"The unexamined life is not worth living." -Socrates
Can therapy be addictive? You bet. But so can watching TV, exercising at the gym, body piercing, tanning beds, and cosmetic surgery. Just about anything that feels good (and even a whole lot of things that feel bad) can be used to excess.
For certain, some people use therapy as a needless crutch, regressively frittering away the years in aimless self-analysis and interpersonal dependency. At the same time, plenty of people have broken emotional legs and need a supportive crutch in order to heal properly. So how do we know when therapy should end? That depends on what you think therapy is good for.
Psychotherapy exists at the intersection of medical and wellness approaches to health. In a medical model, prescriptive interventions target the elimination or management of discrete disease entities. Identify the problem, use a measurement system for determining progress and success, and implement the most effective and least intrusive solution. A wellness approach, however, is an ongoing process for the development of positive lifestyle habits. Individuals are encouraged to take responsibility for their own health and well-being, though they may make use of ongoing guidance from experienced and knowledgeable mentors. In a wellness model, the aim is to improve social, occupational, intellectual, emotional, and spiritual functioning.
Psychotherapy can treat medically identifiable diseases such as depression or bulimia. Therapy can save the life of a suicidal patient in the same way that a coronary bypass can prevent death from a heart attack. Yet for both suicide and coronary disease, a fatal recurrence is much more likely without significant and lasting lifestyle changes. In both forms of illness, long-term interventions consisting of frequent and regular meetings with a health-care provider significantly reduce recurrence and mortality (see 1 and 2).
The dual role of psychotherapy as a medical and a wellness intervention creates confusion for developing treatment methods, evaluating treatments, and creating policy for insurance reimbursement. Proper diet and regular exercise improve wellness in the same way that consistent therapy can, but many insurances do not provide reimbursement for diet plans, personal trainers, or long-term therapy. Should they? Before you rush to say "Yes, of course insurance should cover all of those things", consider the fact that keeping a pet or playing a musical instrument are also good for your physical and emotional well-being. Should insurance cover dog chow, kitty litter, and Fender guitars?
Ultimately, the role of therapy depends on the wants and needs of the individual seeking treatment. Therapy does not always work; it is life-saving for some but harmful for others. The fact that someone is in regular therapy for a long time is no indication of craziness, laziness, or dependency. Even the most psychologically healthy people rely on others for help. Our lives are constantly evolving; the circumstances we face today are vastly different from the ones to be faced a year from now. In taking on the challenges that are the inevitability of life, isn't it nice to have some time set aside each week for personal reflection and consultation with a caring mentor and confidante?
