that's an interesting possibility." Even if they think it may be true, it just hits as abstract information. It's nice to have a sense of where things started, and that may provide some direction for further work, but there's no instant cure.
Every so often a client will have an unconscious motivation from the past driving their issues, and when they uncover it in therapy things do shift rapidly. For example, someone may not know why they procrastinate, and with their counselor they uncover that as a kid they got rejected for being a teacher's pet, and started slacking off to fit in. This reasoning of, "I have to procrastinate, because if I'm too on top of things everyone will hate me" was totally out of their awareness until then, so their mind just followed it without question. Once it's out in the open they see it clearly makes no sense and they don't have to keep following that rule, and the problem resolves. Though like I said, this doesn't happen all the time. Many mental health issues or insecurities have more behind them than one unspoken, unconscious piece of Kid Logic.
Often the goal of past-focused therapy isn't to learn about your history on an intellectual level. It's to get in touch with it emotionally, then work through those feelings. To go back to a previous example, let's say it's true that a client is depressed because his parents were emotionally distant. Let's also say he's not tuned into how that made him feel as a kid. If someone's childhood was mostly good, but still lacking in a few ways, it's really common for them to repress their actual reaction to the handful of bad moments and think everything was great. So just hearing a therapist's hypothesis won't change anything. But if they can finally tap into their walled off feelings of feeling worthless and neglected and properly deal with them, that may make a difference.
Past-focused therapy doesn't always have to be drawn out and meandering
The popular image of therapy that works with the past is some sort of classic psychoanalysis, where the client spends endless sessions free associating with little to no feedback from the therapist. Maybe after years of thrice-weekly appointments they get somewhere.
Sometimes trauma processing work can go quickly. That's most likely if it's a fairly straightforward, isolated trauma, and the client is in a good headspace to do the work. However, for the more complex trauma that comes from an all around crappy childhood, not just one upsetting event, therapy can take a while. It requires time for the client to trust the therapist, to build up their emotional coping skills, and work through everything at a pace they can manage.
If a therapist is trying to dig up past baggage and unconscious motivations, there are techniques that sometimes uncover it quite quickly, sometimes in as little as five minutes. It's not always that easy though. At times it does take some patience and open-ended exploration to find out what's at the core of an issue, but it's not automatically an endless, expensive process.
Some mental health issues aren't caused by the past, but it can still play a role in them
Mental health conditions like Bipolar Disorder and schizophrenia are widely considered to have a biological cause. It doesn't matter how much therapy you do, Bipolar Disorder is an inherited difference in brain chemistry, and isn't going to go away just by talking about it. The main goals in treatment should be finding the right medication and managing the symptoms. Putting that off to analyze your childhood would be irresponsible.
Though that's not to say life history can be ignored entirely in these cases. It's not like everyone with Bipolar Disorder has had a perfect past. If anything, growing up with a serious mental health condition, and maybe having family members with it as well, will make your upbringing more stressful. If someone with Bipolar Disorder has bouts of depression, that's partially down to the condition, but it may also be amplified by their old struggles. Working through some childhood scars may lower the intensity of their depressive periods.
Other mental health problems like Panic Disorder or PTSD from a recent accident may also not be rooted in someone's upbringing. Someone may have never struggled with anxiety, but then had a panic attack during a really stressful period at work. Once they had that first terrifying attack they're now afraid to have another one, and it cripples their life. Once more, it's reasonable to start with here-and-now approaches to teach them anxiety coping techniques, help them learn not to fear and avoid panic, and so on.
However, sometimes conditions that seemed to start recently have a foot in the past too, and that makes them stronger and more difficult to treat. Someone may rearrange their daily routine because they're scared of having more panic attacks. Partially that's because panicking feels awful on its own and avoidance is self-reinforcing, but their symptoms may also be amped up by childhood wounds around feeling weak, unsafe, helpless, and believing everyone is judgmental and unsympathetic toward those who are struggling.
Some people have a panic attack, and they hate the experience, but they go on with their life. They're not disabled by a preoccupation with it happening again. It raises the question of what may be in someone's past if they get so affected by one.
Sometimes when people say they don't want to waste time digging into their past they know on some level it could be useful, but have fears about what it would involve
I'm not saying everyone who's skeptical about exploring their past in therapy believes deep down it could be helpful. I think on occasion people have an inkling they need to do some work around their childhood, but don't want to rock the boat. Here are some common concerns:
- They'll uncover something that damages their view of their childhood and parents - They may believe they had a good upbringing, and don't want to realize it wasn't as great as they thought it was. They don't want the pain and grief of accepting their parents maybe meant well and mostly did a decent job, but still let them down in a few key ways. It can be uncomfortable to acknowledge your parents weren't perfect, but it can still be a necessary, useful step in your healing. It doesn't mean your relationship with them will be ruined, even if you don't idealize them as much as you used to.
- The therapy will stir up a bunch of drama in their family - For example, the therapist will encourage them to play the victim and blame all their problems on their mother, and then pointlessly confront her about it. Sometimes getting more clarity about your past will shake up your relationships and cause conflict (e.g., you finally admit how toxic your father is, and realize you do need to limit contact with him). However, a good therapist won't encourage you to pointlessly be a victim and blame everyone for your troubles.
- The work will unearth some painful, repressed secret that will send their life into a tailspin - This can happen, but it's relatively rare. Even if something does come up, if it's in therapy you'll be already in a good position to address it.
- They'll create a false memory, and then hurt people by acting on it - This has famously happened in the past, but trained therapists these days know how to steer clear of false memories. They tell clients that if they seem to uncover a long-repressed memory that they can't know for sure whether it's real unless they find some outside evidence for it. Especially for things that happened when we were really young, the mind may not have a specific, detailed memory, just a vague sense of what happened. Their mind may create a "memory" that's not accurate, but captures the essence of how they felt at the time. For example, as a toddler someone had to be rushed to the hospital by ambulance, but they don't recall the actual sequence of events. They just have stored a sense of the fear, confusion, and feeling of being snatched away. In therapy they have a sudden "memory" of being kidnapped and thrown into a van. Again, a responsible therapist will help their clients sort through what comes up.