Someone asked me this question. It is an asked question and often has another question just hiding behind it. The other question is often, “I have a psychotherapist, but nothing is any better than before.” I hear another comment behind the first one, which goes something like this: Why should I need therapy? Why should I not be independent? The answers to these questions are always complex and challenging. However, here is my effort at some answers.
Taking the last question first, “why should I need therapy anyway?” the answer is that it is not just “you who need therapy but most of us.” We live in a complex world where the individual gets lost in the masses of people. That makes it very difficult for countless numbers to feel their lives have any meaning.
In a mobile world, where war is impersonal and includes fatalities among civilians, including women and children; where neighbors live near one another for a couple of years and move; where corporations lay off employees as though they are unimportant throwaway cogs in a machine; in which marriages do not last and family seems to have so little meaning; it is common for people to suffer existential angst whereby they wonder why they are on this earth and just what their lives are supposed to mean. If these are not enough reasons to seek psychotherapy, I do not know what they are.
Concerning the first question, does therapy help everyone? The answer is that nothing in this life is ever true of every person. There is too much diversity of temperament, lifestyle, economics, personal motivation, personality, and so on for any universal truth about therapy to fit all people.
Having said all this, let us inspect many variables that influence a therapeutic experience and can determine its outcome.
1. A lot depends upon the motivation to change a client brings to the therapy. When someone is motivated to change because they feel unhappy and are ready to learn, there are a lot of impetuses to grow because of treatment.
2. Trust between the therapist and client is essential. Of course, trust develops. Instead, as in any relationship, trust takes time to build. However, it can help to see a therapist who has been referred to you by friends and acquaintances who know their work. Reputation can be significant.
3. A lot depends on how a particular therapist works. Some people prefer a more formal therapist, while others prefer a warmer and more familiar one. Still, specific facts should hold true: For example, it is essential that the therapist, whether psychodynamic or cognitive behavioral, should be someone the client feels comfortable speaking to. It is essential that the client feel treated with respect and dignity.
4. It is my professional opinion that, regardless of the approach, the therapist and client work in the “here and now” or the present. While client history is essential, present-day circumstances are the most important.
5. Part of working in the “here and now” focuses on the client and therapist relationship. After all, it is that relationship in which all the clients’ ways of thinking and interacting get repeated. That is why both need to focus on the actual relationship in the therapy office.
It is always vital that the therapist not criticize or judge the client. There may be disagreements and areas of tension, and they need to be discussed and clarified. However, the role of the therapist is not to be the judge. Naturally, some people may enter psychotherapy expecting or fearing judgment, but that should be clarified and worked through in the treatment.
Psychotherapy is not meant to be a lifelong pursuit. If clients are still in therapy for over two or three years, they need to discuss that with their therapist. The goal of therapy is to finish and leave. Contrary to what some people believe, even Sigmund Freud, the first actual modern-day psychotherapist, saw people for only a year and many for a shorter time than that. He indeed worked with patients daily except on Sundays. Treatment is supposed to be completed.
How does a client know if therapy is finished?
When someone finds that they are feeling better, functioning at work, have improved relationships at home, and have a social life, there is an excellent assumption that they have completed their work. It is then essential to discuss this with the therapist. Some therapists may raise this issue with the client. Whoever raises completion first, the main idea is to be discussed, and a finishing date is selected.
This next is related to the second question. Nothing is any better than before I entered therapy.
Suppose a lot of time has gone by, and there has yet to be any improvement. In that case, the client must discuss seeing someone else or having a consult.
No, therapy does not help “everyone.” Still, there are all the variables to consider before deciding whether therapy is for you.
Today, we have the advantage of using medications in those difficult situations where it is called to help make therapy more beneficial and available for those who need it.
Instead, I would make an error by believing a specific therapist or type of treatment is not for me rather than concluding that it cannot help me.
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