10 Myths About Therapy

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Operation: Demystify!

Demystifying psychotherapy is no easy task. When we hear the word “therapy,” many of us might automatically picture the grim scene of a low-lit, intimidating room, featuring a suited old man pouring over a clipboard muttering “hmm” to himself while you free associate on a stuffy, antique couch. Others will imagine the inhumane setting of a 1920’s insane asylum. Still others will picture a hypnotist holding two fingers to your eyes, probing about your sexual history and your relationship with your mother. When I am meeting with a client for the first time, I am always careful to get a sense of any preconceived notions or general expectations that they may have of therapy. I have found that once clients learn about the collaborative, conversational, and goal-oriented backbone of the therapy process, they tend to relax a little, knowing that they won’t be forced to lay on a dusty old couch. While Hollywood and the history books have painted quite an elaborate (and confusing) picture of what therapy looks like, I will do my best to address some of the common myths about therapy that I have heard directly from past clients.

Myth #1: It is the therapist’s job to “fix” you.

I really empathize with this expectation of a therapist. After all, aren’t there many other medical professions that work this way? If I get the flu, I could simply contact my doctor with the expectation that he would do his best to fix me right up, prescribing me medicine as needed, telling me to take a few days off and to get plenty of rest. If he did his job, my problem would be solved. When it comes to therapy, things get a lot more nuanced.

First, the real root of this misconception might lie within our definition of the word “fix.” When we come to therapy, we might have a hope that we will be able to get rid of our anxiety, depression, traumatic symptoms, or whatever hurt we are looking to heal. Here, “fix” is used synonymously with “eliminate.” This is a mistaken approach to psychological healing. Most modern therapies (including Cognitive Behavior Therapy and Acceptance and Commitment Therapy) maintain that we are much more likely to achieve real change in our lives if we avoid fighting and battling with our distress and pursue acceptance and valued living instead. As an example, let’s say you could simply reach into your mind and pull out your anxiety altogether. If “elimination” was your ultimate goal, then that’s it – you’ve achieved it! Now, turn your attention to the rest of your anxiety-less life. Are you prepared to simply live your life with this gaping hole that used to be filled by anxiety? What will you do with yourself now that anxiety is no longer taking up any of your attention? These are tough questions, and ones that might even be tough enough to create – you’ve guessed it – MORE anxiety. Simply wishing away your anxiety is not enough; it’s only after you discover who you are, what you truly value, and immerse yourself into these things that you can truly find peace.

Next, I want to point out that life involves suffering. It is part of the human condition; pure and simple. Let’s just say that it was possible for a therapist to wave a magic wand and fix you right up, solving whatever problem you brought into the room. What would you do the next time you had a similar problem pop up? That’s right – you would go right back to the magic wand, over and over again. This would create an unhealthy sense of dependence, and more importantly, a decrease in your own autonomy as a human being who is capable of withstanding life’s great adversities. Here an old adage comes to mind: “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.” A therapist’s job is not to “fix” you – it is to equip you to heal yourself.

Myth #2: Therapists give advice.

I hear this one all the time, especially from friends and family. As a therapist, I am always expected to say the perfect thing, as if I was some fountain of knowledge that simply spews out insightful and therapeutic jargon on-command. To be honest, that expectation is a bit stressful for me, as you might imagine – especially as someone who frequently says the wrong thing! Thankfully, that is not at all what therapy is truly about. As discussed in myth #1, there is good reason why it might be harmful to simply “wave a magic wand” and solve a client’s problem myself (if that was possible). Advice-giving tends to imitate the wand; expecting my words to heal you puts the ball in my court, and you miss out on the necessary opportunity to experience autonomy and self-sufficiency.

Further, one thing that research has shown us is that talking in therapy is only one part of the healing process. Our conversations can help us to build a relationship, establish goals, clarify your values, and motivate you to practice behavioral change. The real healing comes in when we collaboratively establish our treatment plan, and you commit to practicing the techniques and behaviors that you learn in therapy. Granted, sometimes basic advice plays a role in our treatment plan (ie: “you should probably sleep more than 2 hours a night”), but in no way is advice-giving our primary intervention in therapy.

Myth #3: Therapy is supposed to make you feel better.

This one might raise a few eyebrows. If I’m not going to feel better, why go to therapy at all? The whole reason that this is considered a myth is because therapy is all about living better, not only feeling better. Again, suffering is part of the human condition; if our primary goal was to feel good all the time, we would probably start getting into illicit drugs and other behaviors that might conflict with our values. Of course, therapy often does help us to feel better, but this is typically only in response to our decision to live better. There’s an interesting paradox here – when we decide to focus on what we do rather than what we think or how we feel, we often start feeling better as an indirect result. Our focus is on creating the life you want to live, not just creating the feelings you want to feel. 

Myth #4: Therapists just listen to you vent, really, really, intently, while pretending to be interested.

I’ve heard this one a few times and it makes me chuckle each time. Listening to someone rant about their awful mother-in-law while mindlessly repeating the question “how does that make you feel?” might be another common caricature of therapy.

First, ventilating emotions (ie: venting) in therapy has actually been shown to be pretty unhelpful in the long-run. While it might feel good in the moment, venting can cause us to get caught up in a recurrent cycle of negative emotion and behavior, which might even do more to feed our distress than to alleviate it. Therapists typically shy away from allowing clients to vent, especially when it becomes a lengthy part of a therapy session.

Next, I’m a human being, so there have certainly been times when I have been frustrated, tired, or bored out of my mind in session. When I reflect on these experiences, I can almost always trace my inattention back to my not asking the right questions or not interrupting the client when I notice something worth exploring in the discussion. Many therapists (including myself) value transparency and honesty in a therapy session, so “pretending to be interested” would completely go against such values. If a therapist is truly not interesting in helping a client thrive, they should not be working with them.

Myth #5: It’s nice to talk to someone, but therapy is not as effective as medication.

Actually, most of the current research on psychological care indicates that psychotherapy and medication can have comparable results in the short-term, but psychotherapy is far more effective in the long-term. This is because psychotherapy involves digging into the roots of your problems, learning from and overcoming your symptoms rather than covering them up. The science is clear on this.

Many studies indicate that the “gold standard” approach to psychological care should involve careful consideration of a specific combination of psychotherapy and medication best-suited for a client’s particular case, while eventually easing off medication (and ideally, eventually terminating therapy as well). Medication can be very helpful in treatment, but claiming that medication is more effective than therapy is incorrect.

Myth #6: People only need therapy if they are “sick.”

For many years, the field of Psychology has been described under the “medical model,” this idea that we are able to categorize our mental and psychological distress in terms of syndromes (a condition described by a set of symptoms). This approach requires each case to be compartmentalized into a diagnosis, and you receive treatment based on the diagnosis you have. Some good has come from this approach, like ease of communication, research, and treatment protocols. However, it has also led to a pretty stigmatizing conceptualization of mental healthcare. In recent years, through efforts like the positive psychology movement, we are seeing this medical model be challenged more and more. There are plenty of good reasons to go to therapy outside this medical model. If wanting to improve communication habits, increase emotional intelligence, or learning to practice self-compassion are all “illnesses,” then I guess we are all sick!

Myth #7: Therapists try to read your mind.

This might sound a bit tongue-in-cheek, but many people really do expect that a therapist will do their darnedest to try to decode what’s going on in their mind based on carefully analyzing their responses and evaluating body language. While a therapist might take some of these things into account, therapy is not a synonym for detective work. In the cognitive behavioral tradition especially, therapists do their best to meet you where you are, allowing you to only bring forward any content that you find relevant when you are ready. “Collaboration” is a key word here. In short, therapists are far more preoccupied with walking with you at your own pace than they are trying to figure out what’s going on in your mind before you do.

Myth #8: You’ll have to dive deep into your childhood history in therapy if you want to see any real progress.

In psychoanalysis (the type of therapy proposed and practiced by Freud and his contemporaries), a huge amount of emphasis was placed on your childhood. Back when this school was first formulated in the early 1900s, it probably would have been considered heresy to avoid exploring your childhood. However, today we recognize that while childhood events can point to some insightful and helpful realizations, we don’t usually have to spend too much time there. After all, we are living today, not yesterday. Of course, the inception of specific traumas and phobias may need some exploration, but returning our focus to the present day and immediate future is a surer way of eliciting behavioral change. So, if you are worried about being forced to talk about that time in 2nd grade when Mrs. Johnson embarrassed you in front of the whole class, fret not!

Myth #9: You’ll have to explore your subconscious mind in order to find healing in therapy.

In line with my comments on myth #8, another component that was key to Freud’s psychoanalysis was the unconscious. In fact, this is where we get the concepts of free association (where the therapist vocalizes words that we quickly respond to with limited thinking involved), and “Freudian slips.” Needless to say, modern research has shown that it is very possible to achieve similar (and even better) results by focusing on our conscious self rather than the unconscious. Cognitive Behavior Therapy is a good example of this, since our focus is typically on our observable thoughts, beliefs, and behaviors, rather than what’s going on beneath the surface.

Myth #10: There is a difference between “counseling” and “therapy.”

I get this question a lot, since I tend to use these terms interchangeably. Legally, “therapy” or “therapist” are not protected terms; anyone could claim to be a therapist without any sort of legal or licensing repercussions. This is a title that can be viewed as an umbrella term for anyone helping others through discussion. Psychologists, Psychiatrists, Clinical Social Workers, Counselors, and others could all self-identify as “therapists,” though the term does not denote any particular license or qualification. However, counseling is a term that is protected by the board of counseling examiners; if someone unqualified claimed that title, it could result in legal ramifications. Confusing, I know! To make things even weirder, some people insist that “therapy” is really a longer-term and more insight-oriented version of “counseling,” though this is just a colloquialism. To simplify things, I would respond to the myth by saying, “not really.” At Pax, we opt to use the term “therapy” because the word’s etymology can be traced back to “healing” in greek, which we think is cool. Plus, our other clinician is a Licensed Clinical Social Worker, not a Licensed Professional Counselor, so calling both of us “therapists” feels easier. Just our opinion.

Thanks so much for reading this post! If you have any additional thoughts, questions, or comments about the subject, please send us a message. I hope this was helpful and generated some thought for you.

Peace be with you!