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.

Sometimes people have a maintaining factor in their life causing their problems, which no amount of therapy fixes eg unhappy marriage, disabled child, fractured family relationships. Therapy can help people to live with it but ultimately the stress and sadness is maintained by the situation for some people

That sounds really good.

its not as though counsellors do CBT and psychotherapists do something better quality or more professional though, which sounds a bit like what you’re saying?

It's not the job of the therapist to 'fix' you. The job of the therapist is to help and support you to do the work to help yourself.

Mine saved my life and gave me confidence in myself and people again. I am a totally different person and will be grateful to her forever.

Why not look for someone who specialises in eating disorders OP. They usually list these things on the BACP site. Some therapists also provide a free initial session so you can see if there is a connection. As soon as I knew mine had experienced some of what I had, I knew I was in the right place, (trauma) and I imagine there are many who specialise in eating disorders that have personal experience. There are really good therapists but you need to search them out. I remember briefly chatting to one once who didn't know what PTSD was.

It's not an easy journey. You don't expect to instantly feel better. You need to work through stuff, do your reading and journalling. Its painful, thats why some people just can't do it, it would just overwhelm them completely. But you work on patterns of behaviour that aren't helping you. It takes time. I often go on and off for periods but have got better at managing things myself.

I've got a very abusive parent who stays mostly drunk and in denial (we are NC). She would never ever cope with this sort of thing. It would kill her.

Well given the amount of extra training and work hours they have had I suspect it is because they do something better. It is like everything, if you have the years of education and experience you are likely to do your job better than someone who has only done a basic 40hr course.

Yes but CBT is a type of talking therapy as legitimate as any other. It’s not just one the bad therapists do.

i can’t understand the link you’ve identified between CBT being ineffective and you having a poor therapist. When you had a better therapist it seems to have worked?

I didn't say my CBT was poor. I think you meant to tag someone else.

apologies you’re right! Your usernames looked similar 👓👓,

Ultimately you’ve got to be in the right headspace for therapy, you’ve got to have problems that therapy can actually fix, and you’ve got to be willing to go away and do a lot of work in between sessions.

Therapy has been extremely useful to me because I happen to fit into these 3 categories. For someone whose self-destructive behaviours are a way to shore up their sense of identity (regulating though others), therapy can be disastrous and destabilising, even if very unhappy.

A good therapist will not do harm to their client. There are lots of bad therapists out there however.

The use of the word “fix” has derailed the thread from the start. Sometimes it is not a question of having to do work because the relationship between the therapist and client can itself be what is needed.

Gosh, a lot of ignorant comments about therapy and mental health on this thread.

In answer to the OP, I think meaningful change is possible but you have to be ready. It's very hard to tackle deep rooted problems and can take a long, long time.

Though it's usually a time limited and one way relationship that is there to facilitate the client to make changes in their own life. There shouldn't be a dependency on the therapist.

Therapy is to -
talk through difficult experiences/emotions to move past them
develop tools to manage emotions better going forward
it doesn’t stop negative (or positive) emotions. They are a normal part of life it just hopefully shifts difficult emotions and prepares you going forward

The therapeutic relationship is nevertheless a relationship.

A professional one, yes.

After a few weeks I had to write down a when I had an intrusive thought about something that was happening. For example, the DC were home late, my original thought, the train they on has crashed, they are dead, then I’d write realistically what is more likely to happen which is the train is slightly late and all is fine. By doing this hundreds of times my brain gradually stopped jumping to the worst case scenario.
Another week it was to choose and buy a magazine in less than 30 minutes because I found it impossible to make a decision. It took me 29 minutes but I did it.
The first week’s was the hardest, I had to go out in the morning without cleaning all the bathrooms, I had to leave one untouched. It took to day 6 to be able to do this. It brought home how bad my OCD was.
My therapist was brilliant. One week she sent an antonymous surgery to 50 people about how often they cleaned their bathrooms. When the results came in I could see I was cleaning mine at least 20 times more than anyone else.
I then learned coping mechanisms to deal with how how I felt if I didn’t clean or do whatever the compulsion was. I learnt that my stress would go to a 10 out of 10, I then sat on my hand so I couldn’t straighten the blinds or whatever it was. The important thing was there was no 11/10 or 12/10 and that nothing actually happened if I didn’t do it and gradually the 10/10 stress became 8/10 and so on. It was amazing.

That’s such a lovely post! 🤗

I like Gabor Mates approach to emotional shift - the four ‘A’s

Awareness, Anger, Acceptance and Agency.

In my mind a therapist is a bit like a personal trainer and they can support, unravel, guide and hold you through each of these steps. Of course you can do it alone with podcasts, books etc - but a good therapist will gently challenge for you to see other perspectives and nudge you on to agency. There is also lots (same as fitness to continue the PT analogy) of lifestyle context and choices that will provide an optimal (or contrary) environment for your therapy and emotional development and healing.

Equally the academic evidence shows that therapy does have a positive impact but there is often no clear type (bar CBT for phobia and EMDR for PTSD) that is best. Similar to exercise choose what will suit you, what you will engage with and what will be sustainable for you. Most types of therapy (except CBT and EMDR) are about building a safe relational connection with your therapist so that you can gain confidence and skills in managing / navigating your own challenging relationships (most importantly with yourself first) out of the therapy room by becoming aware of your own core values which are your unique boundaries and how to uphold these.

@Christmaseree
thank you for taking the time to write that out.
the list homework sounds similar to mine , unfortunately she didn’t start it until week 18. So we never got to work through the fact I’d just listed everything I’d done wrong that week (my intrusive thoughts!). It sounds like mine was on the right track , just started it too late in the sessions to make it constructive.

id wondered about the point of it, but you’ve made me see there was a plan. Yours does sound like she really got you