I’ve extolled the virtues and benefits of psychotherapy for years. But therapy isn’t a cure-all, and it won’t help every person, with every problem, in every situation. In fact, it’s important to realize when going to see a therapist isn’t likely to help your situation much, because it can save you time, money and needless frustration.
Therapists, by their nature, tend to want to help every person who comes through their door. Even well-meaning therapists may not fully appreciate when they are largely going to be ineffectual in treatment because of the type of problem presented. After all, psychotherapy isn’t some magical elixir. Talking about some topics simply won’t do much to help the situation.
Here are five things that psychotherapy won’t help you much with.
1. Your Personality.
While indeed personality disorders make up a good chunk of the Diagnostic and Statistical Manual of Mental Disorders (the so-called DSM), they also got their own category within that reference book for a good reason — they’re really hard to change.
Personality disorders are typically more ingrained and therefore more difficult to change than most other mental disorders. After all, our personality — the way we relate to both ourselves and the world around us — starts in childhood and is shaped by decades’ worth of experiences, wisdom and learning. You can’t expect to undo decades of personality development in a few months’ worth of psychotherapy. (Years, maybe.)
While psychotherapy won’t likely cure you of a personality disorder or long-term personality trait, it can help mitigate some of the worst features of the problem, or reduce its intensity. For instance, while someone with narcissistic personality disorder may still go through life thinking they’re better than everyone else, they can learn to tone it down in their individual dealings with others so it becomes less of a social and work impediment. Introverted people will still be largely introverted, but they can learn to feel more relaxed and comfortable in social situations.
2. Your Childhood.
Sigmund Freud and many others of his era traced a lot of emotional health problems back to a person’s childhood. As much as we would like to try, however, we can’t go back and fix our lousy childhood. It is what it is — a piece of our history.
What you can fix in psychotherapy is how you interpret what happened in your childhood… And whether you choose to cling to those issues, or whether you can grow from them after obtaining insight into their significance. But therapy won’t cure you of your bad parents, rotten siblings, crumbling childhood home, or sketchy neighborhood where you grew up.
3. Half a Relationship.
It takes two to make a healthy relationship work — and to continue to grow and move forward after the relationship has hit a few rocks. Psychotherapy can help couples through those rocky parts, but only if both people agree to counseling with an open mind and a willingness to work on the relationship. This means both partners also have to be willing to undertake some changes (not just pay lip service to them).
While one half of a couple can go into counseling to work on relationship issues, it’s not going to be nearly as effective as having both halves in therapy. Therapy with only one side will usually only help that person to better cope with their partner’s problems or issues (this is more of a band-aid than a long-term fix). Or, worse, help that partner to decide whether the relationship is even working at all.
4. A Broken Heart.
Nearly all of us have gone through it — the feeling like your heart has just been ripped out of your chest and stomped upon. When love dies, it’s one of the worst feelings in the world. Sadly, it rarely ends after just a couple of days.
But talking to a therapist isn’t likely to help much with this issue. The end of a relationship is one of those really difficult times in almost everybody’s life where there are no shortcuts or quick solutions. Talking to a close friend, focusing on activities (even if you don’t feel like doing them), and immersing yourself in things that will keep you busy are your best bets, as time does its magic.
Therapy may help a person who gets “stuck” in ruminating over the details of the old relationship, even years after it’s over. If a person can’t move on, talking to a professional may help them understand the relationship better, and bring perspective to their life.
5. Losing Someone.
The proposal for the new revision of the DSM suggests that normal grief may become diagnosable as depression, but grief isn’t typically considered a mental illness in need of treatment. Despite the popular common wisdom of the “5 stages of grief,” the reality is that everyone grieves loss differently and uniquely.
Like in love, psychotherapy isn’t going to do much to help speed the natural processes of time and perspective. Grief needs space for remembrance and being with your thoughts of the person who’s passed away (in other words, grieving is best done when it’s done mindfully and with patience).
Therapy can help, however, a person who gets “stuck” in a life oriented toward grieving or a person who, even years later, still cannot get over the loss. But for most people, psychotherapy is both unnecessary and overkill for what is a normal process of life and living.
Like an antidepressant or aspirin, psychotherapy isn’t a treatment that can be used for any challenge life throws at you. But even in many of the circumstances described above, there are exceptions when therapy might be a helpful alternative to consider. Understanding when it’s likely not a good use of your time, money or energy may help you avoid unnecessary treatment.