When Your Adult Child Breaks Your Heart

Coping with mental illness, substance abuse, and the problems that tear families apart

Five Things Therapy Can't Do

(And Five Things It Does Well)

Flip on the television for even a few minutes and you'll likely see a therapist working with a client. Unfortunately, though, what you see probably won't be accurate, and may even be an example of unhealthy and damaging therapy. In Mad Men, for example, Betty Draper's psychiatrist reports on her therapy sessions to her husband, while in Hannibal, Hannibal Lecter acts as friend, accomplice, co-worker, and psychiatrist to numerous patients. These presentations are fictional, but they color our expectations of what therapy looks like. Clear, reasonable expectations are key to getting the most out of therapy. After all, if you're perpetually striving for something that's not possible, you'll quickly feel like a failure. Here are five things that you simply can't expect from therapy.

Therapy Can't Change Other People

If you enroll in couples counseling to change your spouse, or if you hope that by improving your anxiety you'll encourage your wife to be kinder, you're in for some disappointment. Therapy can't change the people around you. Instead, the goal of good therapy is to help you change the way you react and relate to the people you love. In many cases, changing your own behavior will encourage the people you love to change theirs, and altering your emotions can certainly leave you less troubled by others' problematic behavior. These are nice bonuses, though, and not something you can count on when you walk into your therapist's office.

Therapy Can't Offer Guarantees

The brain is a complex organ, and things get even more challenging when you consider that our brains have to interact with our bodies, our environments, and our loved ones. No therapist can offer guarantees, and anyone who does is misleading you. Instead, the purpose of therapy is to promote positive change. You might not reach your goal as quickly as you should, and you might even discover that a different goal is in order. It's wise to judge your therapist according to the progress you're making, but if you think therapy is the only ingredient in the recipe for a happy life, you're bound to be disappointed.

Therapy Isn't Paid Friendship

It's natural to like your therapist, and the closeness of the relationship even spurs romantic feelings in some clients. No matter how close you feel to your therapist, though, a therapist is not a paid friend and is certainly not a romantic partner. If you find yourself competing to become your therapist's “favorite” patient or if you're more invested in the therapeutic relationship than the world outside therapy, you won't get what you need. It can be helpful to discuss these feelings with your therapist, as the patterns you exhibit in therapy are often part of unhealthy patterns that you exhibit in the rest of your life.

Therapy Won't “Cure” You

Therapy offers new coping skills and new insights, but it won't change the underlying stressors in your life. Your mother may still be critical and your father may still be an alcoholic. You might still experience bouts of anxiety or overwhelming stress. The difference, if therapy does what it's supposed to, is that good therapy helps you cope more effectively with these challenges, and makes it easier for you to face struggles without adopting unhealthy or dangerous behaviors.

Therapy Won't Change Your Personality

Some people are worried that therapists can somehow get inside their heads, mix things up, and produce a new person. Therapy isn't mind control, and it's not going to turn you into a new person or change your fundamental personality. Instead, therapy is about working with what you have. If you're a people-pleaser, you can learn to assert your own needs while still being warm and empathetic. Therapy helps you straddle the happy medium between problematic behaviors and an entirely new personality, and progress is steady and often slow.

If the myths aren't true, then, what can therapy do really well? Every therapist has his or her own definition of healthy therapy, but the following five traits are essential ingredients in the recipe for beneficial therapy.

Therapy Can Help You Recognize Patterns

At the heart of any good therapy session is the drive to recognize patterns. Perhaps you pick abusive men because they remind you of your father, or maybe you've adopted your mother's hyper-critical and angry tendencies. We tend not to notice unhealthy behaviors because they feel so comfortable. After all, no one would willingly choose to do things that make life worse. Your therapist's job isn't just to listen to your feelings; it's to examine how those feelings affect your behavior and to help you uncover long-standing patterns, thoughts, and feelings.

Therapy Can Help You Devise Better Reactions

When we know how to do better, we usually do. Often, though, therapy clients just aren't sure of how to get a restart. Maybe you know that the way you discipline your children is aggressive, but you're not sure of a better way to do it. Or maybe you feel like only abusive people are attracted to you. Your therapist can help you expand your skillset and your toolbox to find new ways to react to old, familiar problems. Once you learn these methods, they may seem obvious and even easy. In some cases, though, you'll need some practice, and your therapist can help you with this.

Therapy Can Increase Self-Awareness

The journey toward self-awareness can be painful at first. You might realize you're excessively critical or that you're mimicking your father's problematic behavior patterns. It's only through realizing these habits, though, that you can change them. When you become more self-aware, you'll be better equipped to recognize problematic behaviors long after you leave therapy, and this makes for a happier life and a sense of control over your own destiny.

Therapy Can Improve Social Skills

Even if you're a dedicated social butterfly, you can still probably stand to brush up on basic skills like how to apologize, how to talk to someone new, and how to avoid taking criticism personally. Therapy allows you to practice social skills in your therapist's office, and your therapist may notice patterns in your interaction style that are relevant to your “real” life. As these patterns become apparent, your therapist can help you develop newer, healthier approaches that improve your social life and interpersonal relationships.

Therapy is Temporary

There's nothing wrong with going to therapy several times in your life. Indeed, we all need a tune-up every now and again, and the process of self-actualization never ends. But therapy is intended to be a temporary solution to life's problems. There's no need to sit in a therapist's office and be “analyzed” week after week, year after year. Good therapists give you a plan and a timetable, rather than making you dependent on them. If you're anxious about going to therapy, rest assured that this stage of your life is temporary and good therapists don't keep you – or bill you – longer than they have to.

Every therapist is unique, just as every client has her own challenges which she brings to therapy. But the foundation of healthy therapy doesn't change, no matter what your presenting challenge is. Don't be afraid to speak up if you feel that something isn't right in your therapy sessions, and don't let media depictions of what therapy is like color your perceptions of what therapy should be.

 

Joel Young, M.D., who teaches psychiatry at Wayne State University, is the Medical Director of the Rochester Center for Behavioral Medicine, near Detroit.

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