Therapy doesn't always "fix" people

[ArwenUndomniel]

I've seen a lot of threads on here where the OP is advised to "get therapy" to address psychological issues and work on their self-esteem. While it's not terrible advice, I sometimes do wonder if the people recommending therapy have ever had any and what they think actually happens during a session.

I'm coming at this from the perspective of someone who has had a lot of therapy of different types with different therapists. After many years, I've found it's great for understanding why you have particular thinking patterns and recognising unhelpful behaviours, but in terms of actually changing those things it's pretty useless, if I'm being honest. I feel like I know myself and my motivations very well at this stage in my life, but I still find it impossible to override the negative thoughts (even when I know they're irrational) and I still don't really like myself. According to some ways of thinking, that means I can't ever have a meaningful relationship because you have to love yourself before you can expect anyone else to love you.

I accept that others' experience may vary and I'm genuinely interested to know if anyone has successfully found a way of making therapy "work" in a practical sense. Not just getting to the bottom of your issues but addressing them and making real mindset changes.

You need to remember that with therapy you are doing the work on yourself.

The therapist can help with providing tools, helping recognise pattern and most importantly providing a non-judgemental enrvironment where they will listen to whatever you wish to share. But they won't magically "fix" anyone.

I have had therapy sessions over the years and found it really helpful but you have to be willing to engage, understand that sharing difficult events and memories will be hard especially at the beginning and that it takes time and effort to see results.

Depends on the type of therapy tbh

It didn’t fix me but im in a relationship which is unrecognisable from any I’ve had in the past. I think my partner is happy, I think my son is happy, I certainly am. I think therapy was a major contributor to that. I do think a good therapist is a rare beast though.

Yes, I broadly agree and have recently come to this conclusion. I don’t think it’s always good for people to be churning up the past with the prospect of finding even more things to be unhappy about. And, yes, while it can help you to understand situations, other people and yourself, that doesn’t automatically take problems, feelings and impact away.

I had some counselling last year and, while it was nice to ‘chat things over’ once a week, long-term nothing changed.

I think a life coach might be a better option for a lot of people.

Therapy isnt a magic wand. It's a two-way street. It won't 'fix' you, it's not a passive exercise. Sometimes, people aren't great candidates for it, it's not the right time for them. Maybe it never will be. It's not a one-size fits all, guaranteed cure. Nothing is.

It also covers a multitude of different styles and practitioners, standards vary, some therapists are quacks and some therapies are snake oil. Whereas, others are extremely well trained, experienced experts delivering evidence based treatments tailored to their specific needs, in partnership with their clients.

I thought my OP was very mildly worded and I was at pains to emphasise that therapy can help you understand yourself, etc, but I still seem to have made people annoyed because I used the word "fix" in the thread title (even though I put it in inverted commas).

I know that therapy isn't supposed to fix people. What I was trying to convey is that it's not as easy as saying "just get therapy" and everything will automatically be better, because you have to get the right kind with the right therapist and go into it with realistic expectations, and even then you might find that it doesn't suit you.

I don't have deep, irreparable trauma but I do have a difficult relationship with my family and that's part of the reason I have low self esteem, and also why I can't talk about it with them. I can completely see why people would rather talk to a paid stranger - I just haven't had the life-changing experience that some others seem to have, and I was curious to know if anyone else felt that way. But then again, maybe I just haven't been trying hard enough.

I have had therapy, group and one to one sessions and for me it was life changing.

I went in asking her to fix me and tell me what to do and she gave me the tools to see myself and make my own decisions that help me achieve my goals.

Totally agree. Over a decade of therapy has made me pretty self-aware but made fuck-all difference to the things I wanted to change such as attachment patterns.

Talking therapy got me so far - being more self aware and working out my feelings and what the issues actually are.

BUT the game changer was EMDR which was utterly life changing. You revisit old memories and reprocess them in a controlled environment. My goodness what a difference. I’m so much happier. More relaxed. Able to enjoy life.

I get what you’re saying OP. Most people will only be able to access 6 sessions NHS CBT. And I do wonder whether 6 hours of CBT will actually help people with their massive, lifelong issues.

I’ve just finished my allotted 20 sessions of CBT. And whilst I’m thankful for it, I’m 100% more broken and more suicidal than I was at the beginning.
whilst it gave me an insight, I have no coping strategies. I was referred back to the beginning after very nearly completing suicide, they were not helpful in the slightest.

I totally got what you meant OP

Ive had various periods of therapy of differing types in my life, I may well do again. Only one therapist really stood out and she was a student who was meant to be doing CBT, fairly rigidly but went off piste to do compassion based therapy in a person centred non structured way. It helps that Ive worked in MH and care for many many years so I have insight and experience of different models so was able to use this to guide her to support me, other therapists havent been so flexible or willing to accept my needs.

But my eyes roll considerably when it inevitably gets suggested on threads when more practical 'right now' intervention or changes are needed. There is a naivety attached to some of the suggestions almost as if it will 'fix' the problem, resolve it and remove it. For much of what I see on here it isnt going to. Particularly when the 'problem' as it were is 'shit life syndrome'. Aint no fixing that, and while you can develop strategies to feel better about your shit life, in a gaslighty type of way, its still going to be a shit life if you have one.

It’s a tick box. You see it on here - therapy is pushed as ultimately we’re not sure what else to do.

I think it’s a myth that therapy is supposed to fix you. That suggests you are broken in the first place, rather than what is much more likely - responding to a difficult set of circumstances.
although I am a therapist, so you might think I would say this….therapy saved and changed my life. I wouldn’t say I am “fixed” though. I have accepted some of the awful things that have happened to me, learned some new coping strategies, and made decisions to change things
What worked for me, was a long term therapeutic relationship with a well qualified therapist who had done her own work. It was such a healing experience to have someone who cared about me, challenged me, and was always on my side. Not necessarily alway agreeing with me, never telling me what to do, but allowing me to explore and come to my own conclusions.
sadly, that’s not what most people get from therapy because the NHS is focused on quick outcome measures, and the cost of long term therapy is not accessible to most. The worst part of my job is having to charge people.

I think in you have an acute minor mental health issues or a specific issue like a phobia or following a bereavement but you are generally mentally well i think it can help. But if you have a more serious mental illness thats deep rooted for years then no it doesn't work I've been under cmht for over 2 decades and and I can't say its really helped and I've found medication more helpful

I'm quite interested in EMDR - if you don't mind my asking, what were you seeking hrlp with? Tell me to mind my own business if you like!

IME of several counsellors they come at any problem from their own specific perspective, and are even surprised when it doesn't fit the individual. I would say I have had a few occasional insights but overall it has been a waste of money, where I have been paying privately. My worst experiences were NHS talking therapies - it was supposed to be CBT but was so far removed from that as to be laughable, and hypnotherapy - beware of that as it is completely unregulated.

Interestingly, EMDR didn't work for me (CPTSD), despite having a good record of success.

Counselling and therapy are two very different things.

Well its all unregulated in reality. People can join as many associations and certified organisations with letters after their name as they like, but its often not a method that can be tested, measured etc in the same way that improving from a different condition can be.
The self reported scaling is flawed in so many ways

My friend had it, it was life changing for her. Obviously her traumatic past hasn't been erased but my goodness, her quality of life has improved so much.

I cannot tell you the number of conversations Ive had with counsellors and therapists on behalf of my client group, to set out for them (and me) the difference.

the explanation is usually a load of wooly word salad.

I agree with this !

therapy is about understanding oneself, and practising new ways of relating to one’s thoughts, emotions and changing behaviours

of someone wants to ‘be fixed’ therapy won’t work as the individual needs to do the work

like PP said : people say ugh physio said I gotta do these exercises, GP said I need to reduce unhealthy foods / increase activity ugh !!

see : therapist suggests I reduce screen time in evening / walk in daylight / learnt to detach from rumination - ugh !!!

if we put the same ingredients in the bowl
we get the same pudding

therapy is hard work

I've found group therapy a lot more useful than individual. It's not especially fashionable right now, but I think you learn so much from other people, including how to make changes, and you also get held to account.

I don't think therapy can 'fix' anyone without effort from them - and a lot of people really don't want to change in practice, it's just too painful or hard. I also think a lot of therapists aren't very skilled in practical change, so that's a real issue too.

Group therapy apart, you could look for a life coach with a therapeutic background if you want to try something else - I've also found that useful for real change.

I have definitely had some in the past that I couldn't get to deliver, but these days it does. I think you also need to ask yourself why you aren't able to get things to move at all, as that's quite unusual I think, if you are really making an effort, and have a good understanding of yourself.

It’s quite paradoxical, but certainly in my DP’s case he actually had to be in quite a good place to do successful therapy. It took about a decade of making increasingly positive life choices, observing and understanding background family dynamics, support from me, trying therapy here and there, taking up exercise etc.

There was a crisis that prompted him going back to therapy, but all that other stuff culminated in him having the agency to do therapy in a very proactive way. He only became capable of that in his late 30s, having carried problems since childhood. He particularly needed this long build up because his main problems were lack of agency and low self-esteem, which are obviously big barriers to having the tools to change. For a while I thought it was sad that he hadn’t done it 10 years earlier but I realised that all that time he was working up to it. I wonder if it’s the case that a lot of people need to do other things first, to be in a place to do therapy effectively.

Childhood issues basically. Terrible effect on me as an adult. Nervous system completely out of whack.

much better now. Weirdly even my balance is better when I do yoga. I’m physically stronger can lift stronger weights. Used to be a somewhat problematic drinker now sober. It’s life changing.