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Why Doesn’t Therapy Work? 3 Common Misperceptions about Mental Health and Mental-Health Professionals

Julie Chang, Flourishing Hearts Psychotherapy & Counselling Services Inc.

“This is NOT working!” Mrs. Y (alias for confidentiality purposes) exclaimed in an exasperated manner.

It had been barely 20 minutes into her session, her first session with me, and her very first therapy session in her life, before she unleashed her wrath on me. I could not understand anything about Mrs. Y from her dramatic monologue aside from the fact that she was spewing out her resentment towards her husband for being duped into carrying more than $100K in debt and her frustration that she could not live a life well beyond her means without exacerbating her family’s financial woes.

She was tense and agitated, so I tried to engage her in a calming exercise to help slow down her speech and hopefully acquire some concrete answers; however, before I even started she interrupted me, clearly vexed: “How long do I have to see you before you can help me? How is doing this going to help me with my idiotic husband? I thought you’re supposed to help me! How can I keep travelling and taking my son to skiing every weekend?”

Empathizing with Mrs. Y did nothing but added fuel to her burning fire of complaints about how “something needs to happen right now!” Recognizing that she was not ready nor willing to engage in therapy, I suggested to her either to look into financial counselling or to march right back to my medical colleague’s office right across the hall to see if they would recommend any medication with sedative effects such as benzodiazepines. She literally rushed out the room and immediately got herself a prescription of Lorazepam in less than 5 minutes.

Mrs. Y was an extreme case, but it is not uncommon to see varying degrees of similar presentations among new clients, even those who have been through dozens and dozens of psychologists, therapists, counsellors, family doctors, spiritual healers, etc. These clients often have the following three misconceptions about mental health and mental-health professionals:

Misconception #1: Just talking to a professional will help.

Some people have the idea that we are miracle workers who can solve their problems “just by talking.” Perhaps it is because we talk in an office at scheduled times. Perhaps it is because, unlike your friends and family, you have to pay us for our “talking.” Perhaps it is because we have “fancy titles” after our names. Unfortunately, as much as I would have liked to provide a panacea for all your relationship woes and life’s ills, I am simply not that magical. Therapy is not just about talking, but it involves skills and techniques learned from years of training to facilitate a conversation that interweave interventions and techniques to help promote change and growth in clients – and, yes, this requires efforts from you, too!

Misconception #2: Therapy yields Immediate Results

If this misconception were real, I’d be rich by shamelessly charging every client $100K to have a one-time session with me. After all, by the end of our fifty short minutes together, you would have reaped all the therapeutic benefits there is and have changed – no, actually, evolved! – for the better. Clients usually arrive at our office with months, if not years, worth of built-up distress and stressors. Although there are those who are quicker to seek help before things take a turn for the worse, most clients are not ready to address their issues until they have been pushed against the wall and, even then, many are still resistant to soliciting or receiving help. The issues that have accumulated will take time for us to unravel and to unpack. Considering the fact that we only spend 50 minutes together each week, it will be difficult to produce any lasting changes during such a short period of time. The process could take weeks, months, or even years depending on the issues. I always tell the first-time clients who ask me, “how long will this take?” that it depends on many factors, but that they are free to decide how frequently and how long to see me as I am simply telling the truth and not trying to keep them in therapy forever for my own personal benefits. Thankfully, most of my long-term/regular clients see therapy as a part of their growth and a vehicle for prevention and maintenance, rather than a one-time pill. It is also these clients with whom I have the privilege of working together beyond the convention 6 to 12 sessions that have shown the most positive improvements that they themselves can see to keep them motivated.

Misconception #3: Professionals all have their acts together and are above “normal” human beings.

It is the honest truth that we are human beings, too, each with our own flaws, personal challenges, or even past trauma. Thinking of us mental-health professionals as someone who has the answer to everything and who does no wrong puts an unrealistic expectation on us and on our professional relationship. I find that, rather than my professional skills and expertise, it is more of my therapeutic approach and mannerism, supplemented by the occasional self-disclosure and demonstration of foibles and related learnings that keep me connected and relatable to my clients, even if I do not always share the same or similar life experiences.

I have the working hypothesis that perhaps one of the reasons why clients are not willing to accept the flaws and foibles that make us mental-health professionals is because they also cannot accept their own humanity with distinct weaknesses and limitations. It is a way of projection and a defense mechanism that is one of the most difficult to detect and accept. For these clients, I hope to help them see that I am not without my own challenges: I can cry, get frustrated, or become ill and hospitalized – well, quarantined for a deadly disease and almost died not of my own volition, but that is another story! However, it is through these difficulties and motivation to overcome them that I came to be in this helping profession to support people in their own healing journey.

[Original blog post from “Flourishing Hearts Psychotherapy & Counselling Services Inc” can be found here]