Things to Know About Therapy

What Therapy Is, and What It Isn’t

Therapy is, at its best:


An opportunity to increase one’s understanding of oneself 



When of any depth, hard work

For some, life-changing 

A place to build skill 

A place to resolve emotional pain 

A place to push oneself for change 

A place to learn for oneself when to stop pushing 

A safe place to express your feelings 

A space in which to address internal conflict 

A vehicle for finding your best answers for yourself

A place to update your response to the life you have now

What therapy isn’t:

A means of making other people behave differently

A means of diagnosing other people’s problems

A way to change the people who don't understand you so they finally do

The solution for getting others to see things the way you do 

A way to guarantee that others will become okay with hard choices you feel you need to make, but keep delaying out of fear of their reaction

Something that someone else can do for you

A pathway to ultimate perfection

A place to be told exclusively what you want to hear

A place to be told what to do

A means of giving over responsibility for your adult choices to someone else

The thing that will finally make all life's challenges easy from here on out

A process that will forever remove all aspects of doubt and uncertainty from your life



Myths About Therapy

Therapy should always feel good.

Because therapy often challenges us in areas where we’ve been stuck, or hold a great deal of fear, or sadness, therapy can be very hard, and for some people can feel not only not good, but quite bad!  This can be especially likely early in the process, often accompanied by the fear that “therapy is making me worse.”  What is usually happening, however, is that the client is looking at what has been problematic but at least partly avoided, and is getting a fuller perspective regarding the emotional cost of the issues they have been struggling with.

Therapy should always feel bad.

Clearly, therapy can be intense at times.  It also can be light, philosophical, and humorous.  Everyone’s therapy is different and is usually characterized by multiple experiences and feelings!

If you don’t have something intense or strongly impactful happen between sessions, there will be nothing to talk about or work on in session, and the session will be both wasted and pointless.

Talking about deep issues is appropriate when desired and often necessary.  But some of the best work – including sometimes quite deep work – is often done in calmer moments and in calmer weeks when it seems like ‘nothing’ is going on.

Therapists deal with “the past,” while life coaches deal with “the present.”

While many people believe this, including some therapists, particularly those who identify themselves as coaches and reiterate this talking point, it’s inaccurate.  The false distinction (i.e. that therapists only deal with the past) is basically the product of decades of persistent marketing by the coaching industry as a means of justifying coaching as a practice.  As in any field (including therapy!), there are better and worse practitioners among coaches. Training programs for coaches have developed over the years and aspiring coaches may or may not decide to pursue them, but they are not equivalent to therapeutic training.  The mantra that ‘coaches deal with the present and therapists the past’ started with the reality that coaches are not necessarily required to have any education in order to engage in coaching.  Given that disparity between the training of coaches and therapists, coaches needed to carve out a territory to ‘claim’ in order to distinguish themselves from therapists.  They also needed to reduce the risk of being seen as practicing psychotherapy without a license, since life coaches – unless they’re therapists – aren’t qualified to engage in therapy. Therapists deal with and are trained to deal with both past and present, and the notion that they don’t is somewhat nonsensical, upon reflection; nonetheless, the claim has been repeated enough that it has now, as intended, become standard marketing lore that many people believe simply because they have heard it so much..

Therapists don’t/can’t diagnose you.

Therapists are trained in diagnosis and are typically required to diagnose problems that are presented in therapy.  In fact, in many states, therapists are considered out of compliance with state licensure regulations if they fail to diagnose.  If there is virtually no diagnosis or condition, there is, ironically, a code for documenting that.

Insurance companies will pay for therapy without a reimbursable diagnosis.

Outside of a few exceptions such as EAP coverage, in which employees of a company may be allowed a limited number of sessions with an EAP provider for free, insurance companies will not pay for therapy that is not deemed ‘medically necessary.’  Insurance companies won’t cover treatment for all diagnoses, but will only cover treatment for those they deem significant enough or appropriate such that they can justify coverage according to their standards.  It is not unusual for individuals to have seen different therapists, and to have had their insurance filed repeatedly, while holding the mistaken belief that they have never had a psychiatric diagnosis.  If an individual pursues therapy strictly for personal growth, with no real discernable diagnosis, that is truly a wonderful thing - but it is a wonderful thing that that individual's insurance will not cover.

Everything about the DSM that people complain about in social media is true.

The DSM is a diagnostic manual that American therapists are required to use.  A flawed instrument, it is not without merit, but it is also far from perfect, and it has – no pun intended – a documented history of some problematic diagnoses in the past that were sadly consistent with prejudices of the time.  However, there are many claims in social media about perspectives and statements in the DSM that not only are untrue but often don’t even exist.  If you have a question about whether something is 'true’ of the DSM, you can look it up, or ask a therapist. But just like so many things on the internet, a claim made in print or on video doesn’t necessarily make it so!

It is a personal rejection if, when therapy is over, the therapist acknowledges that you have ceased to be a current client.

While it doesn't always happen, psychotherapy often requires a firm delineation of "when therapy is over."  In many fields a professional can refuse services to someone who hasn't sought their help in several weeks or months, if they are simply too busy and just don't have room for that person on their schedule, and a client can understand this.  In therapy, however, this can be viewed as abandonment or neglect of an existing client who hasn't been in for a time but who hasn't been formally advised that therapy is over.   Usually this represents an interpersonal issue, which can be challenging enough, but in some cases, though rare, it can result in legal action. Making it clear to someone that they are no longer your client can be touchy, given the personal nature of therapy, but it is neither in the best interest of either the client or the therapist for the therapist to be overtaxed with too many clients at once due to a failure to clarify when therapy has officially terminated.  Many a therapist has had the experience of having a full, or occasionally even a too-full, practice, only to encounter a socially challenging time in which a wave of inactive clients all want to come back immediately into therapy, even if just temporarily, and the therapist feels obliged to take them all due to both a desire to support old clients but also a fear of being accused, perhaps legally, of abandonment, because they never terminated therapy.   A former client can always return to resume therapy if it's appropriate, and if the therapist has room in their schedule.  Formally acknowledging the close of therapy allows the therapist to be honest with a returning former client if there is not sufficient time to meet their therapeutic needs properly.

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