Five Misconceptions About Therapy

As a psychologist, I often hear lots of misconceptions about therapy and about what I do. Read on to look at some of these misconceptions, and how things actually are if you decide to have therapy.

Therapy is too expensive

Don't get me wrong, I'm not saying therapy is cheap. The current state of the NHS, and the way it has been previously managed, has led to a situation for psychologists where there is limited career progression. We are more often being asked to lead services and undertake incredibly complex work on pay grades well below what was previously the norm for these types of jobs. That, plus the general feeling of being taken for granted that I've heard a lot of healthcare professionals talk about over the last few years, has led to a situation where more and more psychologists are turning to private work. This is creating a "two-tier system" where those who can, pay - and those who can't, very often end up on a 12 month waiting list.

If you can afford to pay for therapy, I would encourage you to. Ideally you wouldn't need to, but that's not the world we live in currently and if you need help, you can get it faster by paying. Lots of therapists have very reasonable fees and some (like me) even offer a free consultation to see if you get on with each other - and realistically, if you can afford to go out every weekend and spend £60+ on drinks and a taxi home, you can afford a therapy session once a fortnight. And if you're struggling with your mental health, only one of those things is likely to offer you a way to manage it in the long-term.

You'll definitely feel worse before you feel better

There seems to be a perception, especially amongst some therapists, that the process of therapy is meant to be an awful one. I admit, I've said to lots of people in my younger days as a therapist, "you're likely to feel a bit worse before you start to feel better." I no longer completely believe this, and here's why.

If therapy is making you feel significantly worse, or frustrated that nothing is improving (and you've given it a little bit of time), and you have no focus in therapy other than talking about how you feel, it might not be good for you. It's also true that if you're working on something that makes you feel bad, like anxiety or depression, changing your behaviour isn't easy. The only way out of anxiety is through it, and you'll probably have to do a lot of work exposing yourself to anxiety-provoking situations. That's not going to make you feel great when you've been avoiding those things for a long time. But ultimately, you should understand why it's happening and feel reassured that it will be temporary.

Therapy isn't meant to be a 100% fun experience - you're growing and changing, and that can be painful. But it doesn't have to be the worst thing you've ever experienced, and your therapist should be working with you to try to moderate those feelings so that you can tolerate the anxiety that comes up.

Go with the first therapist you find

It's a confusing world and, particularly for people in the UK, most of us aren't experienced at shopping for healthcare providers. We tend to go with whoever works at our nearest hospital and happens to be on shift when we have an appointment. It can therefore be tempting to assume that "all doctors are the same" and just go with the first one you find.

I cannot say enough times that you should not do this! Different therapists are experts in different areas, charge different amounts, hold different clinic hours, and are different people. You should shop around a bit, have a look at a few different websites and therapists, and contact two or three who you like the sound of to ask them if they feel their expertise would be well-matched to your difficulties. See how long it takes them to reply, what they say, and how you feel about their style. Ultimately, effective therapy can be effective due to the relationship you have with your therapist more than anything else. Going with the first therapist you find and believing that you just have to accept that, especially when you're paying for it, won't be that helpful in the long run.

That said...

You have to like your therapist

I try really hard to form relationships with my patients. At best, we'll get on well - we might be able to share a laugh and a joke about things when things are good, which makes it slightly easier to get the work done when times are tough. But at the end of the day, this is a working relationship. I'm using my skills as a therapist and applying them to the things you bring me. You're taking the things we discuss and applying them to your life, and then we're both reviewing the situation as we go along. Whilst a good relationship is nice to have, it's not strictly necessary.

I've done some of my best work with people who have disliked me, and made no secret of that dislike. It's uncomfortable, but as long as progress is being made I'm okay with that. What I'm not okay with is when that relationship starts to feel abusive, on either side but especially if patients are feeling that their therapist is being unnecessarily cruel. You don't have to like your therapist, but you do have to be able to work with them without feeling like everything is your fault, and you do have to trust that they can help you. If that's missing, maybe they're not the person for you.

Therapy should be long-term

When I talk to people about therapy, one of their biggest fears is that they go into therapy for something they feel is simple, and end up seeing the same therapist for decades, due to that therapist finding something about them that needs "fixing" in long-term therapy.  If you want exploratory therapy, or long-term work for long-term difficulties, that's no problem - but no therapist should be pressuring you into more sessions than you need, whether NHS or private sector.

In my NHS role, I'm very lucky - I have no limit to the number of sessions I can offer someone. I'm also aware that my service has a waiting list. All the work I do is a balance between making sure that someone is well-supported and feels confident to move forwards alone, and keeping someone coming to see me unnecessarily because they're worried about managing without regular therapy. If I do that, the people on the waiting list wait longer. I believe it should be the same in private practice too - just because you're paying doesn't mean that a therapist should try to get you to sign up for more sessions. When you're done, you're done!

What are some of the beliefs you have about therapy? Maybe they're misconceptions! Let me know in the comments!