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.

Shit life syndrome- yes.

Hoping therapy helps weather an ongoing abusive relation / a horrible job, poverty -

not helpful, can be invalidating, shaming

I think in the PP's case it's that CBT is wildly inappropriate - it can be an effective and affordable way to change unhelpful behaviours. It's not designed for people who are suicidal, they need much deeper help and medication.

I never felt that when I first asked for help. I felt listened to and like there was help.
I definitely feel it now, they are definitely shrugging their shoulders now. Which almost makes me feel worse

Therapy definitely didn’t fix me. I did that myself in the years after therapy ended. But it did give me an opportunity to say things out loud for the first time ever and have someone validate and question them. It meant I saw certain situations completely differently. It was like I took all the puzzle pieces apart and could start to put them together in a different way, and then it all suddenly made sense. Once all the bits went back together in a way that made sense I could start moving forward with my life, thinking of things differently, doing things differently.

This is excellent. I completely agree that therapy didn’t fix me I fixed me.

I also adjusted massively downwards what fixed means. It essentially means peace and contentment for me.

I am in the thick of peri menopause and I hear a lot of people talk about feelings bubbling to the surface that they simply could never have expected. That hasn’t happened for me. I dealt with the feelings long before peri thanks to addressing some very difficult issues and I actually am very accepting of myself and others as the people we are.

I also have accepted some what “should be” close family relationships can never be healthy for me so I’ve distanced myself appropriately which I would never have done before I was “fixed”.

I found therapy good, it helped me unpack things and get some perspective (I was bullied at work very badly). I really feel that time is really the main healer, I can’t forget but time helps

One of the big issues I’ve come across is an expectation that I know what I need or what’s out there.

I’ve not got a fucking clue. Im 40 years on this planet with issues going back 30+ years, but I’ve never had any sort of engagement with mental health professionals. So I just took what was offered because I didn’t know better.
I only found out it was CBT after it had finished and I saw a reference to it. Would it not be suitable for suicidal people? I self referred after being unable to keep myself safe, and I’ve been subsequently diagnosed with CPTSD

I agree with you @ArwenUndomniel

All I know is that I wished I'd trained as a therapist. When I was young we used to hear about rich Americans going to see their "shrink" which was quite a source of amusement, not least because they seemed perpetually fucked up regardless. Who knew 10 years ago that every other person you meet now would have their own therapist.

It's not supposed to fix you. Only person who can do that is you. Therapy just exposes it. If they are good, your therapist will actively support you while you work on your self improvement. They can offer you support, company, good advice and an outside perspective. But they can't do it for you.

My therapist has been my solid immovable rock, best adviser, cheerleader and occasionally the boot up my backside. He is definitely not afraid of bringing the tough love but he can't make me change. I have to do that.

EMDR isn’t generally recommended for complex trauma. It’s very good for particular incidents of trauma where there’s a clear memory to work through, the very nature of complex trauma means it’s much harder to isolate specific incidents. Complex trauma impacts how you are in relationships and needs a relational therapy to help reset that part of you.

Therapy can be utterly life changing - it was for me. It can give you skills (CBT/DBT), help you understand your responses and reactions that come from past events (psychodynamic) and give you a safe, accepting relationship to explore yourself (person centred). A good, experienced therapist will draw on different modalities at different points in the therapy, and will be able to hold the relationship safely. Part of the problem is poorly trained therapists who haven’t been in long term therapy themselves, so can only do what they’ve been taught to do.

Its also a two way street, the therapist can help you understand why you react the way you do, give you ways of changing that reaction, draw your attention to how that plays out in the therapy. The client then needs to do the very hard work of actively changing, challenging intrusive thoughts, testing out new ways of thinking or reacting.

Too many people have an attitude of “I always think X because of Y” and look for therapy to somehow plant new thoughts in their head. Instead of saying “I usually think X because of Y, bit maybe if I focussed on thinking B instead and see what happens” and then take that process back to therapy.

It’s a relational process, with the therapist and with yourself, not a treatment you apply like a bandage. It’s not for everyone, but if you have a pattern you need to change, or have difficult experiences to work through it can be absolutely transformational.

Id never go to a therapist who hasn’t spent their own time in therapy (by which I mean a good couple of years, not 20 sessions to tick a box on their course).

Completely agree OP. Therapy is hard work, and just turning and and expecting to be fixed is totally ineffective.

the worst is when a poster describes a partner who clearly isn’t in the slightest interested in the relationship or their partners thoughts or feelings and they’re advised to get couples counselling. Total waste of time and (significant) money.

counselling is also a massive privilege nowadays. Telling someone to shell out £60 a week in a cost of living crisis is quite insensitive

I had CBT for OCD and counselling when I had a breakdown after three terrible things happened at once.
Both were absolutely amazing for and absolutely changed my life for the better.

TBH I think while some people say "just get therapy" as flippant, throwaway advice I don't think that's what everyone means by it.

I think you're absolutely right it has to be the right therapist and the right approach. Sometimes people don't realise there are different approaches so that can be one thing which gets in the way. And the NHS offer sounds completely pointless to me - I don't understand what 6 weeks of CBT would do for anyone.

Also I think it doesn't help at all if there is something underlying which is the root cause or heavily influencing the difficulties the person is having. I had counselling four different times in my teens/early 20s and while the counsellor seemed very pleased with my insight so I enjoyed going (I was very much a teacher's pet type) nothing ever really changed - several years later I was diagnosed with ADHD and the insight I've had from understanding that has done volumes and helped with the things I hoped counselling would help with back then. I did have some CBT focused on ADHD after diagnosis and that was also helpful in some ways in that it helped me set up some systems to keep me organised, but I wouldn't call it life changing.

I am looking into therapy again now as I have some themes which keep coming up which I think I need to explore with someone who has a better understanding of brains and behaviour than I do - but it's difficult to know where to start TBH and everyone has a waiting list.

CBT was amazing for me, very challenging but totally life changing. I still get my notes out now from time to time from my sessions 10 years ago.

I think CBT can be, but 6 sessions doesn't seem enough?

Having therapy is better than not having therapy, if someone can find a therapist who they feel comfortable with. It’s not a fix, in the way that you describe.

It’s unreasonable to assume that therapy is being recommended because the person recommending it thinks of therapy as a fix, if by “fix” you mean some effortless bolt-on remedy that solves problems.

It’s also unreasonable to assume that the person recommending therapy has no knowledge of being in therapy.

if you go into therapy thinking it will ‘fix’ you, or, as on another recent thread, that your therapist is there to ‘give you advice’, I think people might want to rethink their own mistaken assumptions.

This is a really interesting thread & therapy/counselling is something I've been thinking about for a while now due to numerous reasons.

How do you know what type of therapy you need? Where and how do you go about finding one suitable without throwing huge amounts of money trying a few?

As a remedial hypnotist I can 'fix' issues such as phobias, bad habits, trauma, over anxiety, pain, etc. What I can't do is fix dissatisfaction – the client who comes to me and demands that I make them happy will get a polite no.

I wondered if those recommending therapy had had therapy themselves. I didn't assume that they hadn't.

Again, I KNOW that therapy isn't supposed to fix people, which was why I put it in inverted commas.

It's interesting to me how protective some people are about therapy and how, if someone says that it didn't do much for them, the conclusion tends to be that it's that person's fault. Either they did it for the wrong reasons (wanting to be "fixed"), or they didn't do the work, or they chose the wrong type (as a pp says, how are you supposed to know what type is right if you don't have limitless resources to try different ones?).

I do have an interest in this because this year I've had an unexpected relapse of an eating disorder, and I know I need to "get help" but I have no idea what would actually help me, going by past experience. I don't hold out much hope that the standard 6 sessions of CBT I might get on the NHS would be useful but then what?

I’ve been thinking of trying hypnotherapy for my fear of flying.

My friend’s 21 year old daughter has entrenched anorexia and has various different types of therapy on a very regular basis. From what I can make out, they are doing her more harm than good. One of the therapists is using rapid eye movement to make her recover early memories which are completely false; according to her mother - who I trust. Also, they are making her relive extremely traumatic experiences she endured and witnessed in a specialist unit for anorexia sufferers - which also did her more harm than good. She is wrung out and distraught after these sessions - and they don’t appear to accomplish any good. The whole family has a weekly family therapy session, but their younger daughter rarely attends because she is too busy. The anorexic daughter has started using these as a weekly opportunity to attack her mother - which is literally breaking her.The anorexic daughter used to be suicidal (though not at the moment) and she still has specialist anti suicide therapy. I asked her mother if it was helpful and she said - well she hasn’t committed suicide yet. You can’t argue with that really, but I’m not sure all this therapy is having any real positive effect.

I have had various types due to dysfunctional parents. none helped one even told me to end relationship with my Dad when really ten years later radical acceptance has worked better ie it’s all on his terms and I accepted it

the only thing that worked was something called Trauma Rewind - literally hypnotherapy erasing emotion from memories. Enormously helpful.

strongly recommend if you’re a visual person and think in pictures. Only needed 2-3 sessions per negative PTSD style event and processed 2 times each. Extremely effective and brought be back from PTSD eg having panic attacks when I received a letter type baseline

Some people are so fucked up and in denial of it - they’ll never actually commit to the work needed to improve their own lives and their family.

I received homework each week too so it’s far from just 6 50 minute sessions. I think if you’re serious about trying to get help and helping yourself then 6 sessions can really make a difference.