We’re getting better at talking about therapy as a society. We are. We just haven’t updated our expectations of what it looks like.
I’d be happy to help with that.
Caveat: There are a bunch of different types of therapy, and the type you need might vary based on what’s going on. But this is what has held true across my experience and understanding.
First, I’d like to discuss three misguided notions of therapy I’ve either had or witnessed in the wild. Then I’d like to share a better one that more accurately describes my experience, as well as that of many others.
Three Popular Misconceptions of Therapy
The Machine Shop
If you feel like a car that’s had every maintenance light on for years, but you’ve continued to put tape over the reminder rather than find out what’s broken or what it will cost, you’re not alone.
But as good of an analogy as that is, we’ve got to stop picturing finally going to therapy as simply going to the machine shop or a NASCAR pit stop.
You’re not a car. They’re not going to remove the banged-up parts of you and replace them with new. Nor is parsing through human trauma as simple and tidy as ordering the right parts from the right maker and screwing them into place.
It’s not that you’re not a machine. It’s that you’re the most complex, fascinating machine on the planet. You’re not simply mechanical. You are mechanical, but you’re also chemical, electrical, spiritual, and probably a half dozen other things we haven’t even discovered yet. You’re not so easy to fix.
But that doesn’t mean it’s hopeless.
The biggest problem with the machine shop imagery is its quickness, absoluteness, and passivity. You see yourself as a broken thing to be fixed and don’t imagine you’ll be part of the repairs. You’ll just go in, surrender to an expert, and finally get it over with.
But life isn’t like that, as you’ve probably already discovered.
The Freudian Trap
The best description I ever heard of Sigmund Freud was by my professor in my very first psychology class: “He was an important historical figure, but not much of a scientist.”
So set aside all of his sexualized notions of childhood (yes, it really was that bad) and simply picture his model of therapy.
The patient lies on a couch and talks, while this little freak with round glasses sits in a corner just out of sight, taking notes and waiting to leap on whatever weird little thing the patient accidentally says that’s the key to the whole ballgame. The patient continues to visit him for decades without showing any signs of improvement, but, it may be imagined, an increasing fear of weird little dudes in round glasses who lie in wait for a slip of the tongue he named after himself.
Let me reiterate: historical figure, not a scientist. He sat in his chair, smoked, did cocaine, and pontificated about unprovable theories. Don’t let him scare you.
He does not represent the modern therapist, at least not good ones.
The primary fears (founded, in some cases) this imagery evokes are of walking into a sort of trap where everything you say gets used against you in ways you don’t understand, and nothing ever improves for you.
That’s not good therapy. That’s a scam.
The Place of Pampering
Don’t get me wrong, therapy can be a huge source of relief. Just having someone believe you instead of shutting you down every time you present your own experience can be life-changing.
But a good therapist is not going to affirm everything you do. Nobody who cares about you is going to support destructive decisions. They won’t beat you over the head or yell at you, but they’re going to call you out. In fact, some of the best moments in therapy have been the ones where I made a statement, my therapist suggested a “What if?” that I hadn’t considered, and I just sat there staring at a wall for several seconds as my paradigm perceptibly shifted.
Sometimes people imagine self-care as bubble baths and chocolates. It can be that. But it can also mean making the decision that regardless of how sad you are, you deserve to be sad in a clean house with good food and fresh laundry, and then committing to maintaining those things. To do right by tomorrow’s you.
I’ll say it again: therapy often does come with a great deal of relief. But it’s not where you go to sit and be told you’re right all the time. It’s a place of making positive change.
A Better Analogy
For some reason, analogies often land the best with me. Maybe I’m just a visual person, or maybe drawing parallels is helpful for a lot of us. But it was important to me that I come up with a better analogy for therapy that will make it understandable for anyone who hasn’t tried it or doesn’t know how to approach it.
Mental therapy is a lot like physical therapy.
The Mechanism of Injury
You come in with something that hurts, maybe that’s restricting your movement. It might have come from a recent injury, or a genetic condition, or bad habits, or anything else, really. What brings you in makes no difference except in that it sets the course for effective treatment.
This is why so much of therapy starts with you talking and your therapist listening. Except they’re not trying to trap you (see you in hell, Freud); they want to understand how you came to the place where you are. Trauma, abuse, life experiences—all of it contributes to the result sitting in front of them.
Then they’ll start to ask a few probing questions. You’ll get specific. You might have to relive a few painful moments. But it will all contribute to your therapist knowing what you need.
In physical injuries, the mechanism of injury is super important. How did you do it? Did you get hit by a car, step off a curb, get punched in the face, have a botched surgery, or did something wear down over time? It all matters.
It’s Going to Hurt Before It Heals
Anyone who’s been to physical therapy is happy to inform you that sometimes the PT can be more painful than the incident that put you there.
But you wouldn’t let that stop you from seeking care, would you?
Because you know that this pain, experienced at the hand of a probing expert, is an investment in the future. You do the painful exercises and allow the doctor to manipulate the injured area in order to one day experience your daily activities without the pain that brought you here.
Sometimes the pain of healing is sharp and momentary, like setting a bone. If allowed to heal incorrectly, a bone will continue to give you trouble and may even need to be broken a second time and get realigned. That pain is awful, but it doesn’t last, and it leads to crucial outcomes. Similarly, reliving the horrible words a caregiver said to you or the moment that changed your life can be extremely hard. But it’s the start of a new world where it doesn’t hurt so much.
Sometimes the pain is more predictable and sustained. A muscle that hasn’t moved in a while, or one that keeps seizing when it shouldn’t, is going to be sore and uncooperative. Similarly, you might have to talk about the same thing several times before the penny drops and something shifts in you. But you wait for it, because a better tomorrow is worth it.
Your Contribution to Your Care
I hated homework as a kid, but in therapy as an adult, I love it. Want to know why?
Because it gives me a chance to sit with what my therapist said with no one watching me, and then apply it in the safety of my own company. If you freeze under scrutiny, this is a good way to do the work on your own time and then report back with what you discovered. It’s also part of therapy that’s taking place off the clock, and if you’ve had a look at what therapy can cost, you’ll want to make the most of every minute.
In the case of physical therapy, you’ll often receive a list of stretches and exercises to do when you’re at home or on the go. If this muscle cramps, here’s how to stretch it. If the pain returns, try this. Do this routine daily, even though it hurts, and gradually the limb will be easier to use. You build strength, learn proper form, and most importantly, change your habits. If you always do what you always did, you’ll always get what you always got, right? So doing the exercises is a commitment to change.
Therapy for the mind is very similar. The first thing you’ll do is practice noticing. When does your temper flare? When does the pain come rushing back? When are your most vulnerable moments?
Then your therapist will help you make a plan for what to do when those things happen.
When I feel panicked, I will do these breathing or grounding exercises.
When an innocent remark takes me back to a bad place, I’ll remind myself I’m not there anymore.
When my new partner does something my ex used to do, I’ll stay calm, but I will trust my own experience and not ignore red flags. I will bring up the problem in a calm moment using this formula.
The Coolest Thing About Therapy
Doctor Mike said something really cool on his YouTube channel about how doctors really don’t heal the body; they set it up to heal itself and support it in doing so. They set the bone where it belongs and brace it in place, but it’s your body that does the repairs.
Therapy does the same thing. It’s teaching you a new way to approach your problems so that not only can you heal what brought you in in the first place, but you’re better prepared to handle the next rough patch, and the next one after that.
So maybe it’s a bummer that therapy isn’t like a pit crew changing your tires in seconds and sending you back out good as new. But taking part in your own healing and learning new skills is deeply empowering. You learn so much about yourself and it improves every aspect of your life.
I’ve met people who are no longer in therapy but who still apply the principles they learned there. That’s what it’s supposed to be: a set of tools and skills rather than replacement parts. And the coolest thing about that is that even after the bill is paid and the time spent with your therapist is over, you get to take those tools and skills with you into the rest of your life.
Physical therapy is less like a massage and more like exercises that hurt in order to help. But that shouldn’t stop you from going. Neither should the work that therapy requires make you afraid to go in for your first appointment.
If you know something needs to change but you don’t know where to start, or if you’ve ever considered therapy, I highly encourage you to pursue it. Knock on doors. Bother your insurance provider. Look for free community resources. Just remember that one of the strongest ingredients of successful therapy is your willingness to put in the work and commit to the needed changes.
And if you’re already in therapy, take your meds, do your exercises, and don’t cancel your next appointment. Someday, you’ll get to look over your shoulder and realize how far you’ve come, from the day you entered and could barely move, to when you’re healed and better informed than you’ve ever been.