By Katie Cowan
Believe it or not, I was a reluctant therapy attendee. You wouldn’t know it now, what with my “Therapy for every adult!” soapbox, but it’s true. So as a convert from sceptic to evangelist I thought I would illuminate therapy a little, for any readers who are curious but not convinced.
Going back to the beginning
When I was 16 I was very unhappy but thought the only response was to try ever harder. Never mind all the work I was already doing. Never mind all the extra curriculars. The correct way to feel better was just to try harder. That technique had worked pretty well until then (in hindsight: it definitely had not), and so it made sense to just try harder and do more work. But by the end of high school, I was approaching a wall.
I didn’t want to go to therapy. I thought it would mean I was crazy, and if anyone found out I was going I would die. Neither of these things were true. But this was 2004, and this was high school. The storyline on Grey’s Anatomy where Meredith gets therapy was five years away, and Crazy Ex-Girlfriend was six years beyond that. All I had heard about therapy then was that it was vaguely American (read: excessive) and took years. I would like to think that your view from 2019 and from adulthood, with the benefit of far more public conversations about mental health, is much more mellow.
When I did go to therapy I was resistant. I now know that was because I didn’t feel safe, which is a necessary condition for effective therapy. It really matters that you like and can work with your therapist. These days I am a couple of therapists in and I really love therapy. The relief and ease that comes from figuring things out and learning safety with my internal life completely outweighs the discomfort of the process. I have learned all kinds of ways other than “try harder” to make life more liveable. To be sure, I am still in the middle of the process somewhere, but it’s a nicer kind of middle, and I have learned that thinking you will get to some perfect, happy end point belies how complex and dynamic and ongoing human lives are. Even though I am not “finished”, it’s much better than it was.
Some dumb, persistent, therapy myths
Still, knowing where to start can be hard. And it can be harder because of some enduring misconceptions, many of which are made worse by pop culture depictions of therapy. Let me zap some of those now.
First of all, therapy is not about whether or not you are crazy. Crazy is a word people generally use to dismiss people they don’t like or behaviour they don’t understand. In either case, it’s more about the person using the word than the person being described. You trying to make life easier to live for yourself is good and right. There may be people who don’t get it, but without passing judgement on their need for therapy themselves, their potential opinion doesn’t trump your actual need.
Second, therapy does not require a diagnosis of anything in particular. The diagnostic manual for psychiatric conditions points therapists towards treatments, but lots of people who would benefit from therapy don’t meet the criteria for any specific condition, or, like me, have a blurry collective blob of almost conditions. The work you get to do in therapy would benefit anyone, because we all have brains that get in our way sometimes. Some therapies, like Metacognitive Therapy (MCT), are explicitly transdiagnostic.
Third, therapy is not about fixing a thing that is broken. The mind is not a thing that breaks in the way a bone breaks; it’s way more complex than that. Therapy is more about making life easier to live, which is a concept outside “broken/fixed”.
Fourth, and here’s something else to get mad at Woody Allen for, you don’t necessarily have to talk about your mother. (Then again if you’re resistant to doing so, that might be something to explore.) Some common therapeutic methodologies, like MCT, Acceptance and Commitment Therapy (ACT) or Cognitive Behavioural Therapy (CBT), are more about learning how to relate to your thoughts and mind as they are in the present than they are about examining childhood (plus they are typically short term modes). But equally, don’t dismiss the more reflective therapies, especially ones that deal in emotions and trauma recovery. The body and brain store our past in ways we have only really come to understand in the last few decades, and common discourse has yet to catch up to the science.
Fifth, magic therapy, where all your pain dissipates in one session, is a terrible myth propagated by TV writers. Depending on what you’re working through, therapy can take a few sessions or a few months or a few years, and in an ideal world we would check in for top up therapy throughout our lives.
The practical stuff
Which therapy might work for you depends on all kinds of factors, but the good news is that for a lot of people, any therapy does good. You don’t have to seek out the perfect therapy, though it can be worth trying different ones if the first one isn’t clicking. A lot of people start with CBT, as I did, but I found that ACT and later short term psychodynamic therapy were much better, since they dealt with emotions and trauma and the self and somatic issues. These days I think a better starting point would be ACT, and all my therapist friends agree, so there.
You get to choose your therapist and you can change therapists at any time. You are also allowed to say anything in a therapy session. There is no shame or judgement in a good therapeutic relationship. If your therapist is going down paths that seem irrelevant or not talking about something you’re dying to talk about, you get to ask for what you need. As someone with what my psychologist calls a “crippling case of middle class niceness”, it took me a few years to realise that telling her I thought something different from what she was saying was not “rude” but “exactly the right thing to do”.
But what might you talk about? Well, anything. Your therapist will be skilled in guiding the conversation, but if you’re minded to go to therapy, you probably have a thing on your mind to focus on. Maybe that’s relationship issues, or exam anxiety, or a general sense that life is colourless, or patterns of self sabotage you can’t extricate yourself from. It really could be anything, specific or general. Part of the fun of therapy is that you get to figure it out yourself and as you go along.
Therapy can, of course, be quite uncomfortable. Your therapist should be able to work with you in a way that is not relentlessly overwhelming, but you will almost certainly experience resistance and fight/flight/freeze responses. Knowing that going in and welcoming it as best you can can help you get more out of the process, as can having some compassion for yourself. Therapy takes courage, and things that take courage demand compassion for how hard they feel to do.
A necessary caveat
All of the above is subject of course to a heavy spectre of privilege that not everyone has. Traditional private therapy costs a lot, and there is heavy strain on public therapy resources. However, we are lucky enough to live in a world where therapy of all kinds is accessible online in more affordable ways, and the public conversation around mental health is yielding more funding and options every year. I also know that my audience of law students will soon likely be law graduates seeking lucrative or at least decent-paying jobs. This makes it more likely you will be able to afford therapy in your working life (and also that you will need it; lawyers being prone to widespread poor mental health). If and when you can afford therapy, it will be worth getting.
My advice for people wondering whether or not to get therapy is always this: if the thought occurs to you that you might need help, that’s the evidence that that you should get some. It takes a lot for a thought like that to break through the chattering of the average brain, and law students and lawyers are the types to put off getting help a long time. By the time the thought comes up, you’re probably already a long time past the time when you started needing help. So if the thought comes up, I urge you to follow it along its merry path, since that path is a means to making the whole of life more merry.