Therapy Isn't Always the Answer (and That's OK)

Last week I was having a conversation with someone and asked how they were able to get to the point of not letting something bother them. They said, “Lots of therapy.” Initially, I nodded and agreed, because I have been in therapy for a long time and I know firsthand that for me it has been a game changer. Then, all of a sudden, I had this thought bubble pop up in my head: “How come with all of the therapy I’ve had, I’m still struggling with this?” A wave of shame washed over me and I instantly began questioning if there’s something wrong with me. Am I not working hard enough in therapy? Am I too broken? What is wrong with me?!

• What is PTSD?

The truth is… nothing. Therapy can be an incredibly powerful and effective tool in healing from trauma and managing mental illness. But, it’s not the end-all, be-all — and it may not be the thing that ultimately helps us feel better. Like anything else in life, it’s not black and white. There’s a lot of nuance. Let’s examine that grey area.

1. Accessibility.

There are a couple of factors at play here. First, it’s no shock that after the last two and a half years of collective trauma we have endured, more and more people are seeking out some form of mental health care, be it online or in person. The problem is that there aren’t enough mental health professionals to supply current demand.

Second, and maybe even more frustrating, is the cost. While most insurance providers do offer some mental health coverage, either the coverage is limited in terms of how many sessions you get or they only cover a portion of the visit; for example, mine only covers 50% of my visit leaving me to pay the rest out of pocket. Then there is the issue of finding a provider in network, which can be challenging if the number of providers are limited in a geographic area. And for those without insurance, the cost of paying for therapy, even more affordable options, can be a barrier to obtaining care.

Fortunately, there are some options that might fill the gap for those not requiring more intensive care. For example, there are many online communities, like The Mighty, that offer some solace in the form of interacting with others going through similar things that can help reduce the sense of isolation and foster a sense of belonging. The only word of caution with online communities is to be judicious with finding one that is being closely monitored and moderated to create a safe environment for all participants.

Other options might include joining a group that meets online or in person. This could be Alcoholics Anonymous, Al Anon, Caregivers Support, or any variation thereof. Many communities are starting to offer these types of services to bridge the gap between the lack of mental health care professionals and demand (often, free of charge).

A third option that can be highly effective for someone who really needs something more akin to a mentor who can provide ongoing maintenance and life skill training is peer support. Peer support specialists are volunteers and paid staff who have lived experience with various mental health diagnoses, trauma, and/or substance use recovery. You can typically locate these services through the Department of Human Services.

2. Previous negative experience in therapy.

There are a myriad of ways in which therapy can be a negative experience, including but not limited to: poor patient/therapist fit, therapist experience not matching the needs of the patient, misdiagnosis or failure to diagnose and treat symptoms, poor medication management, therapist error, and the therapist not providing ethical treatment resulting in retraumatization or harm to the patient. All of these instances can leave someone highly skeptical of the process of therapy and of therapists in particular, and rightfully so.

Honestly, if I hadn’t already been seeing a second therapist who I felt safe with, I might never have dipped a toe back into therapy waters after my own horrendous experience with my first therapist. The idea of going through that again and being so deeply hurt is inconceivable to me. And yet, I have been guilty of trying to persuade those who have had negative experiences to give it another go. While my intentions come from an honest place of recognizing how much therapy has benefited me, in hindsight, I think perhaps I need to be less overzealous in pushing people who have been traumatized in therapy to jump back into the deep end without truly understanding the degree to which they may have been harmed.

3. Everyone is different.

It goes without saying that every human being is going to have different needs and unique life experiences which means not everyone will respond to therapy in the same way. It might just be a particular style of therapy or modality that isn’t effective, in which case a good therapist will either adjust their approach or refer a patient out to another therapist with a skill set that is more suited to the patients needs. But, it may just be that an individual finds what they need to manage their mental health elsewhere and that’s not for me to judge.

Many people swear by yoga, nature, alternative medicines, spiritual practices, or even diet as the key to their well-being. If it works for them and it’s not harming anyone else, more power to them.

I also honor the fact some people may have already tried therapy and have gotten as much as they wanted or could out of it. Their ongoing mental health needs may simply involve medication management and the connection to a strong support system of family and friends.

Ultimately, the decision to seek out therapy is a uniquely individual one. Nobody can force someone into therapy even if they believe it will help that individual. Therapy only works when a person is truly committed to doing the work with a mental health professional they trust. And most importantly, everyone’s journey is different. Comparing one person’s outcome in therapy to another’s is equally as useless as comparing one individual’s struggle to another’s. We all deserve support of some kind and we all possess a distinct capacity for change.