THERAPY: Some Common Misconceptions

by Leslie Karen Lobell, M.A.

Recently I was speaking with a woman on my island home, who, like all of us, has challenges in her life. When I suggested to her that she might want to seek some professional assistance in facing and coping with these challenges, her response was something like, "I'm too stubborn for therapy. I won't listen to anyone telling me what to do!" As a therapist, I was a bit surprised by this response: I don't see myself in the role of "telling people what to do." I was really grateful, however, that this woman was blunt and honest enough to say this to me. Her statement really got me thinking about people's ideas and misconceptions about therapy.

Here are what, I believe, are four of the common misconceptions about therapy (each of which I will address, in turn):

Misconception 1: Only people with mental problems go to a therapist. · Misconception 2: Therapists run your life; they always tell you what to do. · Misconception 3: Therapists just sit there, saying nothing and/or falling asleep, while their clients lie on a couch and speak. · Misconception 4: If I decide to go to a therapist, I am admitting I am "weak."

Misconception 1: "Only people with mental problems go to a therapist." While there are professionals who specialize in working with people struggling with mental disorders, this is not, by far, what all therapists and counselors do. For instance, Counseling Psychology, the area in which I gained my graduate training, has what I call a "wellness model" as opposed to a "sickness model." Academic training in Counseling Psychology has less focus on assessment and diagnosis of mental disorders; it focuses more on normal developmental and adjustment issues: choosing a career; managing stress; coping with life changes such as moving homes, entering retirement, the birth of a child, or the death of a loved one; dealing with depression and anxiety that may follow a traumatic event in which the client felt helpless and/or victimized; making healthy choices in relationships with friends, co-workers, spouses, and others; developing self-esteem; etc. Some people go to therapy primarily for personal growth: they may be highly functioning people, with successful jobs, close friends, and a good family life, who are seeking a greater level of self-actualization to reach their maximum potential.

Misconception 2: "Therapists run your life; they always tell you what to do." A therapist's job is not to run his or her clients' lives. Well-trained therapists work in partnership with their clients. There are different types of therapists, and some are more directive than others. Behaviorists, for example, try to assist clients in changing what both the client and therapist see as "maladaptive behaviors"; these therapists frequently give their clients a lot of homework in the form of more adaptive behaviors to practice (for instance, if the client seeks to stop smoking, the therapist may "prescribe" a daily practice of running, instead). Behaviorists (a minority of therapists) are, generally, the most directive of all types of therapists. Most therapists, rather than "telling people what to do," endeavor to assist people in getting to know and understand themselves better, so that they are better equipped to make their own decisions.

Misconception 3: "Therapists just sit there, saying nothing and/or falling asleep, while their clients lie on a couch and speak." This view of therapy comes from the depictions of the oldest school of modern therapy, traditional Freudian-style psychoanalysis. Freudian analysts see themselves as a "blank screen" upon which their clients project themselves (and their internal conflicts); often, these analysts say very little during a session. There are very few of these strict, traditional-style analysts practicing today. Most therapists are much more interactive: asking questions, listening to the answers, and working proactively with their clients. Therapy offices are generally set up for both the client and therapist to be seated, facing one another.

Misconception 4: "If I decide to go to a therapist, I am admitting I am 'weak.'" For some people, especially for men in Western culture, there is still a perceived "stigma" attached to seeking help. Why, however, should we, as humans, endeavor to solve all our own problems? Why reinvent the wheel? Why not seek counsel from others who may have faced the same challenge and/or may have the knowledge to assist us? While turning to a friend for advice may work in some instances, there are times when all of us could use an unbiased, professional opinion. It takes great courage to admit, to yourself, "I need help." It takes even more courage to ask for help. Rather than a sign of weakness, I believe it is a sign of strength when someone wishes to improve his or her life, and has the courage to ask for assistance in this process.

There is one other issue (not a misconception) that I believe is important to address: confidentiality. Confidentiality is a valid concern. This is important everywhere, but it is especially important in a small town, on an island, in a rural setting, or anywhere with a relatively small population, where many people know each other. Training for Psychology, Social Work, and probably all forms of counseling and therapy includes training in ethics. Maintaining confidentiality is an important aspect of this training. With extremely rare exceptions, such as when a patient is a danger to himself/herself (suicidal) or another (homicidal), therapists and counselors, like medical physicians, cannot give out any personal information about their clients without prior permission from the client (and this usually is done only in rare instances, such as when a client wishes the therapist to consult with his or her doctor). If you are considering therapy, but have concerns about confidentiality, this is a good thing to discuss, up front, before you begin your first session. Whatever your question or concern, don't be afraid to ask!

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