Ten Things Therapists Wish People Knew About Therapy

1. We don’t talk about you to anyone else.

Whether you see a Licensed Clinical Social Worker, a Licensed Marriage and Family Therapist, a Licensed Professional Counselor, or a Licensed Psychologist, we are all held to a high standard of confidentiality by our respective professional organizations. If we were to talk about you to anyone outside the “cone of silence” (meaning outside the supervisor-supervisee relationship), we could be brought up on professional charges and have our licenses stripped by our state boards.

2. We’re not going to ‘fix your kid.’

One of the hardest things about working with children and adolescents, from a therapist point of view, is that parents must realize that change has to happen to the entire family system. The analogy is a little crass, but here it goes: Fixing just one family member, whether parent or child, is like washing just one piece of laundry, and then being surprised when it smells bad after being tossed back in with unwashed laundry.

3. We’re not going to arbitrate your arguments (or tell your partner that they’re wrong and you’re right).

When doing couples therapy, I make it very clear that I’m not on one partner or the other’s side. I’m on the side of your relationship, until you tell me otherwise. (Then we’re working on a new goal.) I’ve often told couples that they can argue at home—therapy is a place for them to learn how to do things differently.

4. There are times when therapy isn’t appropriate.

If there is domestic violence between the couple or ongoing abuse in the family, it isn’t appropriate to provide therapy services to the unit. (It is possible, however, for individuals in those situations to receive therapy services.)

5. Therapists go to therapy.

Some training programs actually require therapists-in-training to see their own therapist. As a rule, therapists of all varieties view mental health checkups as being just as vital as physical health checkups, if not more so. With the things that we see and hear, if we didn’t engage in appropriate mental health self-care, most would leave the profession within a few years.

6. We’re affected by your stories, even when we don’t show it.

As a helping professional, I wouldn’t still be in the business if I didn’t genuinely care about people’s well-being. I’ve cried with some clients, and I’ve cried after some clients have left. Some of the stories that I’ve heard of unimaginable heartbreak and horrific abuse have also included some of the greatest triumphs of the human spirit. It’s this balance that keeps me doing the work.

7. Therapy is hard.

If you’re “doing therapy” to its fullest potential, therapy (and your therapist) will challenge you, make you uncomfortable, and stretch you toward a life worth living. If you believe that therapy is a passive experience, or that all the work of therapy happens in the therapy room (not outside in your real life), you are probably going to be disappointed in the results you see.

8. Not all therapists are the same.

Much of the research about the effectiveness of therapy is now showing that it’s not necessarily the background, credentials, methodology, or training of a therapist that makes the difference—it’s the connection between the therapist and the client. It’s hard to be vulnerable and make progress with someone you don’t feel safe with, or that you don’t feel understands you in a pivotal way. That being said, just because you didn’t make the progress you wanted with one therapist doesn’t mean that therapy isn’t for you—it means that you may just not have found the therapist for you.

9. Most therapists aren’t pro or anti-medication.

I view medication and therapy a lot like buying a house. The house is therapy, but medication is the funding. Can you get an adequate house with so-so funding? Sure. But could you get your dream house with access to all the funding you need? Similarly, you can have Scrooge McDuck piles of money, but if you can’t find the right house, it’s not going to get you anywhere.

10. Change is possible.

The philosopher Heraclitus of Ephesos asserted that “Change is the only constant in life.” Without change, we as individuals and as a species would cease to exist. No matter how overwhelming your problems feel, change is possible!