The limits of therapy
What's missing when we treat therapy as a magic pill
“Going to therapy” is in right now. It has been for a while. People are obsessed with going to therapy and telling other people to “go to therapy.” The general sentiment is that if you’re not doing it, you really should be. But the goal of therapy is, eventually—one can imagine—to not be in therapy. That’s what my therapist told me, anyway.
This isn’t meant to be a hot take on therapy. (In this piece, I’m referring to the “garden variety” talk therapy used to help navigate life’s ups and downs, not therapies used to treat addiction, clinical depression, or other disorders.) I don’t think therapy is silly, pointless, or bad. I can personally attest to its many and lasting benefits. I used to go consistently, every week for the most part, for nearly two years. It was tremendously helpful and I learned a lot about myself. And then I stopped learning that much. Plumbing the depths of my psyche ceased to be that interesting to me. There’s only so much introspection you can do before the whole process starts to feel a bit boring and you need to simply get on with life.1
Limits and judgments
To define the limits of something does not mean that the thing itself is not good or useful. Therapy—like literally anything on Earth—has limits. But these days, it’s positioned as limitless. It’s been distorted in popular consciousness to be something like a modern cure-all or a magic pill.
Also troubling is the idea that if you don’t go to therapy you don’t know yourself or you’re somehow an unsophisticated, closed-minded person. Good People go to therapy. Bad People don’t go to therapy. This simplistic line of thinking is deeply misguided. Don’t even get me started on the binary Us (The Good People) vs. Them (The Bad People) line of thinking that has completely taken hold in the media, but especially in the context of Trump’s election and the pandemic. Then there’s the needlessly dismissive “all men need to go to therapy” meme, which I honestly think is just mocking people in pain. I would expect sophisticated therapy enjoyers (The Good People) to have a little more empathy.
The narrow role of the therapist
If you have a therapist, they play a very particular and limited role in your life. It is unlike any other relationship you have in that it is totally asymmetrical by design, both emotionally and financially. Your therapist knows pretty much everything about you—your thoughts, fears, feelings—and you know essentially nothing about them.
Good therapists believe their clients are the experts in their own lives. They don’t give advice, tell personal stories, or affirm every impulse. (We all have that one friend whose therapist continues to endorse their worst qualities. Rather unfortunate.) Therapists play the role of a “mirror” of sorts, helping their clients to develop better emotional skills and greater self-awareness. They want their clients to overcome their challenges, to triumph in the face of unhelpful patterns, thinking, and behavior, to act with confidence in the world. They can help their clients learn a lot about themselves, others, and life. But they cannot tell you the meaning of life. They cannot and should not tell you how to live. (That one is up to you. More on that later.)
Some of my friends are therapists, and they tell me they genuinely care about and are deeply affected by their clients, but they are not their clients’ friends. This is all as it should be. Perhaps the obsession with therapy these days comes from the fact that people are tragically lacking in friends and family members who are capable of having deep, contemplative conversations. A caring conversation amongst friends is not “emotional labor” by the way—it is friendship. Perhaps your friend isn’t “gaslighting” you, but being honest because they genuinely want what is best for you.
Self at the center
The therapeutic process is also, by design, a self-centered one. This isn’t a problem for an hour or two a week, of course. It’s the point. But it becomes a massive problem when people take this approach to their entire lives. This used to be called simply “narcissism” but is now called “main character syndrome.” If you have ever spent time with a four-year-old, you know that we’re all hard-wired to be the “main character” in our lives, but the work of growing up is to gradually unlearn that self-centeredness and think more about others as you mature. (Before I got off TikTok a year or so ago, this idea of insisting you are the “main character” was being embraced as empowering.)
But do you know what’s really empowering? Forgiving those who have wronged you, taking responsibility for your own life, nurturing and trusting your friends and family, and showing some discretion. We do not have to externalize our every waking thought, feeling, and belief in order to heal. Our agency and our inner strength go missing when we treat the mere act of attending therapy (the process) as the solution.
The point I’m trying to make is that there’s a thin line between self-analysis and self-indulgence. Both can lead to a semblance of self-awareness, but self-awareness in and of itself is not the goal of therapy nor the goal of life. Self-awareness matters, but not that much. If you’re aware you’re being a bad friend, it doesn’t make you any less of one. It is merely the first step. “Yeah, I did that awful thing because I have anxiety.” This kind of pseudo-self-awareness hides much more than it admits.
Looking outside the self
Eventually we all reach the dreaded age of twenty-eight or thirty and stand to face ourselves in the mirror. We realize we cannot avoid the pain of life. We realize we eventually need to forgive our parents, the ex-boyfriend, and the kids we grew up with (who were children after all). We realize that calling ourselves out on our own bullshit is sometimes the best therapy there is. Want to take it a step further? Try subordinating your needs to those of others, to someone you love, or some cause or tradition outside yourself. I’m working on getting past step one over here.
Therapy can only help you help yourself—which, to be clear, is rather helpful. But its role is limited in that way. That’s what I mean by the “limits of therapy.” Your therapist cannot force you to go to the gym or to stop dating people you know are bad for you. Only you can do that. Your therapist can make the space for you to explore these issues, come to certain conclusions on your own, and support you as you make change in your life. All told, it sounds like a worthwhile endeavor.
For the record: when I got depressed again, I went back, and when I felt like myself again, I quit again. I’m not in therapy right now, but I would go back if I felt the need.