“No pain, no gain!”
Is psychotherapy supposed to hurt? Is it necessary
to wear waterproof mascara to every session?
Are you going to be a royal mess after you spill your
guts out on the floor and have to scoop them back
up after “our time is up?” What’s it really like to be
in therapy, anyway? What’s it supposed to be like
if it’s really working? Does good therapy have to hurt?
Great questions deserve some answers!
Physical Therapy for the Body
One way to think about it is to consider how
physical therapy is used to help physical problems.
Some people see physical therapists after a trauma like
a car accident or after they have “yanked their back out.”
They may work with a physical therapist in a rehabilitation
center or outpatient clinic to regain their former
physical capabilities, to help prevent long-term
physical problems that can happen as a result of how
the body tries to adapt to injuries, and to help them
achieve complete physical independence.
Sometimes physical therapy is prescribed to deal with
a chronic or progressive physical condition like
arthritis or degenerative disc disease…not because
the PT is going to heal or “cure” the problem, but to help
the person learn ways to lessen symptoms and keep
what mobility and range of movement they can in spite
of the disorder.
Physical Therapy for the Non-Body
Psychotherapy is like physical therapy for the mind,
the heart, the soul, the spirit…the non-body parts of you.
It helps a person after a traumatic childhood or an
immediate crisis to heal and be able to function normally.
It helps a person to achieve their full potential cognitively,
emotionally, socially, spiritually, and in their community.
It helps a person who has a mental health diagnosis that
must be managed for a lifetime (chronic depression, bipolar
bipolar disorder, addictions are a few) to learn
ways to cope with their disorders better. The goal is not
a “cure”, but to learn how to manage the disorder and get
the best quality of life possible with it.
Does Good Therapy Have to Hurt?
If you’ve ever come back from a physical therapy
appointment and not been sore, like you’ve been pushed
past a limit you’d rather not have gone past, then you’re
likely not going to get much out of your physical therapy.
Growth, change, and healing depend upon stretching
beyond the norm you’ve been limiting yourself to
either because you’re in pain, you’re afraid, or you don’t
know what to do to make any positive change.
Out of Your Comfort Zone
So, yeah, the short answer is that unless you are
willing to feel uncomfortable, get into some feelings
that you normally don’t want to feel, talk about things
that you don’t want to talk about…therapy probably
isn’t going to help you much. But a good therapist is
not going to emotionally dismantle you and then leave
you to pick up the pieces at the end of a session and
carry on…he or she will carefully assess how much
time there is to get into certain issues and topics,
and will pace interventions appropriately. Just like
a good cardiac surgeon doesn’t do open-heart surgery
in his outpatient clinic, a good therapist won’t ask you
to do more therapy work than can be done in an hour.
Good Therapy is Like PT, not Massage
Good psychotherapy should be like good physical therapy.
You should feel challenged and stretched emotionally,
but not so much that it’s causing more damage. It should
not be as gentle and soothing as a relaxing massage…
because as good as that may feel, it’s not therapeutic
enough to create the kind of change you’re looking for.
You should be asked questions you don’t want to answer.
You should be told things you don’t really want to hear.
But you should be allowed the space to be who you are.
Therapy should be just challenging enough that you
afterwards you find yourself thinking differently,
questioning yourself or old outdated modes of perception,
being more aware of your feelings, your wants, your needs,
your dreams, and your goals.
In short, it should be creating the right environment
for change, for growth, and for healing.
It’s the kind of hurt that heals…