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Therapists Spill: What You Didn’t Know About Therapy

Therapists Spill: What You Didn't Know About TherapyTherapy is highly misunderstood. That’s due to several key reasons. For starters, therapy is conducted behind closed doors, which makes it harder to fully and accurately capture.

Clients don’t commonly discuss their sessions with others. Sadly, the stigma of seeking therapy prevents many people from sharing their experiences.

“The ‘you must be crazy if you’re in therapy’ myth persists, despite millions of relatively healthy people seeking therapy to overcome a common obstacle or make a good life great,” said Ryan Howes, a clinical psychologist in Pasadena, Calif.

Even if clients talk about their therapy, or a therapist shares a case study with colleagues, it’s still subjective, he said. “A lot happens practically, emotionally and relationally in a given session, most of which is lost in a three-minute recap.”

Therapists also don’t communicate the specifics of therapy well enough or promote psychotherapy in general, Howes said. “Most of the communication from professional psychotherapists is filled with academic jargon or self-help psychobabble that makes it confusing so people don’t have a clear understanding of what therapy is about.”

The media is usually a shaky source of what therapy really looks like. Naturally, movies and TV focus more on entertainment and ratings than on scientific accuracy, Howes said. That means media is “filled with goofy, sadistic, romantic, or miraculous therapists rather than a realistic portrayal of hardworking, compassionate professionals with normal human shortcomings.”

Misunderstanding also occurs because of fear, according to psychologist John Duffy, Ph.D. “People are afraid of being exposed, afraid of opening up, afraid of vulnerability, and afraid that, once they release their anxieties, will they be able to pull themselves back to ‘normal’ again.”

Our expectations for other specialty services obscure our view of therapy. “It is a socio-cultural expectation that if we pay money that there will be a concrete, measurable deliverable,” said Jeffrey Sumber, MA, LCPC, a psychotherapist, author and teacher. We see specialists for everything from cavities to haircuts to housework.

However, therapy isn’t a transaction. It’s a process, Sumber said. “It is understandable that clients have expectations that the itch in their heads or the throbbing emotion that won’t seem to dissipate will be dispatched of with some time, money and expertise.”

But the key in making positive changes is a willingness to be honest and vulnerable and do the work outside of session, he said.

Here’s what else you might not know about therapy.

Therapists don’t give advice.

Therapists don’t tell their clients what to do. In fact, “advice-giving [just] creates dependency,” said Deborah Serani, PsyD, a clinical psychologist and author of two books on depression.

They also don’t fix their clients. “The real deal is that psychotherapy will not fix you. You will fix you.” Therapists help you help yourself, she said. They “help you discover your desires, motives, blind spots and thoughts, [which] creates self-awareness.”

“[W]e give feedback, resources, information and tools to help our clients discover their authentic self and path and make the choices that are best for them,” said Joyce Marter, LCPC, a therapist who owns the counseling practice Urban Balance.

Therapy also helps clients gain a variety of vital, positive life skills, said Marla W. Deibler, PsyD, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC. This includes “coping and emotion regulation skills, problem-solving skills, and decision-making skills.”

Therapy isn’t like other doctor’s appointments.

Many people think that therapy is like a medical checkup, Howes said. “They expect to report symptoms and then sit passively as the doctor applies the treatment.”

However, therapy is a collaborative and active process. Howes likens therapy to personal training. A trainer provides their expertise, support and skills, but the goals, sweat and hard work are ultimately up to you, he said.

Therapy is backed by science.

“Most people are not aware that therapy has become very much a science, more and more so over the years,” said Duffy, also author of The Available Parent: Radical Optimism for Raising Teens and Tweens.

“We not only know that therapy can be effective, but we know specifics: what types of therapies are most effective for which disorders, for example.”

Deibler also stressed that “the field of psychology has grown to be a science which manualizes and validates therapies in order to provide the most effective care possible.”

Learn more about psychotherapy here. Also, keep up with the latest headlines in psychology here.

Therapy isn’t an unattainable luxury.

“[Most insurance plans cover mental health treatment and many social services agencies provide counseling on a sliding scale or even pro bono,” Marter said.

This piece and this one have information on getting affordable counseling.

You can – and should – let it all hang out.

Some people present their most polished selves in session, said Howes, also author of the blog “In Therapy.” But “while therapy is a professional relationship with a highly trained professional in a professional office — at professional rates — it’s important that you feel free to casually speak your mind.”

If something about your session bothers you, talk about it. If you normally wouldn’t bring up certain thoughts at home or work, share them with your therapist.

The more honest and forthcoming you are, the more helpful your therapy will be, inside and outside the office. “Your thoughts, feelings, and words are the materials of therapy, so we might as well lay it all out on the table.”

Therapists don’t get tired of your issues.

Many clients have told Howes that they worry their problems bore him. But dealing with problems is the reason he entered psychology.

“That’s like imagining a plumber gets tired of leaky pipes. If that’s really happening, it’s time to find a new line of work.” In fact, rather than being bored, he’s actually intrigued by complex concerns.

“When clients say this, it’s usually because they feel bored with their own problems and are tired of discussing them in therapy. That’s fine; maybe that will act as motivation for us to tackle the issue.”

You can see a therapist at any time.

You don’t need to wait until you’re experiencing a crisis to seek therapy. “[T]herapy is perhaps most effective when it comprises something deeper than crisis control,” Duffy said.

Marter believes that people can benefit from therapy at various points in their lives. For instance, in early adulthood, therapy can help you explore how your family of origin has shaped your behavior and how you might be recreating those patterns, she said.

Therapy also can help during milestones and major life changes, she said. This includes “pre-marital or pre-baby counseling; after the death of a loved one; [and] during a relationship change or a job transition.”

Duffy believes it’s best to stay in therapy after a crisis subsides, so you can delve into the deeper work.

Having an official end to therapy is key.

We don’t have many good endings in our lives, Howes said. Think breakups, layoffs, divorce and death. However, “Therapy is one relationship that is uniquely equipped to provide a clean, positive ending, if clients and therapists are willing to go there.”

This is known as the termination phase. This is “a session or series of sessions where we discuss how it feels to end, tie up the loose ends of the therapy, reminisce about our time together, discuss life after therapy, and have an exit interview.”

There are many misconceptions about therapy. In reality, therapy is a collaborative process that can help you lead a more fulfilling life. “We all need support…Therapy is something healthy, preventative and proactive,” Marter said.

Therapists Spill: What You Didn’t Know About Therapy

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Margarita Tartakovsky, M.S.

Margarita Tartakovsky, M.S. is an Associate Editor and regular contributor at Psych Central. Her Master's degree is in clinical psychology from Texas A&M University. In addition to writing about mental disorders, she blogs regularly about body and self-image issues on her Psych Central blog, Weightless.

APA Reference
Tartakovsky, M. (2018). Therapists Spill: What You Didn’t Know About Therapy. Psych Central. Retrieved on September 21, 2020, from
Scientifically Reviewed
Last updated: 8 Oct 2018 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 8 Oct 2018
Published on Psych All rights reserved.