Should Everyone Be In Therapy?

Probably not.

These days, “going to therapy” indicates that you are a “good human.” We are taught that it is not only normal but ideal to seek therapy and unravel all our issues, no matter how mundane.

Whereas therapy used to carry a more significant stigma, apps like BetterHelp and Talkspace have made therapy more accessible. At the same time, athletes like Naomi Osaka, Simone Biles, Michael Phelps (himself a BetterHelp ambassador), and others have prioritized their own mental health and well-being over the expectations of the press and the sports industrial complex.

It’s “cool” to be self-aware enough to seek mental help.

But do you need mental health counseling to become a better person? And what if it actually makes you feel worse?

The mental health crisis

The kids (or adults, really) are not okay. We are in the midst of a global mental health crisis, and while people are quick to point towards social media, it’s also a cultural issue.

Younger demographics feel let down and hopeless as they careen toward an unstable future. The middle-aged and older folks are frustrated because they don’t understand the culture and might feel they, too, are not being heard.

There’s a lot of instability right now; historically, change has not been good for the collective psyche.

You think, okay, things are scary. Maybe I’ll go into therapy.

Then you see how expensive it is. Or you sign up for an app to discover they were harvesting information from your assessment to serve ads on your social media feeds. Or you finally run the gauntlet, get into therapy (either through sliding scale payment arrangements or through Medicaid or insurance services), and discover that the exalted mental health professional doesn’t understand you.

They interrupt you after they prompt you to answer a question, asking another question that shows they weren’t listening in the first place. When your virtual session’s video keeps blinking out every few minutes so that you have to log back in multiple times, they insist you “ignore it” and keep talking while not wanting to investigate why their system keeps causing the issue.

Or my favorite, when they ask you why your parents can’t set you up in your own apartment so you can “live your own life,” even when you just explained to them that your parents are living on social security.

And good luck if you are Neurodivergent. Often, your therapist won’t understand the nuances of conditions such as ADHD or Autism.

One therapist told me, when I brought up my ADHD re-diagnosis (I was first diagnosed at 11), that it was a “learning disability,” so it shouldn’t affect much else in my life.

Another one issued that favorite misconception — “Well, isn’t EVERYONE a little ADHD?”

Still too much of a people pleaser to argue with either of them, I nodded while internally screaming.

It’s not just me

For a while, I thought I was unnecessarily obstinate. I am, after all, often a renegade, eschewing the typical in favor of the unusual and exciting (part of my ADHD, I’ve been told).

Maybe I was the reason the therapy didn’t WORK. Perhaps I WAS too stuck in my ways.

But then I started reading more and saw that it’s not just me — there are large swathes of populations for whom therapy is not only unhelpful, it can often be harmful. And it won’t necessarily make you a better person.

Therapy is supposed to validate your feelings, not hold you accountable

One of my favorite writers, Dr. Devon Price, wrote about this way better than I ever could.

Quite often, a therapist will unwittingly find themselves reinforcing a client’s most negative perceptions of other people, and encouraging them to engage in stubborn, one-sided behaviors that push others away.

This does not happen because the therapist is incompetent, or has any malice, but because of how individualistic and isolated the therapist-client relationship is. Because a therapist is a hired aid with no real-world social attachments to their client, they are positioned to only know their client’s side of the story, and to validate their client’s feelings above all else. This is true even when their client’s perceptions are incorrect and their actions are self-defeating.

To put it another way: a therapist can affirm you, and leave you feeling empowered and correct when no one else in your life is doing so. A therapist can also help motivate you to live the way you want to live, and go after the things you want. But a therapist can’t make you a good person. Hell, from their limited point of view, they can’t even tell if you are one

I experienced the opposite, usually. I was told that I was the one at fault and that my experiences and thoughts about them were a product of my depression and anxiety. Perhaps the therapist was overcompensating in an attempt to make me “challenge” my negative views.

But for those going to therapy hoping to become a “better person,” that’s not what therapy is for. It can potentially make you a more selfish, self-righteous person.

You might be with the wrong therapist

One therapist, Carol* (*not her real name), told me that I “overreacted” and was paranoid when I discussed workplace dynamics and politics, specifically how I got anxious at the first sign of conflict. She couldn’t believe that things were “really that bad.”

Well, Carol, they were that bad.

Negative thoughts and feelings usually don’t happen because you are a “negative” person or a “downer”; they often occur because of past experiences. In other words, they are there for good reason.

I brought with me my experiences of being verbally battered in boardroom settings. As a teenager, I was already serving on non-profit boards as a youth representative and had been berated by adults three times my age. In one case, this confrontation lasted 10–15 minutes while other (adult) board members sat there and allowed it.

I was 17.

Already sensitive and socially anxious, the experience left me traumatized and unsure of what I had done wrong. I was trying to create a new community event and was instead made to feel like I was at fault.

So, is it any wonder I felt slightly triggered when in heated board meeting settings?

Even after explaining all this, I didn’t feel heard. Being questioned and made to feel like I was the problem was just a bit gaslight-y. It made me reluctant to speak freely about my trauma, which didn’t help me resolve it.

Of course, I realize that challenging these expectations is essential. But validating painful experiences and providing a safe space to discuss them (and then challenge the assumptions around them) is also necessary.

Save two, most of the therapists I’ve worked with haven’t seemed to “get” me at all.

I just started talking to my first counselor again. He’s not a psychologist or psychiatrist (he does have a Masters in Counseling), but he knows and accepts me, and his advice isn’t cookie-cutter pop psychology stuff. He knows who I am and what I hope to accomplish, so he helps me see how to work towards those goals and get out of my own way. Most importantly, I feel I can be open and tell him what’s really going on.

If you are with the wrong mental health provider, however, you will know it. They will not seem to understand you, will perhaps “check out” of your conversation, ask boilerplate questions, and might seem judgemental when you reveal certain feelings or keep up specific behavior patterns.

Trust your gut. Therapy can be uncomfortable and challenge you with tough questions, but you should still feel secure. You might not be a good fit if you don’t feel like your therapist is listening to you or they chronically misunderstand your concerns (or, worse, seem annoyed by you).

Therapists are people, too. It’s no one’s fault if you don’t get along with each other. You might need to try several therapists before you find one you like.

Therapy isn’t always a necessity

I just read a great article in The Atlantic about how teens in Australia were given mandatory DBT therapy in school to combat the teen mental health crisis as part of a study on if such interventions work.

But their mental health actually got worse.

Why?

Because, among other things, the kids….didn’t really need it.

That brings us to another problem with universal interventions. Many therapists use DBT to help people struggling with suicidal ideation and self-injury, through months of intensive individual treatment. But the teens in this study weren’t, on average, clinically depressed or anxious to begin with. Many of them were just normal, happy kids. It’s possible that by teaching kids to notice their negative thoughts, the program inadvertently reinforced those thoughts. “Maybe everybody thinking about how anxious or hurt they are might not be the best idea,” says Jean M. Twenge, a professor of psychology at San Diego State University and the author of Generations. “We might be taking people who are doing just fine and trying to teach them these techniques, which may actually call attention to their distress.”

Trust me, I did this during the first year of the pandemic. Convinced there was something “wrong with me” and “holding me back” (I was already depressed, which fueled this behavior), I dove into self-diagnosing and trying to “solve my issues,” which just made me feel worse.

Overthinking your mental health can, unsurprisingly, lead to worse mental health.

I’ve been told this happens on TikTok, by the way.

So unless you notice your mental health is causing significant issues in your daily life, perhaps it’s best not to seek therapy unnecessarily.

Sometimes, fundamental changes in your life, like more exercise, seeking out community, stepping away from social media, and improving your work/life balance, are all you need to do to feel better.

Different demographics have different experiences

For therapy to help you, you must be with someone who understands where you come from.

For those who are from marginalized communities, including people of different races, sexual orientations, and socio-economic backgrounds, therapy can feel pointless because often, the therapist will find it challenging to integrate and respond openly to their struggles and experiences.

Dr. Devon Price wrote another excellent article on this, and his observations showed me that I’m not the only one feeling unheard in therapy settings and that maybe I should walk away instead of making myself feel systematically invalidated. Or, at least, find someone else who might not have the “Ph.D.” after their name but seemed to understand where I was coming from.

As someone with ADHD and also on the lower-middle class end of the spectrum, I can see why most of the therapists I’ve spoken with “don’t get it.” They’ve never had to struggle to maintain focus and manage debilitating overwhelm or hyperfixation, nor have they struggled financially and had to live with their parents because they can’t afford to live otherwise.

Most of them are older Baby Boomers with “normal” lives. They come from a time when you went to work as soon as you got out of school (if you didn’t get married first), dutifully worked for 40 years, had kids, and retired. I understand why it can be challenging to interact with and understand me, a Millenial, who has not been able to choose that path (and does not want it anyway).

Again, it comes down to who you choose as your therapist, but sometimes, you don’t have a choice. You might have to accept whoever takes your insurance or live in an area where there aren’t many mental health professionals. Or you might have to settle for the Tinder of therapy services like BetterHelp or TalkSpace. I had experience with the latter, and while the woman I worked with was lovely, she gave general advice that I felt intuitively was not helpful for the situations I was discussing.

Again, it comes down to choosing someone who can understand and accept your experiences while also challenging you respectfully to think differently.

Therapy is still largely experimental

You might go into therapy thinking it will magically solve all your issues with proven treatments.

However, studies have suggested that therapy doesn’t always do much, regardless of the treatment method used. As this Wired article notes,

In a meta-review of 70 purported empirically supported treatments, Williams and his colleagues found only 20 percent of the interventions are based on reliable studies. An additional 30 percent were in the “murky middle,” and fully half of the treatments under review didn’t have the evidence their boosters thought they did.

Perhaps the most significant thing therapy can provide is a nonjudgmental, unbiased listener to help you feel heard….but of course, the success of that metric is also based on how much you vibe with your therapist. If you don’t feel heard or supported, therapy can genuinely harm you.

Also, despite what culture teaches us, you might not NEED therapy. Sometimes, it can make you focus on problems that aren’t there. And while it can be a lifesaver if you are really struggling, people often force themselves to work with someone they don’t gel with because they think they must be “working on themselves” with a psychologist to be a worthwhile person.

My takeaway? If you can’t find the right therapist to guide you, therapy could do more harm than good. If you can find someone who makes you feel supported and also helps you work on yourself, that’s great. But if you can’t, for whatever reason, or don’t feel you need it, don’t feel therapy is required for a happy, healthy life.