How has therapy been helpful to you?
January 13, 2021 6:06 AM   Subscribe

Metafilter loves therapy. Help me understand why.

I’m a (somewhat newly licensed) therapist and sometimes I feel like outside of training in different modalities or techniques, it’s important for me to understand why people keep coming back to therapy. I offer formal CBT to people who I think will be receptive and who have a problem that might respond well to CBT, but with most clients I’m offering an eclectic approach, drawing a lot from narrative, DBT, feminist, humanist/client centered, and attachment informed approaches.

When I do this supportive, eclectic approach, people seem to like it and keep coming back, but I’m not sure exactly what I’m giving them or what they’re looking for, beyond the therapeutic relationship. Many clients come to therapy with one initial problem, but seem to keep coming back for reasons unrelated to what they may have initially expressed as their reason for seeking out therapy. I do check in with people over time about what they need, or how their needs may be changing.

If anything, I think I may be more skeptical than Metafilter-at-large about the benefits of therapy, and I’d like to know more about what has made therapy a valued experience for MeFites.

I’m curious about the following questions:

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

What techniques or interventions has your therapist used that are most impactful?

How has going to therapy changed your life or your thinking?
posted by unstrungharp to Human Relations (39 answers total) 35 users marked this as a favorite
I spent about five years going in and out of therapy. I was moving around a bit, so I had different therapists. Most of it was not helpful. I found that just talking about my problems didn't seem to benefit me. The single-most-beneficial aspect of therapy occurred when my therapist (who was a psychiatric social worker, and not a psychiatrist) recommended that I do some volunteer work. I was unemployed at the time, and I was self-isolating at home. I really didn't want to do the volunteer work, and I resisted for a while. But I finally gave in and tried it. This was the best thing I ever did. The volunteer work started a positive cascade of events that eventually led to a good full-time job and marriage.

My previous therapy was unhelpful because it just was a bunch of navel-gazing without any practical, concrete benefit. Oh, and the medication just made me tired and overweight.
posted by akk2014 at 6:13 AM on January 13 [8 favorites]

My therapist, whom I've been seeing on and off for a long time, is truly excellent at helping me see the connections between past trauma/experiences and current issues. She basically does modified ACT. She's tried so hard to get me to be kinder to myself, and to experience my feelings instead of shoving them away. It has worked some, lol.

One of the best things she did was an exercise about values, to help me see what I value in myself, so I could start a) seeing that I am lovable and b) have a definition of myself, when I had been basically seeing myself as nothing at all.

Well THAT's personal. But if it helps you see the value of what you do I'm cool with it.
posted by wellred at 6:19 AM on January 13 [8 favorites]

This won't help immediately, but can you ask your former patients? E.g., could you send them those questions perhaps 6 months and/or a year after they leave your practice? I don't know if there are any ethical/legal/regulatory restrictions on doing that, and most people probably would not respond, but it might be particularly valuable to get feedback on the longer-term effects of your specific treatment.
posted by Mr.Know-it-some at 6:19 AM on January 13

I’m on the fence about therapy and have not done much solo therapy though it’s on my endless list of things to do this month, reach out to a new therapist. What I am specifically looking for in the near term is to air out some endless ruminating that I’d like to be free from and can no longer dump on my partner. A safe space to work some stuff out.

I did couples therapy with my partner last year and we had a session just before the holidays. What I don’t like about it is the unearthing of latent nasty thoughts that are evident in actions and attitude but sound even uglier when aired out loud. I don’t know that our therapist or our haphazard approach has been best but we have ultimately moved on from these sessions in a better place. Maybe it’s because doing these in a therapy setting gives you the space where you can air and leave it.

As a child, we did family therapy and my mom was actually a marriage and family therapist. We did family therapy because shit was fucked up. It helped. As an adult I looked back on that time and realized how often I had protectively lied during family therapy. “Yes, I’m fine. Yes, I forgive you.” But it still helped because of the airing out in a safe place and the recognition that things were fucked up and that the adults were taking steps to be less fucked up.
posted by amanda at 6:33 AM on January 13 [1 favorite]

I've been to a therapist twice, very short-term both times. Without snowflaking, both times were when I had completely lost perspective on a major negative life event, leading me to flounder and flail unhelpfully.

What I needed, and what they offered both times, was a stiff dose of third-party perspective to get me unstuck. In hindsight, I can very much see the first one deciding to use insight therapy techniques -- and it was the right move.
posted by humbug at 6:33 AM on January 13 [7 favorites]

My single most useful lesson - not necessarily learned in therapy per se, but more in the process of thinking about & then actually trying & then sometimes even partially succeeding in accessing actually useful therapeutic help - has been that I am a person who is worthy of help. It matters how things go for me - there are better outcomes available (even if hypothetically) - it's worth my while to try to access those outcomes - and in principle, there are therapists out there with whom I can collaborate in trying to reach them.

You can probably tell from such a hedged & partial statement that it hasn't always been easy to see that I'm making progress on any of that. That's (partly? mainly?) because I've never struck up a longer-lasting therapeutic relationship. If you're looking for something beyond the therapeutic relationship that your clients keep coming back for - yeah, I'm not sure you're going to find it. I think the therapeutic relationship is possibly all there is? But maybe I'm over-valuing something that I've never actually had - for reasons that I could perhaps usefully discuss in therapy. And back around the loop we go again.
posted by rd45 at 6:37 AM on January 13 [3 favorites]

I was in therapy for around 5 years for PTSD and DID (and then grief), so those are pretty premium therapy reasons.

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

I would summarize the three most important things as:

1. As someone with a fairly severe adaptation to trauma/mental illness, I/we needed someone to help to learn how to communicate internally and basically to provide a guidepost for what 'healthy' would look like. Although we're at one extreme end and a lot of our therapy -- basically low-stakes hostage negotiating :) -- wouldn't apply, I think the overall principle does.

We needed to know what a range of grounded, ethical, rational responses and behaviours would look like. And we needed help with them. Example: My mother inherited a chair we were sodomized over, we told my mother that, she decided to keep the chair in her living room for over 2 years. With the help of our therapist we did not enter her home for that time, sticking to a serious and important boundary for mental health for the first time ever, really.

2. The therapeutic relationship was in fact important. My good therapist was not especially like, cheerleadery, but she did hold that space of high regard, investing in our health and believing in our strengths and capabilities. She also pointed out where people in our life had not been able to do that. Then -

3. Our therapist held us to a pretty high standard of applying skills and techniques to live in a healthy, ethical way. One issue we were grappling with, for example, was being good partners to our husband and not like, throwing our trauma at him. She held the purpose of being a good person out as an achievable goal, and not in an airy-fairy way but more like asking tough questions from time to time.

I'd say we have a kind of idealized mini voice (in the imaginative sense, not the dissociative sense) available now that is our therapist maybe at her best? Or our best? That allows us to gut-check things and hold ourselves to human, fallible, but decent standards.

What techniques or interventions has your therapist used that are most impactful?

Our therapist was Gestalt-focused overall with a feminist approach, but mostly I would say talking through both past and present experiences and challenges and showing how we could use basic grounding techniques or set boundaries or ask people questions rather than making assumptions. We were always opposed to anything like EMDR or hypnosis (I do think EMDR now is pretty proven but it was less so then), and so we chose a therapist that didn't do those things.

I will say we had a very bad therapist who kept us relieving trauma over and over by focusing exclusively on the past, and that was really unhelpful...our experience was that dealing with past events when they came up naturally was great, trying to force it was really really not.

How has going to therapy changed your life or your thinking?

In some ways I think this question for me is a bit of a chicken and an egg question because we were highly motivated to make changes, and it took a while to find the right therapist, and so if we hadn't would we have found another way? I like to think so. But I do think having the expertise allowed us to do it efficiently and maybe more effectively. So here are the things we came away from therapy with:

- your life and your inner experience does not have to feel 'out of control' even as you acknowledge some of it is not within your control

- it is possible to align your values with your actions most of the time, if you have some emotional intelligence about how to step out of a bad response or at least recognize it

- I'm trying to think of something about self-worth here but it's hard to articulate...I think our therapy gave us a sense of progress and basically helped get rid of some of the feelings that we were so beyond the pale weird/bad/damaged that we weren't...deserving or fully human. Of course the problem is 'human' is a mixed bag.

- While I am sure I make mistakes with my kids and my spouse every single day, I think without therapy it would have either taken so long to learn how not to put our past shit on our present people that either we would have irreparably damaged our marriage or probably just not - had kids. Not sure, but there is something there about breaking a cycle and I think good therapy really, really helps with that.

Things therapy did not do for us:

- make our days great...the most extreme example is that we spent our entire pregnancy trying to deal with the anxiety that it would go wrong and that we were literally cursed, and finally got to a good place with it - only to have our daughter die due to complications at delivery.

- give us the tools to say, deal with misogynistic workplaces or overcome late-stage capitalism in any great way

- make us happy...we had to do that ourselves afterwards

- our therapist actually wasn't that great at the grief piece after our daughter died, which is fine. She was human and excellent, but that just wasn't her thing.
posted by warriorqueen at 6:37 AM on January 13 [10 favorites]

I suspect/hope I'm an outlier here, but when I go to therapy, the underlying root cause is usually the fact that, even after years of trauma therapy already, I still only really feel comfortable talking about my emotions when it's a business transaction and I'm explicitly paying the other person to listen to me.

I had a very emotionally unhealthy childhood, and as an adult I have a lot of issues around feeling disconnected from my emotions and as though it will be unsafe or unwelcome if I talk about them with the people in my life, even people who've repeatedly told me they're happy for me to talk about how I feel with them (like my partner & closest friends). The transactional element makes it feel a lot safer somehow, like I'm literally paying the other person to not reject me and thus drastically decreasing the risk of rejection by making it a business transaction. Which is clearly a trauma response and something I fuckin' hoped I'd be past by this time in my life, but I'm not.

Obviously this isn't ideal for a lot of reasons, especially given the sheer amount of money, time and effort I've already spent on therapy as an adult (and it's even less ideal during the times when I'm not doing well and I will neither talk to anyone in my life about how I'm feeling nor go to therapy), but it is a reason that keeps me going back to therapy.
posted by terretu at 6:46 AM on January 13 [9 favorites]

Therapy gave me a safe place to express and dig into a lot of ugly and/or embarassing thoughts, and be truly heard and understood by another person -- thoughts I could not safely express to the people around me. I love my therapist because she is (as far as I can tell) extremely non-judgemental and accepting, and talking to her has helped me become more comfortable accepting myself as a flawed but still lovable, worthy human.
posted by Anonymouse1618 at 7:07 AM on January 13 [1 favorite]

I mean, specifically, I have figured out that my relationship with my parents isn't really that great and that they are low-key narcissists, which explains why I perceived the relationship as "good" when I was keeping it surface and super at-arm's-length. It's become very clear to me that while I know and understand what I'm feeling at any time, I was treated very poorly as a child and young adult for having anything other than positive feelings, so I protect literally all my other feelings from what I perceive to be scrutiny.

Generally, I have learned to accept that some things in my life that happened are in fact traumatic; it's okay if I have feelings about those things; and it's not necessary to "suck it up" all the time.

My therapist right now keeps encouraging me to feel my feelings and wowee I didn't think I'd be doing what I'm doing in therapy now, at my age, but it's what's happening. She's quite good at hearing what I'm saying, saying it back to me, and asking me incisive questions about what I've just said. She doesn't let my ironic turns of phrase and sarcasm stand as reality, but she digs in beyond that (something most people aren't equipped or brave enough to do).

Therapy has been important for me in that I have access to a third party who, other than wanting me to have a positive, good life, doesn't have a stake in like -- me as a person. My therapist doesn't need to "like" me in the way I want my friends or relatives to do. She's just there to help me, and to be a neutral party. My current therapist is in a practice that purposefully serves LGBTQIA people and people with alternate relationship arrangements, and because of this, she's coming at my problems from a non-patriarchal, non-hierarchical point of view, and as a bisexual woman, I am finding this so refreshing and freeing, to know that she does not care at all about whether I fit some norm.
posted by Medieval Maven at 7:08 AM on January 13 [9 favorites]

I was in therapy for eight years until earlier last year, when my therapist went very weird on me and our relationship no longer worked for me.

Sometimes, just having someone who would listen to me without judgement meant everything. Other times, I actually needed her advice (though I was often resistant to following it). Mostly, personal therapy gave me a better sense of who I am and what I want to do, and gave me a chance to sit with feelings that I would ordinarily put to one side in order to let other folks' feelings come to the fore.

As a counterpoint to that, I have had couples therapy with my partner, and found that to not always be that constructive. We would seem to do well in the sessions, and the therapist would compliment us for it, and then we'd inevitably have a huge fight afterwards about the things that had come up in the session, because it had opened or reopened wounds. Those fights could last for days, and some of their repercussions are being felt today.

So, personal therapy has given me a better appreciation of who I am, how to hold boundaries, how to stand up for myself, and what I'm willing to put up with. Couples therapy, though, only works if both parties are engaged on the same level and with the process, and are both able to handle the emotional fallout in the same way. Otherwise there can be a lot of friction caused.
posted by six sided sock at 7:19 AM on January 13 [1 favorite]

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

I started therapy in January 2019 after a series of medical and personal life events overwhelmed me (see ask history for context). I know that "breakdown" is a meaningless word in a technical sense, but that's that's still how I think about what happened. I lost touch with my interests, my future, and joy. I became an insomniac to such a degree that I was having auditory and visual hallucinations. It scared me and I went to the emergency room at 2 am one day, and after they calmed me down, one of my nurses sat with me and had a long, long discussion with me about therapy. I'm in the hard sciences, and I'm a man, and I was raised on a farm in the deep south, so I think I'd had a lifelong chip on my shoulder about therapy. This nurse was like, baby, you need to swallow your pride and work on this. They gave me a sleeping pill, I got some rest, and the next day I started making calls to set up therapy consultations.

What I learned, in the form of a messy list: You're not losing your mind, major life changes can overwhelm your adjustment/resilience skillset. Emotional resilience is a thing, and there are indeed component skills that aren't taught like a class when most people are growing up—it's ideal to learn these skills when you're young and/or healthy, but you can learn and practice them at any age and when you've already got crisis. Racing thoughts and ruminations can't be suppressed, but they can be addressed. Emotional responses can be observed in action, as experiences that arrive, build, crest, and recede. Mindfulness and meditation practices are effective places/contexts for giving those emotional responses the space to happen and the context for observing them without necessarily having them "contaminate" other parts of my life/day. There are strategies for disengaging from difficult emotions and lessening their impact on my quality of life. I am not (exclusively) my thoughts or feelings. My emotions are an in-built alarm system for potentially threatening situations, so maybe I should be thinking that (for example) my feelings of anger or panic aren't the problem, but rather the symptoms of a troubled relationship. My emotions may be signs that my deepest values are being challenged or disregarded. And when I don't know what to do or why to do it, knowing my values well can give me confidence that I can use them as a beacon to guide my actions.

I feel like I could go on and on. I didn't know any of these things before therapy. I'd never even considered them.

What techniques or interventions has your therapist used that are most impactful?

I started with an IFS therapist when I was in crisis mode. He was very helpful for getting me feeling more stable, stable enough to do more than get by hour to hour. Ultimately I felt that I want the best for for IFS (for a few reasons that make it sound like I distrust the premise of IFS, which may be a little bit true, but I want to make it clear that IFS was extremely helpful for making me feel safe enough in a therapist's office that I could actually trust and engage with therapy). That IFS therapist and I had a conversation about it, and he connected me with an ACT therapist. ACT was a revelation. I saw my ACT therapist weekly for about a year and a half, and I still check on with him about once a month. The ACT defusion techniques were critical in that first year for helping me practice and learn that I could put distance between myself and difficult thoughts, emotions as they arose. That was my first experience "breaking" the chain of events that would otherwise let an association (a song overheard from a passing car or the sight of a memorable place in town, let's say) send me feeling for the rest of the day. I wish I'd learned this approach when I was a kid, it's so simple and silly and useful. The practice of engaging with values, really sussing out the details of deep personal values that I'd maybe never given much direct attention, was really valuable. That helped me find a way to move from a new and profound sense of self-doubt to a place of very, very firm (reaffirmed) conviction about my values, how my values lead my life decisions, and the real but flexible sense of identity that I feel as a reflection of those values. Part of my crisis was feeling a near total disconnect from my sense of identity, and specifically a disinterest in the world that seemed to be filled with arbitrary values, so I can't underscore the utility of this part of ACT in my situation.

The portability of ACT, too, was helpful. My therapist gave me a workbook (that I've recommended to a lot of people on here) that has come with me on work trips and vacations. It's one of those things that feels like a collection of really helpful skills and practices that I legitimately never knew existed, all collected in a manual that distills the information of in-person therapy.

How has going to therapy changed your life or your thinking?

Hoo boy. Well, therapy was the platform on which I came to understand that I was going through an enormous life change. It gave me the language to understand that, the language to process the experience, and some signposts and guidelines when I was at the peak whiteout part of that blizzard. I cannot imagine how this process would have gone had I not had the confidence to endure and engage that came from therapy (along with the support of an armada of friends and family). I have a hard time answering this publicly, but I'm here today to respond to your question and that is really something. Not just here, but finally in the midst of feeling excited about the possibilities of my present and my future alongside the lingering complications and difficulties that sent my to therapy in the first place. I really appreciate the ACT/therapy awareness that life is a practice more than it's a linear thing with a start and a finish. I feel very engaged by the "live your values, every day, see how that leads you" approach. I feel grateful that I've been introduced to honest, simple meditation and mindfulness practices as a component of my awareness of my experience of being alive. The first couple of times my IFS therapist led me through a grounding exercise (as in, your back is on the ground, that is the fucking earth beneath you, you are bound to it by gravity, you are HERE) I remember being kinda like, oh jeez, this is so woo I can't stand it. And then on the third or fourth time, I dunno, just... boom. I am here. I am here. I'm a scientist. I was almost in awe of snapping into this interior perception that a universal force was connecting me to this planet, hurtling through space. It genuinely shifted my perspective, and I return to these practices to touch that perspective again.

I could go on but this is a lot haha. I'm typing on my phone so I apologize for typos, and I apologize for rolling my eyes at your field for 38 years.
posted by late afternoon dreaming hotel at 7:21 AM on January 13 [15 favorites]

I've had pretty mixed experiences in therapy and a lot of it has felt like a waste of time. I did have one really great therapist who gave me a printed list of questions to ask myself when I was anxious about something. I've since lost that piece of paper, but the question "What evidence do you have for this?" has stuck with me, and to this day when I've concluded that my friend hates me/I'm going to get fired/my relative has a Terrible Secret, I go back to that question and it helps me understand that my brain is inventing a lot of stuff.

Anyway: that list was great. I kept it folded up in my backpack for years. I liked having something concrete to refer to, rather than having to remember stuff when I was panicking.
posted by goodbyewaffles at 7:27 AM on January 13 [7 favorites]

Re: people coming back to address things that aren't their original reason for seeking therapy, last year therapy helped me figure out what my problem was. I came in to deal with one thing and quickly realized the problem was actually another thing (my job), which I was able to address, and my life improved pretty fast. I also think that, for me, the decision to go to therapy itself was really helpful--deciding that I was going to invest time and money into fixing things helped strengthen my commitment to actually doing it. (Realizing I was spending hundreds of dollars complaining about my boss was also good motivation to fix the situation. :D) Also, it's good to have someone impartial to talk to when you feel bad dumping on your friends/family/partner all the time.
posted by ferret branca at 7:38 AM on January 13 [2 favorites]

Honestly I don't think I've ever found therapy to be helpful in the sense of "made me less depressed" or "brought about real insight." What it has done is allowed me to preserve my personal life relationships by giving me somewhere to be boring and sad and scary and mean and suicidal. You can't tell your mom that most days you wish you were dead. Your friends get sick of hearing you talk about how nothing is good or fun. But if you have a release valve for all of those things it makes the daily pretending a little easier.
posted by We put our faith in Blast Hardcheese at 7:39 AM on January 13 [20 favorites]

I've done a couple of short term courses.

One, I remember, was in the wake of an event that had made me flail, and she provided useful outside perspective that I wouldn't have gotten elsewhere because I would never have admitted to anyone else that I was feeling as terrible as I was about the event.

One was later in life and it was kind of for general malaise. Because I wasn't real specific, neither was she able to be. But I went several times because it was that at my stage of life - middle aged parenthood - where nobody is interested or available to listen to you unload for free. Old friends are busy; people at work certainly aren't the right audience; spouses and children are probably part of the problem.

What I'm saying is don't discount basic loneliness as a big motivator for people to continue beyond the initial problem's solution.
posted by fingersandtoes at 7:50 AM on January 13 [3 favorites]

I grew up in a household that didn't really acknowledge or express emotion - feelings were for inside, cold hard reality is the world we actually live in. I didn't realize this was the case and always just thought I was very stoic and peaceful. I started having problems in my marriage (entirely on my side) where I was feeling empty, unhappy and unfulfilled and I tried therapy for the first time in my life to see "what was wrong with me".

My therapist helped me realize that I couldn't even name the emotions I was feeling - I couldn't even identify them. This was a huge realization to me that there was an entire sea of emotion going on inside of me that I was ignoring as I went about my daily business. She helped me recognize what I was feeling and find appropriate ways to express it. I ended up getting divorced, and it was totally the right decision - I don't think it would have went that way had I not gone to therapy, and I'd probably still be stuck in a loveless, unfulfilling marriage that was no good for anyone.

The other thing she did on more of a personal-how-she-interacted level was she had no hesitation in calling me out on things she felt were unhealthy. Due to my circumstances in life, there aren't a lot of situations where people question my personal life - this led to a situation where I couldn't see it (due to lack of emotional awareness) and no one really said anything to me about it. She was able to give me the hard truths that ended up being what helped me break out of that emotional darkness.

Therapy was not a long-term thing for me - it's been more of a 6-12 month tool when something in my life comes up that I'm not equipped to deal with. For me personally, it's a great tool for recognizing my blindspots in my thinking and beliefs and finding ways to address them.
posted by _DB_ at 7:55 AM on January 13 [2 favorites]

When I was in a marriage with a gaslighting partner it warped my sense of reality and right and wrong, so therapy helped me because there was a third party with professional expertise in human relations who could call a spade a spade and help me recognize that my marriage was abusive.

It helped me to set an achievable goal at the end of each session, and to know that I had another appointment in two weeks where I would be accountable to someone so that I would keep making progress toward my goal of getting out. It also helped to be accountable to someone whose response if I did not make any progress would be gentle and productive. She would be to help me figure out why I was stalled and how to move forward.

I'm divorced now and I still go to therapy because I'm coparenting with him and my friends and family would definitely get sick of it if I kept telling them about all of the shit he does. You can't always leave an abusive situation or get past trauma, and I feel like dumping shit in therapy helps me be a better friend who doesn't lean too hard on the people around me.

With all of that said: I'm still somewhat skeptical of therapy because there are times when it has made things worse. Once was when I went to marriage counseling--since you're a professional I'm sure you can guess how marriage counseling with an abuser worked out--and once was when I was severely depressed for five years as an adolescent. I'm pretty sure my parents felt like talk therapy was safer than medicating a kid, but when you're so depressed that just lifting your arms to wash your hair feels unspeakably exhausting, you can't concentrate or remember anything, and you want to die mostly because you feel much, much too tired to can't talk your way out of that. You need medication to even have the energy to engage meaningfully with therapy. Therapy essentially just delayed my access to medication and had me spend a year talking endlessly about the "why" of feelings that did not have a why, they were just a byproduct of depression and they evaporated as soon as I got on the right medication.
posted by xylothek at 7:58 AM on January 13 [6 favorites]

I've been in therapy a few times over the years to deal with specific personal crisis situations. The primary good it has done me has to be a place where I could unload the scary/sad/angry /messy feelings that I did not have another outlet for, in a space where I did not feel I would judged or where there would be significant repercussions in the rest of my life.

To a lesser extent doing that has also made it a *little* easier for me to express those sorts of feelings in other parts of my life too, and to be less judgmental of myself for having those feelings in the first place. I wouldn't say either of those things has happened to a life-altering extent, but the limited change has been positive.

I can't say that specific modalities or techniques have been nearly as helpful as just the act of having a safe and validating place to go once a week/month/whatever and feel some feelings out loud with someone who will say "yeah, that sucks, and I get why you feel bad about it."
posted by Stacey at 8:09 AM on January 13 [2 favorites]

So ok, I have bipolar disorder and I'm trans, and both of those have meant I needed specific long-term things from a therapist.

But also:

I get a place where I can get as upset as I need to, or go as far as I need to into bad memories or scary trains of thought, and trust that there's an adult in the room who's keeping an eye on things. I can self-monitor less and keep less control over my thoughts because I know someone will help me put myself back together. I also know that if I get into really alarming territory — like, "call your psychiatrist when you get home" territory — they'll say something. So I can just focus on feeling how I feel, and not have to ask myself "shit, is this a symptom?" after every sentence.

I get an external memory for my scariest thoughts. My therapist can say "I'm not surprised you're thinking about breaking up with this person. Every time they come up, you end up breaking down in tears, and it's been like that for a year now." And ok, I can ask my friends for advice too — but I try to keep my shit together around my friends, so they might hear some of my complaints, but they don't see all the tears. Also: "This emotional crisis you're having sounds really different from the last one," "You've been in a shitty place all month and it's getting worse," "This fight you're having with A reminds me a lot of a fight you had with B a while ago, does it seem similar to you?"

I get a sort of case manager for self-help advice, if that makes any sense. Like, there are a lot of practices, habits, etc that are useful for people who have problems in their life, but I can't study them all or try them all, and I don't always know which ones would be good for me. My therapist can say "When my patients are struggling with X, they often get some benefit out of Y" or "When you were dealing with these thoughts in a session, I asked you to Z and it helped, so maybe you could try that out in your regular life?"
posted by nebulawindphone at 9:04 AM on January 13 [6 favorites]

Therapy only helped me when the therapist was on my side. People often say the therapist isn’t supposed to be on anyone’s side or is supposed to provide tough love or some bullshit like that, but I strongly disagree with those people.

Any sort of challenging way of diagnosing me as “a problem” never helped me. A kind caring person telling me I was not wrong, I was not “crazy”, and other people WERE taking advantage of me, helped me immensely. To boil it down to the essence that’s all I ever really took from therapy in the end: kindness, a friend, someone on my side with supportive words and advice.

Of course, I am a sort of introvert/pushover type who had messed up parents and a messed up marriage with messed up in laws. If I was say, an alcoholic or had a personality disorder or something, maybe the “tough love” theoretically would have helped. I don’t know.
posted by stockpuppet at 9:31 AM on January 13 [2 favorites]

I've talked to the same therapist since 2017. I specifically chose her because she was a woman who had almost 3 decades' worth of experience and interests in areas that I was dealing with at the time. No offense meant whatsoever, but I didn't want to work with someone who was fresh out of school, because I was a psychology major myself and wouldn't have trusted a lot of the people I went to school with to help me in any meaningful way without more life experience. Having the trust that she'd been through and seen a lot helped me open up to her. I admit that it's a bias on my part, but it's probably one that you're going to face while you get started, so it's probably better to know that.

I didn't have any interest in going—my former partner insisted that I go and refused to go themselves until a couple years later, after I'd made progress that was moving me toward breaking things off. I made it clear I needed them to work on themselves too, not just as a way to try to save our relationship (which couldn't be saved, ultimately). Therapy gave me the recognition of what some of the issues were they were facing and patterns in our lives together and what we each contributed to that, respectively, and how to even begin to try to talk about any of it. Even learning to recognize and name my own feelings has sometimes been an interesting challenge, due to my particular family history.

Because my therapist is closer in age to my parents' generation than to mine, she doesn't always think of things in the same terms I do. We've had a lot of interesting discussions in which I explained various facets of my views on feminism and gender and protest and intersectionality and emotional labor and a lot of connected ideas. She approaches these discussions in such an open, nondismissive way that it's given me space to talk through these ideas and discover what most appeals to me about them and how they inform my worldview while also teaching her a bit. I appreciate that she's open-minded while also able to think through and challenge how I apply those ideas in my life or see them affecting me day-to-day.

Why do I keep talking to her? Working through the dissolution of that relationship was and is an ongoing thing. I've dealt with lots of other situations since then—family stuff, professional stuff, health stuff, other relationship stuff—that she's helped me think through and deal with through some useful practical approaches. Knowing me and how I respond to things and what the inputs and outputs are (e.g., PTSD, OCD, anxiety, etc.) helps her give me really informed advice.

She brings to the table 1. a wealth of knowledge of scenarios clients have faced and the outcomes of various approaches, 2. practical ideas for ways to proceed in various situations, 3. a partnership where she respects but also challenges me, and 4. a listening ear, after I wore out friends' ears with years of what I was going through in that relationship before I went to therapy.

After a few years of this, I feel like I have a lot more tools for dealing with unpleasant or difficult interpersonal situations, or even just my own brain. And if I can't figure things out or get overwhelmed, we can have a call. I don't even live in the same city anymore, but we talk by phone now, just less often than when I was in my previous situation and would go to her office.
posted by limeonaire at 9:54 AM on January 13 [2 favorites]

My first marriage was not successful, in part because I was not processing my emotions because I didn't trust them. Something would happen that I didn't like, but I didn't feel safe expressing the feeling, or I felt that the feeling was wrong, or both, so I would bottle it up. Eventually I would explode into semi-controlled anger. My positive emotions were similarly tempered and processed, so I was hard to read and trust even when I was happy or content. My first wife often felt like she was 'walking on eggshells' with me because she was not getting normal emotional responses.

Therapy helped me recognize, acknowledge, and trust my emotions. I learned to let myself feel the feeling, name the feeling, and express the feeling in a healthy way in the moment. I learned to feel safe giving my emotions a seat at my metaphorical table, so that they could guide me in my life and not take over completely after they had been neglected.

This has helped me in all of my relationships, romantic and otherwise, over the last seven years or so.
posted by Kwine at 10:02 AM on January 13 [3 favorites]

I got a lot of useful information and coping techniques from CBT, my therapist bringing some DBT techniques to me got me interested in meditation and developing that practice changed my life in many profound ways, and I'm honestly still learning things from ideas my therapist brought up through just talking about what I was going through. I didn't always get it when she'd tell me things but years later it would become clear. I'm seeing a student therapist now and it's honestly just useful to have a place to talk out my feelings and say out loud some things I don't need to say to my friends, and even if she's not extremely insightful it helps to have another person validate some things I'm going through.
posted by jeweled accumulation at 10:39 AM on January 13

I started therapy in June this year when my anxiety over my husband's Covid - unsafe work environment overwhelmed me. I had lost a lot of weight and my fear dominated my life, making it difficult to do things that had to be done like grocery shopping, or being a supportive partner. My therapist uses a mixture of CBT, ACT, BRT and some other approaches I don't really know much about.
The therapy helped immensely.
I still have fairly bad anxiety and depression but I've got to a place where I can leave the house, get groceries, walk with friends, go to a hospital for a mammogram, have fun cycling, even read the news.
My therapist taught me some mindfulness techniques that helped a lot. She also did some sessions of BRT designed to ease particularly frightening memories.
I'm not sure how effective those were.
But the simple process of talking to a neutral person who occasionally nudges me to notice where my take on things isn't rational is very helpful.
I do find that I have to be careful not to ruminate too much about my therapy sessions, always imagining how I will explain myself to my therapist instead of being in the moment.
A technique she taught me that I found very useful: I have a constant fear that my mental health and anxiety will prevent me from being able to be there for the people I love when bad and scary things happen. She made me vividly visualize a real memory of a recent time when I was brave and competent, so that I could conjure up that version of myself, whenever that fear came to me. A visceral and vivid reminder that I can cope, and be strong.
So it's a mix of specific techniques (like meditation) and mostly just letting me muddle through and work things out for myself with occasional nudges and reality checks.
I'm not sure if I'm going to continue with therapy this year.
It depends on how well I cope in the next few weeks. At the moment I feel like I am managing pretty well with the tools the therapy has provided, without needing more sessions.
posted by Zumbador at 10:40 AM on January 13 [1 favorite]

I ran a focus group on a related topic a couple years ago. About half the people in the group maintained therapy long-term because they did not view it as the job of their friends/ loved ones to provide emotional labor to them. They saw their non-positive emotions as their own responsibility to handle without the support of other who weren't being paid.

This was not a representative sample of all therapy recipients, but might be a significant factor for long-term patients without obvious therapeutic goals.
posted by metasarah at 10:41 AM on January 13 [6 favorites]

You sound pretty self aware already, so I doubt you actually do any of the awful and invalidating things discussed in this thread, but you might find it interesting anyway. A lot of the comments are about what did or didn’t work for people who had gone to therapy for grief, loss, and trauma.

I have a comment in there that basically explains what my best counsellor did and why it was helpful, after going to one who was very uncomfortable with my grief and immediately tried to CBT it away:
I will never forget the enormous relief and validation I felt when I went to a new counsellor who, on our first session, asked me to tell her what had been happening on my life. She let me talk until I was finished--probably at least 20 minutes solid. On hearing my story (years of infertility, followed by a much wanted pregnancy that ended traumatically in the second trimester, followed by all our pets dying one after the other in rapid succession), she just said quietly, I'm so sorry all that has happened to you. It's a lot of loss and trauma that would be hard for anyone to deal with.

That's all I wanted. I wanted her to say, wow, that is horrible and your response is really understandable. You probably need to talk some more about it.
I think this validation, this need to feel seen, is what brings some people to therapy. It’s repeated in that thread a few times:

I just needed room to be told by someone, confidently and objectively, that I was dealing with some bullshit and that it was understandable that I was struggling with that.

I love that the author finally found someone to acknowledge their pain. Just that simple thing seemed huge. I must remember that.

I was lucky enough to have a therapist point out to me at some point that lots of things were not in my control (age, cost of living, being female) and that it was important to acknowledge the very real obstacles I was facing at the time. That is incredibly important, bizarrely rare, and I am grateful, in fact, that I had that experience.

This boils down to "people start to heal, the moment they feel heard". Makes sense.

Finding doctors who were like "what you're dealing with is, in fact, objectively fucking terrible! your tooth grinding is valid (although bad for your teeth)!" was the second most important thing for recovery.

in my limited experience, therapists working with clients going through trauma at least develop the humility to understand that bad shit happens whether you're thinking positively or not, and people need to be (figuratively) held while processing the normal emotions that trauma or loss brings up. You can (and likely should) layer cognitive techniques/insight-oriented techniques into that over time, but you have to start with "That sucks, and it makes total sense that you feel what you're feeling," before you even think about shifting someone's thought patterns. And half the time (probably more than half the time), the person shifts their own thought patterns once they start to feel heard.
posted by hurdy gurdy girl at 12:04 PM on January 13 [4 favorites]

I was pushed into therapy a lot as a kid because I was really unhappy (for some fairly obvious reasons) and also managing a lot of anxiety which wasn't as well understood when I was a kid. Also my dad drank and my mom was a narcissist and I had a lot of bad habits to unlearn in how I needed to be to survive in that shitshow of a family. So I HATED therapy as a kid--three different people, all trying to get me to get along with my parents, who were mostly just neglectful but still!--and I rejected it as an adult until after my father died and I had some stuff I was just not... moving on from. Working here for a bad boss, for one very major thing. So I finally saw a therapist who helped me do a few things: get a little space from my online life, learn to talk about my feelings effectively with my partner who I adore but who I sometimes can't talk well with, start talking to a psychiatrist about medication, stop being so responsible for everything, meditating regularly, stop pathologizing myself, I'm sure there's more. It's been very nice. We talk for an hour approximately once a month nowadays. I don't have insurance so it's not cheap, though her rates are reasonable, and it's money well spent.

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

- That I can be rigid in many of my ideas, maybe because of being on the autism spectrum, maybe not, that can be challenging and it's both okay to be this way but also not how many other people are, so it's worth learning some strategies to manage that.
- That getting some distance from my online life (literally timewise, not getting online until I've been awake for X amount of time, putting the technology away for X amount of time before bed) can help me feel better about it overall
- Mindfulness generally which just puts some space between me and the immediacy of my feelings. Regular meditation practice help with this.

What techniques or interventions has your therapist used that are most impactful?

See above. She's often tossing out ideas like "Maybe try this..." and that's been helpful. I don't find her pushy. I find her on my side but not like super in thrall with me if that makes sense (previous therapists had praised me in a way I found insincere and unhelpful). She resembles me, like literally physically, which I find really relatable and helpful. She'll use examples from her own life, not in a "Oh we are the same!" way but to explain when she is facing a similar situation what has helped her work through it. She does not try to get me to quit bad habits I don't want to quit.

How has going to therapy changed your life or your thinking?

I think it's been a really good way for me to get outside my own head. I have friends I can talk to and a good relationship with my sister and partner but sometimes I don't want to just BITCH about whatever is bugging me, particularly if it's the same thing that has BEEN bugging me for a while but I feel okay talking to her about it. Very similar to terretu, above, there's something about the transactional nature of it that makes me feel okay being like "This is all about ME right now" in a way that is pretty hard when I am talking to other people with their own concerns and issues.
posted by jessamyn at 1:17 PM on January 13 [6 favorites]

I like that my therapist is a little odd and has a dry sense of humour. I thought therapists were supposed to be more...neutrally diffident, but she has a pretty irrepressible personality and at first I thought "wtf" but now I think we're a good team.

Sometimes, I feel like she's just throwing educated guesses at me and hoping something sticks (and sometimes it does). I was a journalist once, it feels amusingly like a similar process. Other times (your question reminded me of that) it feels directionless, like I'm talking about a different thing every session, but it turns out that they do have things in common. I have control issues, so that thing alone - not being able to control and quantify the outcome of therapy - was immensely interesting to explore.

But here's a specific example of how therapy helped me.
I was complaining to my therapist about my dad, who is abroad and a problematic person, and she asked me why I couldn't just tell him that like I told her. I said that, ugh, he would probably want to argue and get to the bottom of it and therapise me, endlessly, and I couldn't face this conversation. And she said, "you know that just because you say something it doesn't mean you signed up for having any follow-up conversation, right? You could just...put down your phone and walk away."

Well, I am results driven. And this seemed like a very practical thing to try out. So at the next opportunity I figured I would just tell my dad what I wanted to say. I wouldn't try to control or engineer the outcome. I would just...drop the filter and say what I thought. And if I was done with the conversation, I would walk away.

And you know, that was the most amazing, glorious feeling I have ever had. Like a cage door opening and me standing there, frozen, thinking "wow. Anything could happen. Dangerous things could happen. Good things." I didn't know what he was going to say, or what I myself was going to say next. I just stopped caring about managing the consequences. And when he tried to deflect and move the topic I just put it all back in his lap. Managing his emotions was not my problem anymore.

So anyway, she said this small thing that anyone could have said, and it changed the way I thought about everything forever. It's not always the big things you get stuck on, sometimes it's the small ones you didn't even recognise.

I think I'm pretty good at having useful thoughts about myself, but I realised at some point that if I wanted to stop running in circles I needed some help sorting these thoughts and getting over the blind spots.

I think that maybe the randomness of the process sometimes bothers you like it bothered me? But also maybe that's okay?Brains maybe need to process things in random ways? My therapist suggested drily at a time when I was grumpy about being too frazzled to have a coherent, therapy worthy conversation, that maybe I needn't put that much pressure on the process.
I really have no idea where we're going next, but I'm warming to the idea of that.
posted by Omnomnom at 1:27 PM on January 13 [5 favorites]

Memailed you!
posted by Omnomnom at 2:30 PM on January 13 [1 favorite]

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

I started therapy when I had a job that gave me a breakdown. She primarily works with ACT so it was particularly useful for me to get away from the persistent chatter of CBT and focus on what is happening. Values exercises were fundamental in being able to recognise what was going wrong in my job and my relationship, and how I could go about fixing or accepting those.

I learned that my specific brand of weird isn't something that can be fixed just by pretending it isn't there, or ignoring it, and it's not something that needs to be fixed. It just is. I can make choices that help me not have weekly meltdowns and hate myself for being wrong and broken, and in turn that helps me actually do things like my job, be present and helpful, engage emotionally with people.

An example I often use is the values exercise where "quiet" came up as a core value. I was somewhat bewildered because what. How is that a value. That's the stupidest thing in the world. I shouldn't be like this. But part of therapy around it made me realise that actually I have been this way my whole life - thus finding out I have auditory processing issues - and I can't just make my life look 'normal' and not have meltdowns and struggle far more than necessary. I changed careers, I made choices about my free time, wear ear plugs when I want to, accept that I listen primarily to familiar sounds not new ones, which all help when I am 'stuck' in noisy environments (I have a kid with ADHD and my ex has ADHD so competing accessibilities ahoy).

My ex and I separated, without any screaming matches or drama or anything like that because of what I'd learned and what he picked up. We were able to acknowledge our serious differences in core values, and recognise that they are incompatible, and that doesn't make either of us wrong or broken, just that we could make choices about our lives together and apart to support that for ourselves and each other. I changed career to something that is, yes, quieter, but also fulfils a lot of my other values as well as suits me.

I also learned I am controlling in a lot of ways, far too prone to passive-aggressive nonsense with attendant emotional manipulation, and the meltdowns were part of that. I learned ways to recognise what was happening at those moments and techniques to not be such a jerk to loved ones. I'm still struggling with communication sometimes but it's an ongoing process. And as much as I also learned the myriad reasons behind that (socialisation, upbringing, PTSD, queerness) I also learned kinda doesn't matter in the moment. In the moment I need to recognise when I am reacting because something is unfamiliar or unplanned, or I am not saying something and hoping the other person reads my mind, and change my own behaviour.

What techniques or interventions has your therapist used that are most impactful?

EMDR has made a startling change for me. I still have triggers and so on but the aftermath is not so heavily sunk into reliving that memory because I've been able to...shift it into long term memory? Put it where it belongs? And when I am triggered I have a really simple set of exercises tied to a word that I can do. We did a lot of that work in ACT as well but my tendency to intellectualise everything made accessing the real emotional/physical aspects of trauma somewhat impossible.

(Also a very important thing I learned - for me talking is often a defense mechanism to distance myself from emotions, but is also how I make sense of things, so it's a balancing act)

As above, values exercises have been fundamentally change agents for me recognising myself. Being able to give myself what I need vs what I 'should' be like. I'm the kind of person for whom lockdown has been good because it's my preferred form of living, so it's obvious that 'should' is very very far from 'good' for me.

How has going to therapy changed your life or your thinking?

Well, I'm divorced. I have a happy supportive life. I have gone from weekly meltdowns to one or two a year. I've been able to deal with how triggering wearing a mask is fairly quickly. I can recognise when I'm treating myself badly out of an imagined 'should' and change. I can recognise what others need and respect that much better. I can recognise the signs of an impending auditory overload, or triggered response, and act accordingly. I can make a lot more space for other people in my life.

Like yeah I'm still a bear hermit, as my child says, and still have days where I can't quite understand speech well, and currently am sitting with the way I make it very hard for people to show me they care about me, but also? I have my house and my bright sunny blanket, good food, work that suits me, my meds, a great kid, wonderful friends. So I can be content in that.
posted by geek anachronism at 2:36 PM on January 13 [7 favorites]

For me, many things.
One psychologist suspected I had ADHD which meant I now have access to medication to help me concentrate.
One (a very lovely nun) helped work out what to write in a letter to my narcissistic mother to set boundaries.
One gave me mental techniques to deal with the bullying I was experiencing at work.
One introduced me to ACT, and another to CBT.
My current therapist (who I saw about 5 years ago until I didn't need him anymore) worked with me on issues arising from autism, and social anxiety and had me developing skills so that I would be more comfortable and resilient in a world of NTs. This time, my goal is to quit drinking and start exercising again, but I also find myself whinging a lot about obsessive thoughts about family relationships. He reminds me not to "time travel" - not to spend time regretting the past or the future. He helps me to see that my children are adults and if they fuck up their lives, my job as their mother is to either be their cheer squad or their shoulder to cry on, not to try to fix their mistakes or anticipate them. This really helps as the time for my daughter to complete her phd ticks down to the last couple of months with no more extensions and she's unlikely to finish, and I am devastated in advance for her (see, people with autism DO have empathy), but it's not my job to push her - that's her job. So I guess in a lot of ways, we work on my anxiety which is definitely connected to my drinking. I never feel judged by him, and it's only on rare occasions that I am aware of his shock at some of the shit that I and my children have gone through (might be that I can't read him because autism, but I think he deliberately doesn't react, because then I would feel responsible for his feelings). He treats crying like it's completely normal without getting tender or more sympathetic which would embarass me because I hate crying in front of people. He engages with my experience as an autistic person, openly enjoys my non-sequitors and says he likes the different viewpoints people like me give him. He keeps on track with my goals, always coming back to the fact I need exercise for well-being and when I make excuses, he treats them as reasons and comes up with a new tack. He knows when I'm making a joke even though my facial expression doesn't change and he doesn't mind the lack of eye contact. And I've noticed he won't comment or offer advice out of his realm, like I have a number of medical issues, which are being treated by specialists at a big hospital and my GP (who I respect) and some I am just not getting better, and I've googled the medical journals and it could be this rare disease or that, and he just listens interestedly and makes no comment.
posted by b33j at 4:56 PM on January 13 [2 favorites]

Basically just... a different perspective and not listening (emphatically not listening) when I answered all her "what do you want" questions with "I should".

Unhelpful therapy was therapy that went like "oh yeah your partner should definitely do the dishes immediately after you eat, they're a slob" (this rings false because by this standard I am also a slob and that might be true but it shows you don't understand my complaint and are trying to put me into a mold).

Helpful therapy went like "Give me an example conversation. How does your partner respond if you ask him to do a thing in the moment? What is important to you, and what can you be flexible with? How can you talk to your partner and tell them what you want in a way that makes them feel cared about and part of a team and gives them a chance to succeed?"

Actually, she started out giving me, like, the abusive partner questionnaire, because I was telling her how I walk on eggshells and feel like I can't criticize or ask for anything. It helped me to hear my own WOW, NO answers to those questions. Turned out the abusive partner was inside my head all along. The misunderstanding was helpful because it showed me a place where I was wrong ("oh, I don't have to be on eggshells to have a good relationship?") and then she pivoted really well.
posted by Lady Li at 4:57 PM on January 13 [2 favorites]

To be honest though, I tried therapy a bunch of times on the basis that "I should be continually improving myself, right? People say everyone should be in therapy! There are imperfect things in my life, maybe therapy can make them perfect." and it was not at all helpful until I actually had a problem that I wanted to solve.
posted by Lady Li at 5:22 PM on January 13 [1 favorite]

I saw a CBT therapist for eight weeks in the summer of 2019 and really appreciated how he helped me reframe my thought process. I’ve always been prone to catastrophic thinking, ruminating and a little bit of OCD. I began therapy to deal with my feelings about our relationship (I was ahead of my partner on being ready to take the next step), but found that I spent more time discussing some work situations and a possible health scare that presented itself within my family during that time. He had me read a very old book and most sessions we would spend time focusing on how to address an issue and not only see the worst possible outcome. I am so thankful I went to therapy ahead of the pandemic as I feel that I’ve taken a more balanced, level-headed approach to a lot of uncertainty.
posted by icaicaer at 6:33 AM on January 14

I keep coming back to my therapist because she already understands the broader context & history of my life, which has been shared over our sessions. And, I don't really have this person in my personal life besides my husband, who I try not to dump too much of my messiness onto. It's easier to talk about feeling frustrated w/ work last week, when she already knows what I do, what I have done, and how I've thought about those experiences.

Maybe this is a bit of transference, but I intentionally picked an older Asian woman because I felt like I needed a supportive / non-judgmental voice, when my own mother (older Asian woman) has not been very supportive or non-judgmental. I just needed to *know* and *see* that this supportive, in order to work on my feelings towards my parents/upbringing.

I know the above aren't like things my therapist has done, but I think by being supportive/validating, open-minded & letting me set the pace about talking about some painful things, I was able to open up to her about things I literally have not thought/talked about for years, but have been bouncing around in my sub-conscious unhelpfully during my adult life.

We have not gone too deep (I think?) on specific techniques. I have come to therapy after reading a lot of CBT/self-help books, so I had the basics of practicing countering my immediate negative thoughts. Recently, I have found her helping me to reframe some persistent views (that I probably couldn't get to on my own due to blind spots) to be helpful -- e.g., why not just have a low key vacation? and lower your expectation of what you want out of this vacation? vs. my natural tendency of wanting to "make the most" of my vacation with lots of hobbies AND lots of relaxation.

She has also been really helpful in being just a light accountability partner, e.g., checking in on some of the things I've wanted to do, but have been stuck in getting going. And b/c I've been having a tough time in doing things that only benefit myself, somehow, knowing my therapist would care to remember/check in if I did my thing & not wanting to disappoint her, actually got me going to do the things, which is what I ultimately wanted.
posted by ellerhodes at 9:36 AM on January 14 [1 favorite]

My experience with therapy was that it was completely unhelpful, and that if you don't respond to therapy, providers blame you. When I've asked questions about therapy here, I've gotten the same blaming response. I think people are TERRIFIED by the idea that therapy doesn't help everyone, they want desperately to believe that when it fails, it MUST be the client's fault--the idea that sometimes it just doesn't work is scary, because that would mean that if they have mental illness, they might not get better.

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

I guess I learned that our treatment for mental health is garbage. We don't actually try to find things that will work. We just offer therapy and shrug and blame if it doesn't do anything. There's no "mental health treatment person" you can see to determine exactly what could help you, you have to basically self-diagnose that therapy will, and then when it doesn't you have no idea. (Yes, I realize that psychiatrists should be that, but in practical purposes they are not--if you see a psychiatrist you are basically self-diagnosing for meds, and they just decide which ones.)

What techniques or interventions has your therapist used that are most impactful?

None, zero, zip. I went to therapy because I wanted treatment for severe grief and anger. I've seen multiple therapists and not one has offered anything to actually TREAT this. What I got was "that's hard" or "I understand why you feel that way."

How has going to therapy changed your life or your thinking?

It made me feel worse, because I spent years (and also lots of money) trying to find effective treatment and still don't feel better.
posted by Violet Hour at 3:53 PM on January 14 [1 favorite]

What specific things have you learned in therapy (about yourself, your relationships, or the world) that are most valuable to you?

Having been in therapy for close to 20 years on-and-off (more on than off, especially of late), it would take too much space to list all the specific things. Generalized, I could say that it has lead me to a sense of where and how to place my own life. It's nothing like "having all the answers" (nothing close), but more a sense of how to get lost in life from this point on, now knowing more about the trajectory of my life up to this point. I expect this to be an on-going process for as long as I'm alive, and what's helped with this are the things I've learned about being a human subject: that nothing malfunctions quite so regularly as human reality; that in human reality nothing is ready-made for any other thing; that all of us who live in language will always live with a gap, an alienation, from the world before language. Though this might sound depressing, I've found it to have quite an opposite and liberating effect.

What techniques or interventions has your therapist used that are most impactful?

This changed as I changed and grew throughout my life. In my teenage years, when I first started, it was just being able to talk to a relatable adult who showed an interest in my internal world, and could speak my interest in myself into existence. In my darkest years, when I was suicidal, it was learning how to tolerate the suffering, and then to distance from it (while not evading it), and then to relinquish it (however little I could). Later, as I improved, it was to having a screen onto which I could transfer the unresolved conflicts of my parents, and come to terms with the reality of that past, so that it wouldn't ruin my relationship (which later turned into a marriage). Now, it's to have a presence who listens to me free associate, and hears the things that I am saying which I do not realize I am saying, to pick out the knowledge which I did not know I already have. All in the service of making a home out of my symptom, to become a subject of my symptom and traverse however much or little will remain of my life on those terms.

How has going to therapy changed your life or your thinking?

It is unimaginable to me what my life would be without therapy. This is, if for no other reason, because I am now myself a therapist. I suppose that's what I've done with my symptom, and it's working out pretty well for me.
posted by obliterati at 6:38 PM on January 14

I'm the person who posted the first comment in this thread. I wanted to add some information to my earlier answer.

I suffered from depression for about a ten-year period, starting in the early 1990s. Therapy didn't help me (with the exception that I outlined above). When I look back on those dark years now, I think what I needed was help with concrete problems of living, rather than talk therapy or something that messed around with my neurotransmitters.

These were some of my specific problems at the time:
  • I had terrible sleep habits and would watch TV late into the night. I'd wake up around noon. That wasn't healthy.
  • I ate crappy food, and lots of it.
  • I didn't exercise, or even spend much time outdoors.
  • I drank too much and smoked.
  • I didn't pay my bills on time, lived beyond my means, and otherwise mismanaged my finances.
  • I held pointless, petty grudges against relatives (grudges that really took a toll on all concerned).
  • When my depression started, I had a terrible job, but I was stuck in a rut and didn't have the motivation to look for a better job. Instead, I stayed in it, until I got fired.
There were other, similar things, but you get the picture. My life was a mess. Some people might argue that these are the symptoms of depression. Well, maybe. But I wish that someone had helped me address these specific problem areas and try to improve or solve them -- and do so in a concrete, practical way. I think it would have made a huge difference in my life. So what did I actually need? Maybe a life coach -- I don't know. I've never worked with one. But I do know that most of the therapy was too abstract and impractical to be of any real use to me.
posted by akk2014 at 7:23 AM on January 15

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