Skip to main content

Verified by Psychology Today

Therapy

What Therapy Can and Can’t Do

Therapy can accomplish a lot—but not everything.

Key points

  • Hope is a key element of effective therapy, but unrealistic hopes can lead to frustration and disappointment.
  • Most of the benefits that therapy brings come through the changes it helps you to make.
  • Learning to roll with life's problems can be just as important as removing them.
Microgen/Adobe Stock
Source: Microgen/Adobe Stock

One of the most helpful things about psychotherapy is the hope it can bring. So many men and women in my clinical practice have said they felt better after our first meeting, even though nothing in their lives had really changed. Most of the time, they described feeling more hopeful that the issues they brought to therapy could improve.

What Therapy Can Offer

Just as hope can be buoying, disappointed hope can be deflating. What is realistic to expect from therapy? We can’t know what any individual will take from it, but the following are common benefits.

✅ Self-Knowledge

A skilled therapist can help you discover aspects of yourself that you might not be aware of. They can also help you recognize how your thought patterns contribute to your struggles, or how your present-day reactions to certain people resemble some of your earliest relationships. These kinds of insights can help you make important changes in your life.

Emotion Regulation

Many therapies can help you gain more control over how you handle emotions. You can learn how to tame anxiety, for example, or channel anger in more effective ways.

✅ Validation

Most therapists are empathic and affirming toward the people they work with. Even if you’re confused or dismayed by the things you feel and do, a therapist can help you see that your thoughts, feelings, and actions make sense given your history, learning patterns, and beliefs.

✅ Self-Acceptance

Practically all forms of therapy aim to help you be more accepting of who you are, including the parts of yourself that you might be ashamed of and want to disown. Paradoxically, the willingness to accept all of yourself just as you are is an incredibly important step toward the changes you want to make.

“The curious paradox is that when I accept myself just as I am, then I can change.” -Carl Rogers

✅ Symptom Reduction

Whatever issues brought you to therapy will tend to get better: Depression lifts, anxiety diminishes, stress becomes more manageable, and so forth.

✅ Distress Tolerance

Therapy can reduce suffering not only by relieving symptoms but by helping you make peace with the ones that remain. You can learn to be open to anxiety, to release resistance to dips in your mood or a bad night’s sleep, or to find resilience in the face of stress. While you’ll still experience pain at times, you’ll suffer less as you stop fighting it.

Openness to Life

Just as you learn to accept yourself, you can learn to accept life as it is. You can shift from a stance of pushing things away—a sense of saying no—toward an openness that says okay to what life brings. Therapy can help you see life less as a struggle and more as a dance, less as a series of unwelcome problems and more as a continual adventure. You won’t be denying that sometimes life sucks, but rather finding ways to work with what is.

What Is Too Much to Expect

While therapy can be powerful and life-changing, there are some things it can’t promise.

❌ Eliminating Symptoms

Therapy can be extremely helpful, but it almost never gets rid of symptoms entirely. Even the best-tested treatments, like cognitive behavioral therapy (CBT) tend to reduce symptoms without abolishing them.

❌ Forcing You to Change

It’s normal to feel ambivalent when you need to make an important change. You want to make the change but another part of you doesn't want to. Working with a therapist can support the side that wants to change, but no therapist can make you change before you’re ready.

❌ Turning You Into Someone You're Not

Most people come to therapy because they want to change, and therapy can be a powerful catalyst for altering your thoughts, feelings, and behaviors. There is even evidence showing that therapy can change personality, especially on the dimensions of neuroticism/emotional stability and extraversion/introversion. But the changes are generally a matter of degree, not of kind. If you're a highly anxious, better-safe-than-sorry type of person, therapy probably won't make you a YOLO thrill-seeker. If you prefer small, intimate gatherings, therapy almost certainly won't make you a life-of-the-party socialite. Instead, therapy can help you be a better version of someone who is still very recognizable as you.

❌ Changing Others

You can learn in therapy how to deal more effectively with others, whether a child, a boss, a spouse, a parent, or anyone else. But just as therapy can’t make life smooth and easy, it can’t make other people behave. In a parallel way, you can’t make someone else change by sending them to therapy if they have no desire to make the changes you're hoping for.

❌ Making Life Easy

Therapy can help you deal with life more effectively, and it can even make life easier by helping you make important changes. But no therapy can make life easy. Life is challenging for everyone, even the most “well-adjusted,” privileged, enlightened souls. Dealing with difficulties is part of being human.

You can accomplish a lot in therapy. Not everything, but most people who work with a therapist grow in ways that range from small to transformative. Bringing realistic goals and expectations to therapy can help you get the most out of it.

To find a therapist near you, visit the Psychology Today Therapy Directory.

References

Roberts, B. W., Luo, J., Briley, D. A., Chow, P. I., Su, R., & Hill, P. L. (2017). A systematic review of personality trait change through intervention. Psychological Bulletin, 143, 117-141.

advertisement
More from Seth J. Gillihan PhD
More from Psychology Today