As a clinical therapist, I’ve gotten comfortable with the questions and common misconceptions that exist around the topic of therapy. I vividly remember my grandmothers’ response when I told her I was pursuing my graduate degree and licensure as a psychotherapist. At the time, she was genuinely concerned for me. In her mind, psychotherapy was for the very ill, the certifiably insane. I sit here now and think about those conversations with my grandmother and wonder what it would have been like had she lived in a world where therapy was not only destigmatized, but encouraged and even celebrated.
In psychologist Guy Winch’s TED Talk, “Why we all need to practice emotional first aid”, he gives an example of the difference in how we treat physical and mental health. His example: if someone is feeling depressed they’re often told to shake it off, think positively, it’s all in their head. However, if that person breaks their leg, no one tells them to just shake it off or that it’s all in their leg. We can all agree that that would be absurd, yet as a society we often respond to mental health concerns in that way.
Many people don’t struggle with a major mental health diagnosis, and they have resources and support in their lives that help them remain resilient even in the face of stressors and other troubles. For others, therapy may be their life line. The vast majority of people fall somewhere in the middle.
If the question is really asking who should seek therapy for treatment of a diagnosed mental health disorder, the answer is 1 in 4 of us. However if the question is who might benefit from the services of a skilled psychotherapist, the number is larger. Much larger. Take 2020 for example, most of us have experienced drastic life changes in some way. This year, more than ever, we’ve noticed increased anxiety and the somatic and psychological ways in which our bodies hold stress and trauma. Who wouldn’t benefit from meeting with a mental health professional once a week to explore their life from a solution-focused lens, work on identifying obstacles and attaining personal potential and life satisfaction?
Therapy has two possible goals: to treat illness (medical model) and/or promote health (wellness model). Unfortunately, therapy is primarily known for the illness side. People view therapy as something they should engage in when they’re not emotionally well, they assume that everyone who goes to therapy isn’t emotionally well, and that as soon as their emotional condition improves and symptoms reduce they shouldn’t be in therapy any longer. This is the medical model talking.
The World Health Organization defines health as more than the absence of disease and emphasizes a wellness quality, which includes mental, social and physical well-being. The wellness model is considered to be more of a proactive, preventative approach to mental health care. Anyone, whether they have a DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnosis or not, may choose to go to therapy because they want to enhance and enrich their life. Maybe they want to figure out how to have healthier relationships. Maybe they want to work through an experience in their past as they notice ways it may be affecting their present. Perhaps they want to live more purposefully, develop healthy habits, have a better attitude, challenge negative self-talk. So, they choose to go to therapy. Do they “need” therapy? As a medical or psychiatric necessity, they may not. But as a quality of life aid, it could certainly help. Ultimately, therapy is about growth and creating opportunities for positive change.
When we frame our situations in terms of needing therapy, some people feel there is something wrong with them and participating in therapy would only strengthen the embarrassment or shame that goes along with that. Sadly, this mistaken belief as to what therapy is about and what it means keeps many from the opportunity to improve their lives. Good therapy helps us to understand and rebalance the power we give to the different beliefs, expectations, and goals that we acquired at different stages in our development.
All of this is why I would answer the question of “Does everyone need therapy” with a definitive no. But just because you don’t need something doesn’t mean you couldn’t benefit from it. Fundamentally, therapy is about mental health, and health means so much more than the absence of illness. It means growth, resilience, understanding, and strength.
Rebecca Bowers, MA, LMFT
Individual and Family Therapist
Lakes Center for Youth and Families