Therapy Sucks

Therapy can be bad.  I want to make that abundantly clear.  I don’t just mean there can be bad sessions or sessions where the work you do leaves you feeling somewhat exposed and raw in the aftermath.  I mean that therapy can be really shitty.  My job as a therapist is to be real with you, to hold you in positive regard and to point out some of the shitty patterns you have undertaken in life that aren’t actually doing you any favors, despite the fact that they got you this far more or less alive and kind of unscathed.  I will work to help you feel safe and heard, valued and respected and ensure that you know that you can say damn near anything in our space and it is confidential.  We cover the things that I am mandated to report but outside of that everything you say I hold as confidential, to be kept between you and I and not shared unless you give me permission to do so.  I value the therapeutic bond we establish because it enables you to feel comfortable to share with me which then in turn allows me to work with you on this journey to uncover the things that have been holding you back.  If I am the right therapist for you, then I know we will make progress and our work will be productive.  However, I also know that I am not the right fit for anyone who seeks therapy.  There are countless reasons why maybe I am not the right fit, and that is okay with me.  I want you to find the right fit.  As we go, if I realize I am not the right fit, I will tell you that too, and work to help you find the right fit, either by referring you to someone I know or helping you determine what you need from a therapist.

I am a good therapist, and I believed that all of us were good at what we did.  However, the more I hear from clients and even family members the more I find out that there are some really and I mean REALLY fucking shitty therapists out there. As with any profession you have people who got into it for the wrong reasons.  You also have people who just don’t know what they are doing.  But the really dangerous people are the ones who have good intentions but lack the professional abilities to actually utilize those good intentions.  Maybe it is an educational issue or maybe it is them needing to feel like an authority or be in a position of control or power within the aspect of a client therapist relationship.  It is important to note that all of us therapists are human.  We all have different backgrounds and approaches, and we are fallible and can make mistakes.  However, the therapists I am specifically targeting here are the ones who overstep, do things well beyond their scope of practice and approach their client as a friend rather than as a client there to work through things in therapy.  This gives all of us a bad name and drags the profession down to practically a snake oil level of efficacy.

To make a few key distinctions, therapists are not medical doctors and as such should not be consulting on your medications because we are not licensed to prescribe them.  This falls well outside of our scope.  A psychiatrist is a medical doctor who CAN do therapy but often focuses on medication management primarily to ensure that those who need psychotropic medications are followed closely by someone with expertise in that area specifically. This is not someone I would describe specifically a therapist, so if you receive therapy on an ongoing basis from a psychiatrist then this is a point where I would note the difference in terminology.  To return to the point here, many therapists have personal opinions on medication.  They may have a history of being on medication, having a loved one on it, working with people on it, or some other reason they have developed a strong opinion one way or the other related to medication, in general or even specific ones.  However, therapy is YOUR space, and the therapist’s opinions do NOT belong there.  If you ask them about medication they should relate factual (read: medically and scientifically supported) information that is obtainable online and keep their personal beliefs and experiences out of it.  You aren’t paying for someone to give you opinions, you aren’t paying for someone to be your friend or confidante. Rather, you are paying for someone with training, education, and a license to utilize their unique skills to help you traverse challenges life has thrown your way.          

To further the notion that the time in therapy is YOUR time, your therapist shouldn’t be doing all of the talking.  There may be times where they explain a concept or are trying to pull things out of you, or hell even just show you that you deserve to love yourself and are trying to build you up.  If the therapist is doing all of the talking, and their talking is focused on them, their idea, beliefs, or just them sharing anecdote after anecdote and stories, then they aren’t actually working with you.  Instead of a therapist you are paying for them to perform their one-person show that’s significantly off-off-Broadway.  Therapists should do a lot of listening, we should be asking questions, but beyond that, we aren’t just there to blindly agree with you when you do get to speak.  Your therapist should occasionally point out things you do that may be less than optimal and may actually be working in a way that takes away from your overall life satisfaction.  I lovingly refer to this as “calling you on your bullshit”.  It isn’t something that is mean or hurtful, and it isn’t delivered in a way that demeans you nor makes you feel like a failure or a screw-up.  Instead, often when I call clients on their bullshit, they may stop and laugh recognizing the role they play in their lives, or they may stop and write down something that brings up for them.  Therapy isn’t about punishment nor monologuing.  It is about finding out the root cause for our displeasures we identify and working to address and correct the things that keep us trapped there. 

I am an advocate for therapy.  Therapy works when done right by both parties in the therapeutic relationship.  However, sometimes therapy is bad and you shouldn’t have to go through bad therapy.  You should be able to have a therapist who you connect with.  Not one who will simply take your money on an ongoing basis for six years without actually helping you address any of the issues you are dealing with.  Therapy should be a time-encapsulated process where you can measure progress over time.  Sure, for some the process may take man many months or potentially over a year.  However, you should notice progress, you should be able to have sessions decrease in frequency.  You are not a cash cow, you are a client, and I would be doing you a horrendous disservice if I didn’t share the ways that some of my unmet, unknown colleagues are doing you and I both a disservice.