What Is Therapy?
Updated: May 29
Vicki L. Loyer, Ph.D., LMFT
First published in the Desert Leaf November 2016
I’m not crazy; my mother had me tested.
—Sheldon Cooper, a character on The Big Bang Theory
Therapy, aka the treatment of mental or psychological disorders by psychological means, often generates curiosity and misinformation. The media can both help and hinder a clear understanding of what therapy is and isn’t.
Some who have never been to therapy may be fearful of it. Attempts to demystify therapy and reduce the fear include the 1998 book The Man Who Mistook His Wife for a Hat, by Oliver Sacks, who wrote for the lay audience about his work with persons with neurological disorders. In 2015, The Try Guys posted a YouTube video in which they “tried” therapy:
Distress is the common experience that often prompts people to get help. Families push loved ones to get help because behavioral and emotional challenges affect everyone in the family. The American Psychological Association estimates that while 25 percent of patients presenting with symptoms to their primary-care physician are depressed, the primary-care doctors identify fewer than one-third of those patients as depressed.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 45.1 million adults have mental illness, yet 75 percent of respondents to the Centers for Disease Control and Prevention believe there is a stigma to mental illness. In today’s U.S. macroculture the large number of choices to be made and stimuli to filter out creates anxiety experiences for many people who would not have suffered with anxiety in past years simply because the choices and stimuli didn’t exist then.
A vocabulary lesson in mental health: “equifinality” is the principle that there are a number of ways to get to the same place. The principle can be applied to addressing both physical and mental health challenges.
As is the case when addressing your physical-health challenges, you can begin to address your mental health challenges by employing the least-intrusive level of assistance and build from there. Start with “bibliotherapy” at your local library. Don’t worry if the books you find are not the most recently published: nothing new is true, and nothing true is new. Forget the gimmicks; forget the “cures.” Mental health, like physical health, has a science. There are some things we know, and some things we do not know.
The science of mental health is empirically validated: (1) moods are influenced by foods, activity levels, and basic body-chemistry; and (2) behavior is logical. Behaviors may not be wise, and they may not be good for you, but they are logical. Why does the child throw a tantrum? Because it is rewarding to the child. Why does the neighbor gossip? Because it is rewarding to the neighbor. Changing the reward will change the behavior. Food, however, is not a good reward for behavior change: once someone is full, the reward is no longer motivating. There are many self-help books, TED talks, and YouTube videos that can be helpful in learning basic behaviorism skills.
Research indicates that just answering questions on couples conflict, substance abuse, or anger can serve as respective interventions in those areas; when you answer a questionnaire you think about things related to what you are experiencing. Visit the SAMHSA website, for Recovering Your Mental Health self-help guides, which provide
information on a variety of mental health topics.
Find a Professional
The primary training of the therapist is designed to help individuals communicate their needs and increase their life functioning and satisfaction, whatever those goals may mean for an individual. A therapist hears not only what is said but also what is not said. Look for a licensed professional in good standing with the licensing board.
Therapists are legally and ethically secret keepers. The therapy room is an opportunity for openness and vulnerability. What transpires in a therapy room stays in the therapy room in strict confidence unless there is danger to self (DTS) or danger to others (DTO), in which cases further action is mandated in terms of notifying the appropriate authorities. Unlike friends and family, professionals are obligated to protect both the patient and the public.
Ethics standards for therapists prohibit dual relationships and require referrals when a therapist’s relationship with a patient in another area impairs the therapist’s clinical judgment.
Choosing a therapist is like buying shoes: some styles fit, some do not. Remember equifinality? There are many ways to get to the same place.
Counselors, marriage and family therapists, social workers, and substance abuse counselors are all licensed by the Arizona Board of Behavioral Health under the same umbrella. Imagine a line stretched across this page from left to right. At the left are the most individually focused, trained professionals (psychiatrists, psychologists, counselors). In the middle of the page are those trained in social psychology: the social psychology of groups and, in particular, family groups (marriage and family therapists). At the far right are social workers: professionals who can organize and motivate communities of people. All behavioral health professionals learn a bit about each area. And professionals can complete continuing education and supervision after licensure to expand their areas of competence.
Professional ethics mandate that when there is a lack of fit between your needs and the therapist’s skills the professional must provide you with the names of at least three other professionals who can be of help. You can also search the Internet to find clinicians in your area by using one of the many therapist locator sites (for example, psychologytoday.com and therapistlocator.net).
Most people do not suffer from severe mental illness. But many well people can benefit from the work of therapists. Mental health check-ups are much like physical health checkups; the appointment will not make you ill. For many reasons, depression and anxiety can increase over time, and physical health and mental health are interconnected. Learning that your lack of interest, difficulty remembering things, or frequent teariness are all symptoms of depression will not make you depressed. It will provide a direction. It can restore hopefulness in your life and assist you in preserving your mental health.