Does therapy work?

[Storyteller.]

I guess I'm just after some reassurance, and maybe some personal experiences.

A couple of months ago I stopped seeing my latest therapist, and in thinking back over my history with therapy I realised that I've never actually found it helpful. I think it's likely that it's because I haven't ever found a therapist I clicked with, but I can't help wondering if I'm somehow doing therapy wrong. When I've done it of my own volition I've tried to be a good patient - being honest, doing homework, trying to work with the therapist. But I've never had a session where I had any breakthrough moments or a therapist I actually felt comfortable with.

This last time in particular has made me feel so much worse; it was an uphill battle even getting to see this therapist, and the emotional fallout from it has made me even more reluctant to try again. At first I thought we were getting along but it eventually became clear that it wasn't a good match, and I felt very dismissed and invalidated by the end of it. Being that open and honest with somebody who ended up not listening to me or helping me at all has exacerbated the issues I went to therapy for in the first place, and I'm worried about the effect another failed attempt at getting help may have on my already pretty fragile mental health.

So... yeah. How many misses did you have before you finally got a hit? How long did it take to find a therapist you worked well with, and did the end result outweigh the stress and uncertainty involved? Any insights or anecdotes would be much appreciated.

[Tigereyes]

TW: brief mention of abuse and addiction (mention of maladaptive drinking), but no details

I've had negative and positive experiences--probably more negative because I was doing "free" counseling at my university (only therapy I've been able to afford lol).

First time, a once close friend forced me to go. I was uncomfortable and anxious, made worse by the hour long "interview" session. I have a history of abuse, so this put me into survivor mode, and I lied about literally everything because someone I didn't trust upfront wanted every detail of my life. I didn't go back for years.

When I did go back to the counseling center, it was that same first session interview. I needed to talk about something urgently and didn't get to. Mentioned concerns about maladaptive drinking, which were ignored because I didn't drink dangerous amounts daily. Was told to try a CBT counselor next time.

I did, and she blamed me for "irrational beliefs" about logical possibilities. I just wanted help with my new and severe test anxiety. She kept invalidating my fears, made me feel bad about myself for them, and told me since I was unwilling to change my thoughts, my only hope was trying to physically calm down. She told me to practice taking 5 deep breaths per day and come back in 2-3 weeks, and was irritated at me for acting noncompliant when I asked what to do about the 5 major exams (think mid terms) and weekly quizzes before the next appointment. I didn't go back. Things got very bad.

Eventually went to recovery meetings and was offered to join a program for students recovering from addition (me). Almost didn't because it required appointments with the designated addiction counselor. She's the only one who helped me and whom I connected with. She didn't interview me and understood my past on a personal level and knew what to do and not do. It still took me months to open up to her, but we could problem solve issues, and she actually said I shouldn't go back to the regular counseling center. Instead of invalidating my test anxiety, she would focus on validating the feelings, planning what I can control, coping with the anxiety attacks, and letting go of the outcome in a safe way. Unfortunately I graduated and can no longer work with her, but I can say I'm very glad I had that opportunity for a year because I'd be in a much worse place now if I hadn't. I've been able to take those same approaches and tools and apply them to other situations (ie this pandemic).

[Celyn]

Therapy is tricky because it often comes down to the 'fit' between therapist and client, the type of therapy and what you want out of therapy (and it helps if this is 'realistic' e.g. not expecting to be 'fixed' like I did). I, personally, don't think it's possible to do therapy wrong, but there may be different expectations at play. I noticed that you mention you realise you never have any 'breakthrough' moments and I'm wondering what this means to you? Is it important for therapy to have these moments or can these things happen outside of therapy?

I have mixed experiences with therapy, but despite this, I am still tempted to maybe have therapy again, although I feel I know myself more and can identify what exactly I'd like to work on (a mistake I made previously, not knowing what I wanted out of therapy).

I'm happy to share my experiences of therapy, but as a disclaimer, I don't think I'm 'typical' in my experiences. I've never self-harmed or felt suicidal, nor engaged in any harmful behaviours like drug or alcohol abuse. I have often felt conflicted in that I feel ‘not bad enough’ to justify therapy but that said, I have struggled with anxiety for as long as I can remember, and 'low mood' since I was around 10 or 11. I also experienced child on child sexual abuse when I was 9, on and off teasing and maybe some bullying throughout (although not continuous) the ages of 10-18 and have been a 'young carer' from the ages of 15-21.

This will probably be long winded because I feel that in order to share my experiences, I need to start with how I ended up in therapy to begin with and what might have worked and what didn’t, which is likely to be very different to other people’s experiences.

I had never realised I had been sexually abused when I was 9. It didn’t occur to me at all, what was going on or what happened. At the time, I didn’t feel like it was anything bad. Until something happened that caused it to end and I started feeling bad but I still didn’t know what it was and had never been taught about boundaries or abuse. So I never talked about it and in a way forgot about it. I thought I was ‘normal’ but also ‘different’. I didn’t think there was anything ‘wrong’ with me but equally I was aware I wasn’t quite like anyone else. I started getting taken advantage of in school but again didn’t realise what was going on. I was happy when I was younger, but after the age of 9 or 10, things just didn’t seem so good anymore, but I couldn’t pinpoint why. When it came to the end of primary school, and just about to start secondary school, I thought I would be okay. I had been told I was ‘intelligent’ so the workload of secondary school didn’t scare me, and I assumed I had friends and wasn’t worried about making new friends either.

High school was the opposite of that. I pretty much ended up being, what I felt, was the ‘lamb in the slaughterhouse’. I didn’t fit in, and I didn’t make any real friends. I quickly felt depressed and cried for weeks and months on end. I was anxious every single morning before school, anxious at night, anxious on Sunday evenings, anxious the last few days of school holidays. This lasted for about 1-2 years and I stated developing, what I assume was panic attacks during the 2nd year which would happen throughout the rest of my time at school, even when the low mood had started to subside by the 3rd year. Equally, I was very attached to an old teacher from my previous school, much to the annoyance of a friend who would stress that I should talk to someone about this. My poor parents were at loss and didn’t know what to do with me. I think maybe my mum might’ve suggested to me to see if there was a school counsellor but I got scared and never went and didn’t feel ‘bad enough’ to get counselling. Although to be fair, mental health wasn’t talked about and I had no idea about counselling or what would happen.

Then when I was 16, I found out that what I had been through when I was 9 was sexual abuse. I then read up on it so much over the next 2 years. I would also read about being ‘attached’ to teachers. I ended up reading everything on abuse, neglect, attachment, transference. I was convinced that my life was a mess because of the abuse. That a family where abuse was perpetrated was unhealthy and all the evidence pointed towards ‘talking to someone’ and having counselling. I was scared as to what would happen if I didn’t get help. I struggled with insecurity which lead to a break up but I also realised I didn’t know how to interact with people or children and that coupled with what I had been through made me feel like I needed therapy considering I thought I also wanted to be a teacher. I felt like I had to put things right and be the one to ‘break the cycle’. I felt I had to do this before I even set foot near a child. Also, because ‘friends’ I had in high school kept wanting to change me, and I realised I had low self-esteem, I felt that I needed to ‘fix’ myself…if only I could improve my self-confidence then everything would be fine and I would be ‘normal’.

So in my final year of uni, I reached out to the university counsellor and opted for email counselling (I was too scared for face to face counselling and I struggle with talking on the phone). I was scared as I realised I had told everyone I wanted to be a teacher and yet I didn’t feel like I could actually be a teacher. I thought it was my past that was holding me back. At the intake, I mentioned how I wanted help with anxiety and low self-esteem. I had no concrete idea as to what the problem was or what I wanted help with. Later on, I just kind of monologued everything in email form about all that I had been through. I thought you were supposed to open up (that’s what everything I had read had suggested doing) and I felt like it was now or never because I didn’t know how to access counselling once I graduated. I wondered why I didn’t realise that I had been sexually abused when I was 9 and the counsellor said that I was too young and wouldn’t have known, but this didn’t satisfy me. Eventually, the counsellor realised that I had had double the amount of sessions and asked if I would mind pausing sessions as they had a waiting list. I felt guilty but agreed to it. The counsellor said she would get back in touch with me a few months later, but she never did and I was too scared to contact her in case she was still working through the wait list. I didn’t find it helpful talking about things but I did find it helpful learning how to deal with depression as I really struggled with that once I graduated and didn’t have support in place. So that’s something I suppose. The thing is though, I can’t fully outright say that the counselling didn’t help because I now realise that a) I didn’t have a particular goal of therapy in mind and b) this is bad but due to my natural curiosity, I feel that I had already understood the abuse that I went through…to the point where when I had told a friend, they were actually really impressed by how I figured everything out myself. I guess looking back, it makes me really wonder why I wanted to talk about it.

When I graduated, I felt awfully burnt out. I wasn’t looking after myself and just felt in a fog all the time. But I tried using the previous counselling stuff to help with depression and over time like 1-2 years, I started feeling a lot better. I decided I wanted to try again with counselling, but this time with a trauma counsellor (thinking the university counsellor didn’t get me if she didn’t specialise in trauma). This time was different as I was paying, so I thought that I really had to make this work. I did the same thing and just monologued everything in email/webchat form. This time I opened up about a particular aspect of the abuse that I had held back and was so scared of doing. But it was worth it as I got reassurance and this helped me with my relationships with family. However, I often felt worse after therapy and thought this was normal. I also found myself going along with things that my therapist would suggest rather than actually trying to get her to understand my point of view. This was problematic as I ended up going along with things that didn’t even help.

Unfortunately, things came to a head when I had some sort of breakdown back in 2018. I quit therapy (although the therapist didn’t want me feeling like I had wasted my time and money) and had to take up group CBT in my local area. I was offered face to face therapy as well but declined. I still use the CBT stuff for challenging thoughts. However, I don’t believe CBT was appropriate for me at that time. CBT works by focusing on internal factors- helping to change our thoughts and feelings. But a lot of what I experienced and what lead to my breakdown was external. And I believe it was wrong to try to change my feelings given that situation. Though I realise I need to find ways of dealing with thoughts and feelings and not bottling it up (I bottle things up because I don’t know how to talk about things unless I type stuff out and that when I messaged my friends, I guess they felt burdened by it). Although, I liked the fact that in the last group CBT session, the facilitator said ‘and sometimes life is just crap’. It reassured me that even though there are techniques to use for all sorts of situations that sometimes life really is just crap (although the facilitator was aiming this at a woman whose husband was diagnosed with Alzheimer’s….).

It was at this time that I realised everything I had been through, all my reading up on abuse and attachment etc., I had been trying to ‘treat’ the wrong thing. I wrongly thought that because I and my family were ‘different’ it meant that it was wrong. I wrongly believed that because many people had told me that the way I was, the things I liked, my thoughts and feelings were wrong that I had to change them. I naively thought that if I could go to therapy, lower my anxiety and improve my self-esteem, then I would be ‘normal’ and fine. I naively thought that therapy could give me self-esteem, when I’ve later realised that volunteering and getting good grades in uni has helped me feel surer of myself, while allowing myself to be more ‘me’ with friends has let me feel closer to them (well, some of them). Ironically, my journey has lead me to go from trying to change myself, to trying to accept myself….which I think is what I really needed. I’m also not too sure what I wanted from counselling. Part of me thinks I just wanted someone to talk to who would ‘get’ me….even though I didn’t experience that with either therapist. Ironically, the one person that I really believe would’ve understood all of this, is the person that an ex-friend wanted me to stop contacting based on social norms (the old teacher I stayed in touch with).

I don’t think it’s all that bad as I’ve realised I have a particular problem of feeling unsure of myself when it comes to trying to get out of my comfort zone so I wouldn’t mind going back into therapy for that specific reason. I did find it helpful for easing depression and realising that I’m not a bad person as well as reassurance that my ‘attachment’ is okay and I don’t need to try to change that. But ultimately, I feel it is down to why you want therapy, what your expectations are, what type of therapy is helpful to you as well as the relationship with the counsellor (although debatable since I’ve always had online counselling because I struggle with talking about things but am really comfortable online, and some may find it difficult to have a ‘connection’ online). I’m not saying that what I went through is normal or that it doesn’t have any effects, and I would always recommend counselling for anyone who has been abused, but in my particular case, there were factors that complicate things (suspicions of autism, in which case, I feel I needed acceptance more than change and to be understood rather than just talking to people who don't 'get' me). I’m sure that there can plenty of criticism such as therapists might say that I have ‘intellectualized’ everything rather than explored my emotions, and maybe by focusing externally, I’m not taking responsibility and keeping myself in a ‘victim mindset’ but I really believe there was more going on and that it was never as simple as what I thought it was.

This is just my experience and my reflections on those experiences and given how individual my situation is probably doesn’t apply to many people. It's safe to say that I am probably too self-absorbed/introspective and that I've probably sabotaged the whole therapy experience for myself. But I still wanted to share what I’ve learnt from it all. Though it is too long

I agree with Holly. I don't think there's a way to do therapy "wrong." It largely is a combination of having a therapist that's the right "fit" and having the willingness and dedication to do the difficult work outside the therapy. The importance of therapy doesn't just end after your hour long session is up.

It sounds like you are doing really great with the homework piece but you might not have found a therapist that's a good fit. Personally, I am in a similar situation to you. I do not like my current therapist very much. However, seeing her is free because of the type of insurance I have (most therapists in my area don't take insurance and a 50-minute session costs $130-150), so I see her. For about nine months I didn't have a therapist last year and my life was a complete wreck. There were lots of severe changes and I didn't have a individual professional to talk about them with, which probably exacerbated my depression, self-harm, and SI. So when my therapy office told me they'd hired a new therapist and she was seeing clients (the whole reason I lost my old therapist was because she left the practice) I was excited.

The first session was great. I felt really positive about her. But as time has gone on I feel that way less and less. I did mention to her (in a nice way) how I feel she's sometimes invalidating and condescending, but not much has changed. However, I still get some things out of our sessions and that makes me nervous to switch.

I've been in therapy since I was nine and I've probably had at least a hundred therapists if you count individual, group, and inpatient. You'll know when you meet a good fit. I have had some wonderful fits in my past that really pushed me to grow and change. I've also had some, like my current one, where I feel awkward during our sessions. The goodness of the fit can make a big difference in how you feel.

I know you're scared of failure to find a good therapist and how that will affect you but honestly you just have to go through the process if you want to reap the benefits of therapy. I think it's worth doing. Yeah, when it doesn't work it sucks, but when it does it's wonderful and may even help your life get to a better place.

[Storyteller.]

I don't have the energy to respond to each answer individually at the moment, but thank you all for replying. I really appreciate you all taking the time to share your thoughts.

[Iena8778]

if you find the right professional, it worked. Absolutely. He/she must become your 'best friend' in order to start talking about deep and painful topics. compare the approaches they try to apply. if they are strict and threaten you, it's a sign of a bad psychotherapist. Run away from him