Melissa Miles Therapy FAQ
Melissa Miles — at the time, a psychology student and someone who had been in psychotherapy — wrote this frequently asked questions (FAQ) file about psychotherapy in 1995. Although it is somewhat outdated, it still has a lot of good information about psychotherapy and the therapy process.
So many people have asked me questions about therapy and there is so little information out there on the web that I decided to write this Psychotherapy FAQ (Frequently Asked Questions file). Its purpose is to help people who are not yet in therapy but would like to try it out.
Why go to a therapist?
Not all therapy experiences are alike, nor should they be. In this FAQ I explain in detail the various types of therapy and people who give therapy, but to simply answer this question, the question I would ask you is: What do you want out of therapy? This is important because a lot of the success between the therapist and client depends on your expectations. I had a psychology professor who cited a study which showed that success in therapy is correlated with wanting to succeed, and I would argue that success in therapy also depends on what you expect to happen, and whether those expectations are compatible with what a therapist can and will do.
Going to a therapist can be a worthwhile growing and stabilizing experience, good for times when you have specific problems, interpersonal problems, or generally feeling down. You can go to a therapist once, for a few months or embark on long-term therapy–each depends on different expectations and goals.
The time when most people tend to go to a therapist is during a crisis. A crisis is an immediate threat to your life, where you feel in danger, suicidal, or inability to live your life in a normal productive way. Examples of when a crisis can occur includes:after love ones have died, breaking up in relationships, times of depression or if you are in danger or have been harmed in some way. The reason for going to therapy at this point is so to be able to stabilize your life so that it is not in any immediate threat. Sometimes, this entails only having a short visit, in which the therapist uses crisis counseling. The point in this case is not to uncover any underlying motivations or access you for long-term treatment, but to provide "intervention". Sometimes, however, people go into a therapist's office with a crisis and find that there are things that underlie it that you want to uncover or work on. At this point it is no longer intervention, but on the path to psychotherapy.
Another time that is common for people to go a therapist is for specific non-crisis problems, such as insomnia, procrastination, low grades, or even feeling depressed. This is often called "counseling" rather than psychotherapy. The defining factors is that the person does not have an immediate threat to life but has a specific identified problem to be worked on. Many people tend to go to cognitive-behavioral therapists or rational emotive therapists. I had a psychology professor who argued that specific behavioral or emotional problems are best treated by the cognitive behavioral camp, so you might keep this in mind if you chose to go into see a therapist, however I am a little less adamant about this distinction. One thing to keep in mind though is that your problem might be like a symptom. An example of this is a person who comes into to a therapist's office because they are having trouble in school. This might be the result of many factors, such as interpersonal problems, an addiction or alcoholism, an eating disorder, etc. It might end up that the counselor or therapist might not be qualified to work with your problem or might have time constraints (school, employee or college counselors often will be limited by expertise and time). This might also lead you to psychotherapy.
Finally, what used to be the most common type of therapy, and now is a dying art, is personal psychotherapy. This usually takes place with a psychotherapist or clinical psychologist, although MFCC's and MSW's are doing it more and more lately. Sometimes people go into psychotherapy in order to work on problems which seem more nebulous. Often people go in for growing, rather than stabilizing. An example of this is a couple who has been together for 15 years who are dealing with an affair. A crisis intervention or dealing with the affair as a specific problem might be what brought the couple in but it might turn out that more is going on, such as years of resentment, an environmental pressure, a death in the family, etc. Another type of reason people go into psychotherapy is so to work on psychological problems. This can range from being abused and having intimacy problems to having a smothering family which has led you to overeat. As you can see that these are problems which need a more in depth analysis than intervention or counseling would provide. Despite this managed care does not usually believe that psychotherapy is worthwhile for the time it might take, and you should keep this in mind if you are depending on insurance to fund your therapy. Psychotherapy is often a long-term commitment, however short-term therapy has been "in" for awhile and there have been studies that show it can be effective under the right conditions. This is a discussion that is best had with a therapist you are considering going to–they would give you advice based on an assessment of your situation.
You don't need to have a "major" problem to go to a therapist. Just feeling unable to deal with your problem or feeling unhappy makes you a good therapy candidate. As I have shown, therapy can have many different levels, all which might be more appropriate at certain times than others. I once had a psychology professor who said that at times, going to the gym will help more than going to a therapist. I know from experience that sometimes art, or writing will do the trick. But therapy should be viewed as a *tool* which can be used to work on even problems you consider "minor." So, Why go to a therapist? Now that you have read some reasons people go to one, remember that therapy is the commitment to improving your mental health, and sometimes this can be done with out a therapist, and sometimes a therapist is a god-send. And anyway, it doesn't hurt to try one out.