I have always considered therapy a “gift” and the decision to work with a therapist a proactive sign of self-compassion and courage as well as a healthy statement about one’s desire to learn, grow, and heal.
However, for countless people the idea of seeking out therapy and opening up about painful emotions, intimate or shame-based thoughts and behaviors is too daunting, and sadly, keeps them from the getting the guidance and support they deserve.
The therapy process and relationship can be a reparative, growth producing, and healing experience. I have certainly gotten that feedback from the countless clients I’ve worked with over the years, as well as the many clinicians I have consulted with and taught. And yet, the overwhelming response to that blog came from people who had either ineffective treatment, unsatisfying encounters with their therapists, or worse, actually felt emotionally or psychologically harmed by the experience.
Although I steadfastly hold to the belief that therapy can be extremely helpful, even life changing or life saving for many people, I think it’s important to acknowledge another equally true reality. As is the case with all other professions, there’s a bell curve of competence and effectiveness. Meaning, there are incredibly talented, compassionate, non-judgmental, effective, and extremely bright clinicians and there are mediocre, ineffective, even bad clinicians. They may have gone into the field for the wrong reasons, experience triggering or dissociation in session due to their own unresolved issues, or engage in power plays with clients. They may lack the qualities that can’t be taught and are associated with the ‘”art” of being an excellent therapist. This can have tragic consequences and I wish more would be done to supervise and monitor their work!
Having said that, I would like to continue highlighting the benefits of treatment, with the caveat that it’s critically important for clients to feel supported, listened to, understood, and competently guided in their work.
If you or someone you know feels ambivalent about starting treatment here are some reasons why a therapist and therapy can be so beneficial.
Getting outside support breaks the cycle of handling pain alone.
One of the reasons you might be resistant to getting outside support is because you’re so used to dealing with your feelings and overwhelming experiences alone. It won’t occur to you to ask for help if you grew up feeling alone or “invisible,” were neglected by caretakers, or had parents who were overwhelmed, distracted, or unavailable. When needs and feelings are discounted, ridiculed, or ignored, it makes sense that the template for life is it’s unsafe to ask for help and difficulties must be handled “on your own.” Therefore, seeking out therapy may feel unnatural because it challenges your core belief about the futility of reaching out. Finding the courage to let a safe person support and guide you in your healing journey is a way to break free from a powerful cycle of neglect. And once you experience the comfort of being helped by a nurturing, safe therapist you’ll be able to open your heart to the love and support of other safe people in your life as well.
Therapy helps you see yourself and your situation from a different angle.
The expression “you can’t see the forest for the trees” applies to anyone overcome with negative thoughts and feelings. A therapist is able to “stand back” from those thoughts and feelings providing a more objective, clear, and often more accurate take on your situation as well as your progress. You may tend to downplay your accomplishments as not important and exaggerate the seriousness of your mistakes. This is common in people who experience depression, anxiety, or have a history of unresolved pain. Or you may have people in your life who didn’t celebrate your accomplishments and inflated your missteps. Sometimes, we can’t see ourselves in the same way that others see us because of self-esteem issues. You might have gotten the message that it’s “selfish and egotistical” to think well of yourself, making it impossible for you to accept accurate compliments about your abilities. With these damaging messages, seeing the glass as “half empty” becomes an automatic response. But automatic responses are often rooted in the past and aren’t accurate reflections of current situations. An honest, objective therapist can help you sort out your automatic assumptions, separating the past from the present. He or she can help you look at your experience from a different angle, re-framing the way you think about a current situation, measure your progress, or unfairly assign self-blame.
Getting outside support breaks the cycle of secrecy and shame.
If you’re struggling with issues that embarrass or shame you it’s understandable that you’ve tried to keep those issues hidden from everyone else in your life. This often results in having to invent and keep track of complicated lies, and lying only adds another layer of guilt. Keeping secrets adds fuel to the belief that there is something “wrong” with you or “bad” about you. Your lies may leave you feeling dishonest and fake and that can further compromise self-esteem. The ongoing fear of being “caught” or “found out” can add to your anxiety. Working with a therapist is a way to break the secrecy and reduce the lying and guilty feelings. It makes sense if you feel the need to lie and keep secrets especially if those behaviors got modeled and reinforced in a dysfunctional family. Children are taught to keep secrets or lie about sexual abuse, domestic violence, addiction, and any other issue that is not being openly talked about within a family. Keeping secrets becomes a way to cope and survive and is “normalized” in families where grown-ups don’t take responsibility for their actions, or don’t want to deal with what’s really happening.
Therapy gives you the “cheerleader” you deserve.
This is an idea that may be hard for you to believe or relate to when you think about what you actually deserve. It’s possible that you haven’t had too many “cheerleaders” in your life. Yet, everyone needs support and encouragement with no strings attached, especially when it’s hard to conjure feelings of optimism or hope. Repeated negative, frightening, or painful experiences can make it more difficult to believe in yourself or believe things can actually get better. A supportive, non-judgmental therapist can maintain a level of hope for you until you are able to feel it for yourself and believe it! A good therapist is also able to point out your progress, including the baby steps. Even when this positive feedback feels uncomfortable it’s important to experience someone praising you and taking pride in your growth. Eventually, you’ll be able to hold these positive messages inside and learn how to be your own best cheerleader.
Therapy makes you more accountable for your actions.
Doing insight-oriented work by yourself is difficult because you don’t have the same degree of support, guidance, and encouragement. It’s also really hard because it requires a level of self-discipline that is tough for anyone to maintain. Like many people, you might go through phases where you at least feel curious about the possibility of examining your emotions or behaviors. You may even tell yourself that you will change and have made noble attempts. And yet, without the resources, psycho-education or ongoing support, you fall back into the same patterns when you get stressed or overwhelmed. Oftentimes, when a therapist guides you through the process, you’re more likely to follow through and accomplish your goals. Therapy can keep you honest and on track. When you know you have someone in your life who genuinely cares about your progress it can motivate you to actually make progress. A therapist can also help make your goals specific, measureable, and doable. You’re more likely to try a new behavior when it is clearly spelled out and presented in a positive way.
A therapist provides comfort and support when you relapse.
When it comes to giving up well-entrenched thoughts or self-destructive behaviors the work is often two steps forward and one step back. Relapsing can be a common part of the process. Many people “relapse” or experience a setback when they’re trying to let go of behaviors that used to be helpful and served a purpose. And then they verbally beat themselves up when they do fall back on old behaviors. If you relate to this you’ll understand how easy it is to think relapsing means ‘failing.” Ironically, the more you beat yourself up the more likely it is that you’ll do your self-destructive behavior again. This is because hurting yourself feels “right” when you feel badly about yourself. With the support of a well-trained therapist you can think about these relapses as opportunities to learn and grow. As you compassionately revisit your self-destructive act with a therapist, you can process the “triggers,” or things that set the relapse in motion, and brainstorm about what you could you have done differently. You can come up with a game plan for the next trigger, which prepares you for future incidents, making you less vulnerable and more able to respond in a healthier, more self-protective way.
A therapist can be your advocate with family and friends.
As you know, it can be very challenging to talk openly with loved ones about your emotional struggles or behaviors that feel shamed-based. Family and friends might feel panic, fear, or worry and might not be able to express that in effective ways. They may get angry about relapses, especially after you’ve promised them that you are in recovery. They may be confused when you can’t really explain your moods, or challenge your need for medication. They may express frustration that therapy is “taking so long” and may even take it personally, making you feel guilty and ashamed for “hurting or scaring them.” It’s easy to get triggered by their reactions and a well-meaning conversation can turn out badly as your upset feelings increase and you get more defensive. A therapist who has an expertise in treating your issues can work with you to create an actual “script” you can use when loved ones ask about your situation. It’s also useful to role-play with a therapist to identify your expectations, work out the rough edges, anticipate how loved ones might respond, and brainstorm about how to handle conflict when it arises. When you feel too overwhelmed or ashamed, your therapist can be your voice, representing you to family and friends in a caring, non-judgmental way. This, in turn, increases the likelihood that other people can see you through the same caring lens.
A therapist can invite you to attach new meaning to your experiences.
If you are like a lot of people, you may get “ tunnel vision” about the painful things you’ve been through. This means you have a limited view of yourself, what has happened to you, how it’s affected you, and the ways in which you have attempted to cope. Sometimes, the meaning you attach to your experiences is almost more important than the experience itself, because the way you think about things profoundly influences how you feel and the subsequent behavioral choices you make. It’s easy to get stuck in a narrow, negative view of yourself and your life, and when you attach certain meanings to your experiences you can actually add another layer of trauma. This is particularly true when you blame yourself for past events that were outside of your control or assume that something bad happened to you because you “deserved it” or see your trauma as a “punishment.” A therapist can help you “stand back” from your experience and view it with greater insight and compassion.
Working with a therapist gives you a witness for your painful experiences.
I believe that it’s human nature and perfectly normal to want a witness for personal pain. Even when you have been forced to keep things a secret, there’s a natural desire to share your experiences with people who are safe and non-judgmental. And yet, it’s often really difficult to explain, in words, what trauma feels like or the impact that it’s had on your life and your sense of self. When words are not forthcoming, many people often suffer in silence or use destructive behaviors to creatively “show” what they are unable to talk about. Unfortunately, those destructive or provocative behaviors can be frightening and are often misunderstood by loved ones. They focus on the scary behaviors and not the message underneath. A well-qualified therapist can help “translate” these behaviors and de-code this form of communication so the trauma narrative is finally heard, understood, and supported. When you work with a therapist who “gets it,” and can non-judgmentally bear witness to your experiences, the need to act them out by hurting yourself will dramatically decrease for you. A trained therapist can also give you safer, alternative ways to “tell” your story, so others can bear witness as well.
Therapy can offer you creative new ways to think about and work with your symptoms.
If you are like many people who struggle with self-destructive behaviors or overwhelming symptoms, the diagnosis you may have given yourself is “weird,” “sick,” or “hopeless.” A well-trained therapist can give you a whole new way to think about your actions and your symptoms. They can be connected to your family-of-origin, the possibility of prior abuse, neglect, or trauma, the challenges of adolescence or another developmental milestone or life stressor you may have experienced, or a medical or mental health diagnosis you didn’t know about. A therapist can move you away from the hopelessness of a diagnosis like “borderline” and help you to re-frame your symptoms as the inevitable by-products of trauma or pain. This restores a sense of hope into the work and takes the glass ceiling off of your progress! It’s important to seek out a therapist who can keep an open mind about treatment options, and who recognizes the value of focusing on your strengths, resiliency, and creativity. If you are considering going to a therapist don’t be afraid to ask them how they intend to work with your symptoms and what they have found most useful.
Even if you choose not to use a therapist at this point in time, if you are currently struggling think about reaching out to a relative, friend, teacher, 12 step sponsor, a safe and supportive chat room, or member of the clergy. Without sharing personal details, let them know you are working on important, difficult issues and you may need an extra hug, more time to just be in their company, a listening ear, or a friend to do something fun.
If it still feels too scary to connect with another person consider using a 24-hour hotline. It’s a way to feel supported while keeping your identity and feelings private. Most hotline workers are well trained and non-judgmental. They can help to re-ground you or comfort you, even in the middle of the night!
And most importantly, if you have had a negative therapy experience in the past don’t let it keep you from reaching out again. Although it takes a lot of courage and a big leap of faith, your experience the next time around might give you exactly what you need to move forward with your life, reconcile your pain, and truly heal.
Have you ever tried therapy? What has been helpful for you? Share with us your thoughts!
Lisa Ferentz, LCSW-C, DAPA is a clinical social worker, psychotherapist, educator, and the founder of The Ferentz Institute, formerly known as The Institute for Advanced Psychotherapy Training and Education. She presents workshops and keynote addresses nationally and internationally and is a clinical consultant to practitioners and mental health agencies. She is the author of “Treating Self-Destructive Behaviors in Traumatized Clients: A Clinician’s Guide,” now in its second edition, and “Letting Go of Self-Destructive Behaviors: A Workbook of Hope and Healing.” Lisa’s newest book, “Finding Your Ruby Slippers: Transformative Life Lessons from the Therapist’s Couch,” was recently published in 2017. In 2009, she was voted the “Social Worker of Year” by the Maryland Society for Clinical Social Work.