Worries Or Misconceptions People Can Have About Psychotherapy

In another article I talk about how it could be an option to see a counselor for help regarding your issues. My opinion is that counseling is just one way to seek outside support, and that there's nothing weak or desperate about it. I hardly think every last person has to do it, but at least the choice is there . Some people hesitate to consider seeing a therapist because they have fears or misconceptions about what counseling involves. This article will cover some of the common ones. I'm a counselor myself, so many of these are worries I've seen in clients firsthand.

In a related article I talk about some of the misconceptions people can have about therapists themselves.

Just a quick note: In this article I use 'counselor/counseling' and 'therapist/therapy' interchangeably.

Therapy is only for really messed up people who have run out of options

People with more "mild" concerns see counselors all the time. A young office worker may want to talk to someone about her niggling feelings of career dissatisfaction. A married couple may visit a psychologist to get some quick pointers about parenting. There's no rule that says your problems have to cross a certain severity threshold before you can see a professional. As I was saying a second ago, talking to a counselor is just one more avenue for seeking help. In many cases it can even be more effective to see someone about a problem when it's still relatively mild. You can nip it in the bud while it's lower-intensity and more responsive to an intervention.

Therapy is just weird and scary

People who have never been to counseling before often have this vague fear. They don't know what to expect. Even if they can't point to a specific concern they have, they're still uncomfortable with the unknown. Once they get started, many people find the process isn't nearly as bad as they imagined. It's mainly just sitting down and talking to someone.

Therapy involves lots of odd techniques

You can blame movies and TV shows for this misconception, probably because you can wring more entertainment value from a scene of a shrink trying to use some wacky, out of touch exercise. Your average counselor doesn't use Rorschach ink blots or dream interpretation. Within a minute of you sitting down they probably aren't going to pull out a puppet, hypnotize you with a pocket watch, ask to speak to your inner child, or suggest you confront an imaginary version of your mother who's sitting in an empty chair.

It's hard to say what exactly a "typical" counseling session is, but they're often a lot more mundane, and just involve supportive listening, problem solving, and maybe teaching some practical skills. That said, there are types of therapy that use seemingly strange methods, like having someone role play a conversation with their inner critic. Many clients actually find this stuff more useful than they originally would have thought. It can help them unearth things that a more straightforward conversation can't.

If you see a therapist, they'll just want to put you on a bunch of drugs

Medication is an option is certain cases. It can be effective, especially if it's done in combination with counseling. However, it's the client's decision about whether to take anything. There are also many situations where drugs aren't appropriate or necessary. It's not standard operating procedure for every therapist to listen to their client for five minutes and then go, "Yep, well it sounds like we need to dope you up into a zombie-like state so you don't feel your feelings anymore." Also, not every type of therapist even has the ability to prescribe drugs.

Therapy is mainly about exploring the past and unconscious conflicts

A lot of the portrayals of therapy in the media are based on classic Freudian Psychoanalysis, which emphasizes delving into the past and the client's unconscious conflicts (e.g., the therapist saying, "Tell me about your mother", Oedipal complexes, etc.) Most mental health professionals don't practice from that exact school of therapy anymore, though some modalities are focused on the past and the unconscious. However, a lot of counseling methods focus on the here and now, and in finding practical ways to tackle current problems in the client's life.

Both past and present-oriented approaches can be helpful. It doesn't have to be an either-or choice. It often comes down to the client's reason for attending therapy. If a man in his late 40's sees a counselor because he's had a string of failed relationships with drug addicted partners who he's tried to rescue, it would be quite reasonable to look into his past, to see what formative experiences and unresolved childhood baggage may be driving him to keep playing out the same pattern. However, another client may have developed a fear of driving after recently getting into a bad car accident. In this case many counselors would say there likely aren't any relevant past issues to go into. The client has become fearful of driving for a pretty clear cut reason, and they need some help processing that trauma and learning some straightforward strategies to regain their confidence behind the wheel. Only if they're still struggling after doing those first line treatments would the therapist try delving into their past to see if the current anxiety is tied into something older.

Related: Is It Pointless And Inefficient To Explore Your Past In Therapy?

Therapy goes on forever

This is another misconception that comes from equating all therapy with Psychoanalysis, which is notorious for lasting for years and years. Therapy can be much more brief. Again, it depends on why someone is attending counseling, but for some issues a client may feel they've gotten all the help they need after a handful of sessions. For example, a happy couple may see a marriage counselor for some quick advice on resolving conflicts, to help them "tune up" their relationship. Or a student might talk to someone a few times to deal with the temporary stress of switching majors. Also, there are ethical guidelines that strongly discourage counselors from keeping clients around long past the point that therapy is useful for them.

A more practical reason why therapy doesn't always go on forever is that depending on how you access it, there may be a limit on how many sessions you can attend. For example, if the cost is being covered by employee benefits, you may only be able to go for eight sessions. If you're going to your university's free clinic, you may have a similar limit on how many appointments you can have each semester.

That all said, sometimes therapy does have to take longer, and not because it's some drawn out, inefficient scam. Some more-severe issues, like undoing the damage of an abusive childhood, unfortunately just take time to resolve. Also, therapy can stretch out if the client addresses a string of problems, not just one.

Therapy involves laying down on a couch

...and one more we can thank images of Psychoanalysis for. If you go to see a therapist these days you're almost certain to do it sitting in a regular old chair.

Therapy is about the counselor quickly trying to figure out if you're "crazy"

Some people worry that if they go to counseling the therapist is going to tell them they're crazy. Firstly, "crazy" is loaded word with a negative, judgmental connotation. Counselors aren't there to judge anyone. Secondly, "crazy" doesn't really mean anything. It's certainly not a technical term. No one gets diagnosed as it.

If someone does have a particular mental health issue, it will be thought of in more specific terms. If their mood shifts between crippling depression and self-destructive elation, they may have a type of Bipolar Disorder. If someone's become housebound because they're worried they'll freak out if they go outside, that may be Panic Disorder with Agoraphobia. Maybe someone doesn't have any kind of officially diagnosable condition, but the therapist sees they have trouble controlling their anger and trusting others. Whatever the issues, just labeling someone "crazy" doesn't have much point.

Therapy can fix another person for you

It's not uncommon for parents to bring their "problem" children or teenagers into therapy, with the expectation that the counselor can fix their kid for them. Most of these parents mean well, but other people aren't like appliances, where you can just bring them into the shop if they aren't working the way you'd like them to. What often happens is that the child in question doesn't see things the way their parents do and isn't keen on being treated, so the sessions go nowhere. Therapists have some tools for connecting with and motivating reluctant clients, but they can't magically make anyone do anything. Not to mention that the counselor may not even agree with the parents' view that the blame lies entirely in the child. A similar dynamic can play out in couples counseling, where one spouse may want the therapist to talk some sense into their "unreasonable" partner.

If you have anxiety, therapy could make it way worse

Someone may worry that the process of therapy will challenge and push them, and could send their anxiety spiraling out of control. I go into more detail in the article below, but generally that's not a big risk. Counseling can create some short-term, manageable stress, but won't push a typical client over the edge.

Could Therapy For Your Anxiety Make It Worse?