Thanks to increased conversations around mental health, therapy has become more normalized for Americans than ever before. According to a 2019 CDC study, more than 9.5% of American adults have sought out therapy or counseling from a mental health professional. Yet while therapy may be a normal part of many Americans' lives, there are still many misconceptions and myths about the practice.
Psychotherapist Lori Gottlieb has been on both sides of the therapist's couch, and now, the mental health expert and New York Times best-selling author of Maybe You Should Talk to Someone is debunking falsehoods about mental health treatment.
Myth 1: All the work of therapy happens in your session
"A lot of people get their ideas about therapy from the media, and what they've seen in movies and television series," Gottlieb tells Yahoo Life. "They think that you're going to go to therapy and you're going to download the problem of the week, and then leave and come back and download the problem of the next week. And therapy is not like that. It's a very active process."
In fact, she says, the benefits of therapy show up outside of the sessions, when you can synthesize what you learned about "yourself, your patterns and your blind spots."
"You bring that out into the world during the week, so that you can actually change the way you're navigating through the world," she says. "I think another myth is that you go to therapy and the therapist just sort of validates you. And hopefully, your therapist is actually challenging you to look at yourself in a way that maybe you haven't been able to before."
Myth 2: A therapist will give you solutions to your problems
Gottlieb says therapists don’t inherently know what's best for their patients. Instead, a productive therapy session should "quiet down all the outside noise" for a patient.
"Sometimes people have trouble accessing that place knowing that they have inside of them, and it gets drowned out by all the noise out there," she says. "There are societal expectations and family expectations and cultural expectations and their friend group's expectations — so, they really can't hear themselves. We help people to really hear themselves so they can get clear about what they actually want."
Myth 3: Therapy is exclusively for mental health problems, and has no benefit for people with physical health issues
Gottlieb works with patients who are suffering from chronic physical conditions. Since 6 out of 10 Americans live with at least one chronic illness, she notes it's important that they feel supported not only by doctors but also by mental health experts who can help them navigate their emotions around their illness. That can also include frustrations over getting diagnosed in the first place.
"I think the problem is that in our society, we separate out the physical health from the emotional health and they're very much intertwined," Gottlieb says. "With people who are dealing with a chronic illness, is, first of all, it takes a long time to get diagnosed. So a lot of people will come to their doctors and say, 'Something is not right — I'm tired, I'm having this symptom and that symptom.' And often, people — especially women — get written off like, 'Oh, it's anxiety or it's stress or you need more balance in your life or take this vitamin.' They don't really dig deeper to say, 'Wait a minute, something else might be going on here. Let's investigate that.' So often, it takes people sometimes months or years to get diagnosed, and that has a huge impact on someone's emotional health because not only are they feeling bad, physically, they're being told this is kind of all in your head or there's really nothing wrong with you. And so it's very difficult. And so people will often come to therapy, and one of the things that I helped them do is to really advocate for themselves to, first of all, believe in themselves."
Myth 4: Your therapist will be upset if you criticize your treatment plan
"One of the nice things about therapy is that you get to talk about everything, including the fact that you might be wondering if you're with the right therapist, and you can talk about that with that therapist," Gottlieb explains. "So out in the world, we would find that very uncomfortable to say to someone, 'I'm not really sure this is the right friendship for me or the right partner.' But in therapy, we welcome those conversations because we want you to be with the right therapist, first of all, and second of all, it will help you to grow as a person to have that conversation."
The relationship one has with a therapist, Gottlieb notes, is much different than one with other health providers, who you may see once or twice a year.
"The most important factor in the success of your therapy is the relationship with the therapist," she says. “That matters more than their years of experience or the modality that they use. Those things matter, but not as much as the relationship as the right fit. So it's something you can bring up. You might find that maybe this isn't the right person and you want to go try somebody else — and we would support that and welcome that."
Myth 5: You can't talk about your therapist's personal life at all
Gottlieb says that therapists shouldn't bring up things in their personal lives that aren't relevant to the therapy session — but that doesn't mean you may not learn something about a therapist in other ways. If you find out something that makes you uncomfortable about your therapist, it's OK to speak up, she says.
"I don't know that you would necessarily know your therapist's political views, but let's say that you're Googling around and you find that your therapist has contributed to some campaign that is for something that you don't agree with — you can bring that up in therapy," she explains.
Myth 6: Your therapist is your friend
Not exactly, says Gottlieb.
"It's a unique relationship because it's not a friendship, but in some ways, it is more intimate than a friendship or more personal than a friendship," she says. "But it's not something that takes place outside of the therapy room, and it's not reciprocal in the sense of your therapist is not sharing their life with you. it's a very meaningful human connection that you don't get in the same way anywhere else."
One thing that's different from friendships? Your relationship with your therapist may end when you have gotten all you need from it.
"That's one of the unique things about the therapeutic relationship is you know, from day one, that this is going to be one of probably the most meaningful relationships you might have, and that it will end and it will help you to have more meaningful relationships with other people outside," she explains.
Myth 7: You should be in therapy forever
You don't have to commit to going to therapy for the rest of your life.
"I do a podcast called Dear Therapists with fellow therapist Guy Winch, where we do actual sessions with people. At the end of the session, we give them homework and they have a week to do the homework and we hear how the session went. And we love doing that because we want to show people that you can make shifts in even one session," she says. "So one session can help people move forward with this issue they’ve had for months or years."
Of course, exactly how long one sees a therapist depends on one what they're coming into the sessions with.
"I don't think that this myth that you're going to go to therapy and you're going to be there for years really holds up," Gottlieb explains. "I think some people do that. But there are lots of ways to move forward and to heal."
Gottlieb says it's not about how much time you spend in therapy, but whether you are meeting your overall goals.
"If it feels like you're not clear about why the person is there and what the goals are, the therapist really needs to bring that up and most therapists will," she says. "I think that people don't understand that we are thinking all the time about why you're here and whether or not we are meeting those treatment goals."
And just because you've left therapy on a regular basis doesn't mean you can't return for a yearly check-in, she says.
"It doesn't hurt for people to want to do a check-in maybe once a year or maybe every couple years [after leaving regular therapy]," she says. "I think that therapy is really flexible in terms of how you use the therapist."
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