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Over my 50 years of practice, I’ve learned that therapy, like most professions, has both limits and strengths. Here’s my top-five list of what therapy cannot do.
1. Motivate you
You’ve probably known people who could benefit from therapy to help them resolve problems, gain a different perspective, learn skills, and make sense of their pasts. But they don’t try it because it seems too overwhelming, or they don’t know how to find someone skilled enough, or they’re afraid they’ll be stuck in it forever. And then there are those who come in once or twice because they are sent by the court, their attorney, their partner, or their boss. They come to comply, to get these others off their back, but basically they believe they don’t need therapy.
A good therapist can make starting and attending sessions as comfortable as possible for the anxious; they can inspire hope, but they can’t get them through the front door. And for those who don’t want to be there, there’s little to do—the therapist is providing a service; they’re not a cop.
2. Directly change other people in your life
Often, those who come to appease someone else believe the other person is the one with the problem and who really needs therapy. Similarly, many of the couples I see come in with the hope and expectation that, if only they or I can get the other person to change, their lives will improve by 100%. Therapy can provide a safe space for someone to express what they’d like the other person to change, but it’s up to the other person to decide whether they are willing to do it. We’re back to talking about motivation.
That said, therapy can help you become a change agent in the relationship. Because relationships are based on patterns—the ways individuals bounce off each other—one person’s change can motivate change in the other. The dance between them shifts.
3. Fix vague problems
Therapy can’t make you happy because happiness is a byproduct of fixing something else—a relationship, your job, or the chemistry of your brain through medication. Ditto for “improving communication” or “getting respect.” The key lies in focusing and fixing the specific underlying issues.
4. Guarantee you will achieve a concrete goal
This is the other side of the same coin. If, say, your goal is to make $1 million or find your soulmate, therapy is not the genie in the lamp. Like happiness, the money or soulmate are the end points of a process, and what therapy is good at is helping you navigate the process—for example, increasing your self-confidence or your ability to take risks or to be less impulsive. But delivering on that million dollars or soulmate? Nope.
5. Guarantee it will work
Therapy, unlike, say, plumbing, isn’t straightforward, and even plumbers can have trouble fixing certain problems. Successful therapy clearly depends on the therapist’s skill, their approach to your problem, as well as your full buy-in as the client. When all these factors align, therapy works, but when they don’t, for any reason, the outcome becomes less certain.
So, if this is what therapy isn’t good at, what is it useful for? Here again are my top five.
1. Teach skills
If you struggle with anxiety, anger, or depression, therapy can help you learn to control your emotions. If you find yourself arguing with your partner, therapy can teach you effective communication skills.
2. Help you understand how your mind works
Again, patterns. Just like a skilled card player takes time to learn the tells of other players, a therapist gets to know you and identifies your emotional and cognitive patterns. Providing you with this feedback helps you become more aware of what makes you tick.
3. Change your story
Psychodynamic approaches that explore your past also help you view it from a different perspective. The story you’ve been telling yourself for years may now seem different. This change in how you see your past can, in turn, alter your view of yourself in the present.
4. Create a safe space for mediating relationship problems
Many couples and families I’ve seen over the years often needed a strong referee to help guide difficult conversations, as well as someone with fresh eyes to ask tough questions and point out the elephants in the room everyone was ignoring.
5. Encourage new behaviors and provide support.
A therapist is like a coach, a cheerleader, a strict headmaster, and a kind Mr. Rogers all in one. They can hold you accountable so you don’t slack off, show empathy when you feel discouraged or helpless, and help you get unstuck when you’re feeling stuck.
Go in with eyes wide open
The theme here is to have realistic expectations so that you not only avoid feeling disappointed or frustrated, but also hit the ground running and make the most of your time and money. Don’t hesitate to shop around or ask questions, no matter how trivial they may seem.
Most importantly, don’t settle for what you get.
To find a therapist, please visit the Psychology Today Therapy Directory.
