Five Obstacles to Effective Therapy

Whether you have a serious psychiatric disorder, such as major depression or OCD, or are struggling with a major life issue, such as going through a painful divorce, therapy can be highly effective and very beneficial. It can also be a waste of valuable time and money. So what makes the difference between effective therapy that truly makes a positive difference in your life, and time in a therapist’s office that would have been better spent twirling your hair or throwing your best china against the wall? (Actually, the latter can be a great way to let out some anger, but only if the china was a gift from your cheating ex-husband’s meddling aunt!) Humor aside, it’s important to be aware of potential obstacles if you’re in – or considering starting – therapy. Whatever the reason you’re seeing a therapist, you probably want to make the most of it and gain a lot of value from it. And more than anything, the last thing you want is further pain, frustration, or disappointment when life is already enough of a struggle. Being aware of the things that could end up or already are interfering with your progress in therapy could help you adjust course before it’s too late. (By the way, it’s important to note that a skilled, experienced therapist should already be paying attention and noting any of these issues and addressing them along the way. But therapists aren’t perfect, and there’s no reason you shouldn’t have some idea of what problems you may be bringing to the table – in addition to the one(s) you meant to focus on in therapy.) So, let’s take a brief look at five of the most common obstacles that keep people from making progress or dismissing therapy as the most useless invention since the “noodle fan” (yes, that’s a real gadget!):

Your Attitude Is a Subtle Saboteur

Your parents, coach, boss, or teacher probably told you at some point in time that “attitude is everything.” Well, they were right – and it does apply to therapy. This isn’t so much about having a super positive attitude from the beginning – after all, this is therapy not a social event! But attitude does matter. If you approach therapy with one of the following attitudes, it’s going to be a problem:

  • I don’t need therapy – I’m just doing this to get my nagging spouse, mother, boss, drug and alcohol counselor, or other annoying but important person in my life off my back.”
  • Therapists are over-educated idiots, but being the center of attention for an hour each week is nice.”
  • I know myself far better than any therapist ever will!”
  •  “This is a waste of my time.” (this one almost always becomes a self-fulfilling prophecy)
  •  “If this therapist suggests I’m the problem, I’m outta here!”
  •  “I’ll just tell my therapist what he wants to hear – I’m sure not gonna reveal anything deeply personal!”
  • “Why am I here??!!”

The general idea with attitude is that if you 1) expect therapy to not work for you, 2) believe it’s a waste of time or that your therapist doesn’t know anything, or 3) treat it casually, your attitude is an obstacle. But, if your therapist confronts you about it early on (which is a sign of a therapist who knows what he or she is doing), there’s a golden opportunity for you to move past it and do the real work.

You Have Unrealistic Expectations

Unrealistic expectations can quickly sabotage your time in therapy. It’s one of the reasons many people drop out prematurely. If you start therapy with the expectation that after one or two sessions you’ll be “cured” or turn your life completely around, you will be sorely disappointed. Therapy is a process. And, in most cases, it takes a fair amount of time. Granted, some therapeutic approaches are designed to be “brief,” like solution-focused therapy, but even those have their limitations and don’t lead to miraculous results – even with the best therapist in the world. Other unrealistic expectations about therapy include the beliefs that:

  • It will be easy and comfortable (it’s often uncomfortable – like cleaning an infected wound so it can heal)
  • You’ll notice the benefits right away (you may feel worse before you begin to feel better, because addressing painful issues is hard work and may open up some wounds)
  • You’ll feel better after each session (unfortunately, peeling away the layers of an onion can lead to tears…)
  • Your therapist knows everything and / or can read your mind (therapists aren’t omnipotent)

You Spend All Your Time Venting (or not…)

Venting can definitely be cathartic – you know, that feeling of freedom and relief when you finally get something off your chest – and the other person is actually really listening to you. It feels good. At least for a short while. But if you use every session to vent – especially if you’re rehashing the same thing over and over and over – you won’t make any progress. In fact, you’ll just keep yourself stuck in the muck and mire that led you to therapy in the first place. Venting has its place, and it’s often essential from time to time. But there needs to be a balance between venting and working on your issues. On the flip side (the “or not” above), if you approach therapy as if it’s afternoon tea with the Queen, being prim and proper and never letting your true feelings show, you’ll still remain stuck. Because all the hurt, anger, and other painful emotions will just fester and eat away at you. You can vent – you need to let your guard down, take a risk, and allow yourself to be truly open about how angry, sad, miserable, lonely, insecure, scared, and so on, that you really are. THAT’s the meat your therapist can work with. If you are passive, stoic, or overly guarded, you might as well go home and have tea. Don’t make your therapist pull teeth to elicit a genuine emotion, but don’t spend all your time venting either.

You Don’t Trust Your Therapist

If you don’t trust your therapist, you’re pretty much dead in the water. Trust is vital to making progress in therapy. Don’t get me wrong – genuine trust doesn’t (and shouldn’t) happen overnight. It needs to develop naturally and must be earned as well. Often, the first two or three sessions (and sometimes more, in cases of severe abuse or trauma, for example) are really spent on two things from a therapeutic perspective – gathering information (i.e. what is the real “presenting problem” and the history behind it) and establishing what therapists call a “therapeutic rapport.” That rapport is crucial and is based primarily on trust. If you don’t trust your therapist, how will you feel safe enough to talk openly and let your guard down? If you don’t think you can ever truly trust your therapist, then it’s best to either address that in therapy, or find a new therapist. If you find that you can’t trust any therapist, it’s even more important that you find someone – preferably a seasoned, highly respected therapist – who can help you work through the trust issues together – which isn’t going to be easy but will likely have benefits that carry over into many other areas in your life. Sometimes just getting past the trust issue is half the battle.

You Dismiss the “Little” Things as Unhelpful

Actually, they’re not really little, but their purpose just isn’t obvious to you. Therapy is a much more involved, complex process that most people realize. Most clients approach it with the idea that they want to work on A, B, and or C. What they may not realize is that many of the benefits of therapy don’t come from solving or fixing A, B, or C – but rather come from the process itself. Nifty, huh?! The trust issue is a perfect example. Let’s say you went into therapy to deal with a painful divorce. You felt disrespected, betrayed, unloved, and so on by your ex. You want the pain to go away so you can get on with your life and actually enjoy it. That’s your “presenting problem.” But that issue of trust rears its ugly head, so you end up spending several sessions discussing that. You might be thinking to yourself, I’m not here to address trust issues – I’m here to find a way to get past the pain of my divorce! But your divorce also stirred up (or may have partially been caused by) some serious trust issues – and now they’re playing out in therapy. Does that make sense? So, working on the trust issue with your therapist will also help you heal the pain from your divorce. Sure, there are other aspects that need to be addressed as well, but don’t dismiss this one. The process can be invaluable, even though it feels like a temporary (and frustrating) detour. A skilled therapist will use everything that comes up in therapy to help you. It’s a lot like working with a really good athletic coach. You’re a figure skater who wants to master your jumps, so you hire the best coach you can afford. You have your first session and are all warmed up and ready to get out on the ice and start jumping. Your coach has a different idea. He tells you to spend an hour carving perfect figure 8’s. “Huh?” (You think to yourself). “I’m paying a fortune for this guy?? I already know how to do figure 8’s!” What you don’t realize is that your new coach, who’s trained numerous gold medalists, knows that jumping is not the real issue – it’s a lack of discipline and precision. It’s not obvious to you – yet – but in time you’ll reap (and understand) the benefits of your coach’s wisdom and experience. The same is almost always true with therapy. These are just a few of the more common obstacles to therapy. A skilled therapist will recognize obstacles (just about every client has at least one or two) when they appear, and address them as needed – sometimes subtly, and sometimes directly. If you hang in there and keep doing the work, you’ll likely be surprised at how much progress you can make. There’s an old saying that goes something like, “Don’t get so focused on your destination that you fail to appreciate the journey.” Keep this in mind when you’re in therapy, because the most effective therapy has much less to do with the final destination than the process of getting there.

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