The Side Effects of Psychotherapy

When contemplating psychological interventions, it is common to think that they are completely free from any associated side effects. However, this idea could not be any further from the truth. Psychotherapeutic ‘cures’ may in fact come with a range of unintended and unexpected adverse effects.

It seems logical to assume that any intervention cannot work without at least some associated risks or repercussions - if it were that easy, the difficulties faced by individuals in need of therapy would be solved much more quickly and efficiently. Instead, issues related to psychotherapy often prove to be more complex than many people anticipate.

The idea of voluntarily entering a type of treatment which carries potential negative outcomes can seem very intimidating, yet there is an important realism associated to it. On the one hand, part of the process of transformation and progress entails taking risks – although we must always be aware of the consequences that these can carry. On the other hand, understanding the possible reactions of being exposed to our hidden deep rooted problems is equally important.

In some cases the risk of side effects may come in the form of the patient actually having to feel more psychological distress before becoming better. For example, with exposure therapies (used to treat PTSD and other phobias) patients may have to deal with the stress resulting from facing their fears as well as feeling more isolated as it intensifies their awareness of their psychological distress. Furthermore, other therapeutic approaches such as Cognitive Behavioral Therapy (CBT) may be harder for some patients who need to confront their problems in more detail and thus increasing their anxiety for a period of time before eventually finding relief.

Yet, there are ways to make progress without facing too many unpleasant physical or psychological effects. Certain mental-health professionals specializing in ‘talk-therapy’ believe that facing our emotions using gentle methods like re-development of a narrative, can have positive results without triggering too much discomfort during the process. Techniques such as mindfulness, where the goal is to stay present with what we are going through, are a great example of this.

At the same time, the contact between the therapist and the patient can increase the chance of feeling rejected, misunderstood or overly criticized. This may cause unwanted stress and anxiety not just for the patient but also for the therapist. Such dynamic can happen when there is lack of connection or tension between them which can be avoided. Keeping in mind the different needs of both roles involved in the process, as well as the boundaries needed in order to maintain a professional relationship can be key factors for success.

Although the risk of side effects is undeniable, the reason why many people struggle to face it is because of the great reward at stake. Nothing comes free and psychotherapy is not an exception, however, making the effort to overcome and accept such reality ultimately brings many benefits. As with anything, it is important to really understand the process and be careful when choosing the type of therapy and the therapist best suited for each individual, as this can anyway have an impact on the outcome, whether it is positive or negative.