Going to therapy used to be something that happened in the shadows. It wasn’t something you talked about in public, or even with friends and family. Today, however, in some circles, the idea of therapy has gone from being stigmatized to something that everyone should do.
Therapyspeak is now mainstream. I’m in therapy is something you’ll see on dating profiles. Among some people, going to therapy is as much a part of being healthy as exercising and brushing your teeth.
Therapy has indeed helped countless people understand themselves and the world around them.
But should we think about our mental hygiene with the same consistency that we think about, say, dental health? What if you get nothing from therapy? What if you retread the same ground over and over or maybe it’s making you feel worse?
What if it’s time to leave therapy?
Melissa Dahl, a health journalist and author of Cringeworthy: A Theory of Awkwardness, recently asked this question in a now-viral article on The Cut.
In the article, she talks to psychologists and patients who have opted out of therapy or are advocating for it. Dahl spoke with Kousha Navidar on a recent episode of All of It about her reporting, departure and more. An edited version of their conversation is below.
Kousha Navidar: Melissa, how would you characterize the trajectory of our cultural attitudes regarding therapy that I touched on in the introduction?
Melissa Dahl: It’s been so interesting even in my adulthood, and I’m really not that old therapy went from something that wasn’t talked about. Maybe you were a little embarrassed about it. There were negative connotations … about this thing that people post on their dating apps. They just want to meet someone who is in therapy.
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It just became something that was in the shadows to be quite ubiquitous in certain circles.
I would like to talk about the different types of therapy. Can you walk us through a 30,000-foot view of these different modes?
Dahl: For this piece, I really focused on the broader definition when you hear the word therapy, which is just basic talk therapy.
This is what people refer to when they just talk generally about therapy. There are also things like somatic therapy that is more focused on the body. Or there are things like EMDR, which use these kinds of similar impulses that are supposed to really help with trauma.
But my part really focused on talk therapy.
What did you hear from people who had left therapy?
Dahl: I talked to about 15 to 20 people who had recently left therapy. It was actually wild how easy it was to find subjects for the story. Almost all of them told me that they came into therapy to talk about something specific, a breakup or a family crisis or something like that. And then they just stayed. They just kept going for years and years and years.
And it was helpful until they found themselves rehashing the same old topics or perhaps dealing with things they hadn’t really worked on.
Most of those who had left therapy said they would go again. It’s not that they were anti-therapy. But they would go again with a different thought. They would come in with a sober problem they wanted to talk about, talk about it, and then go back to their lives without therapy.
We have a caller. Hello Lee. Welcome to the show.
Lee: I went to therapy. I think everyone should try therapy at least once, especially if you need it. It was really great, very helpful. I started thinking, Well, when, when does this end? How do I know it’s over? I was brave enough to ask that question. And she said, Oh, you’re just at the beginning.
And that was the day I left. And since then I have done well.
I’m sure you’ve heard many stories like this, Melissa. I mean, it’s an interesting dynamic, right? Do therapists have an incentive to keep it up?
Dahl: From the doctor’s point of view, I suppose there is an incentive of a client who brings in reliable money every week. But the psychologists I talked to, and most therapists you talk to, will say that the goal is not like indefinite therapy.
The goal is to give you some tools to apply in your life and then get out there and use those tools.
Something people told me a lot is that they would be in therapy. They would talk about these tools with their therapist, but then they just wouldn’t implement them. But there was something about ending therapy that took away that safety net and made them feel like, okay, I have to figure this out on my own. And hey, I know how to do it, because I’ve been in therapy. I have learned all these things.
Do you have any insights from talking to all these clinicians about ways to navigate that conversation about an end date?
Dahl: It’s just something you can bring! Many times you are in therapy, perhaps to work on communication.
I think it’s actually very important that you don’t just fantasize about your therapist and stop going. I think part of the point in therapy is to model the relationships and communication skills you want to use outside of therapy.
I will say that I tried not to ghost my therapist earlier this year, but I was like, okay, like, I’m done.
And she really insisted that we come back for just one more session to talk things over. From the therapists I spoke to, I think most of them would take a similar approach. As if they will help you reduce it. Many of them are really excited that you feel ready to graduate.
I would think it’s something to bring up quite directly.
We have a therapist on the line now. Gio from Queens, welcome to the show.
Gio: I just want to say real quick: Freud said that therapy ends when you are able to love, be loved, and work. This is. It’s over and done with.
No therapist should keep you longer than necessary. And they should check in with you from time to time. And when the relationship evens out, when you and the therapist start to feel more at ease, then that’s a sign that it’s starting to come to an end.
And then when you say it’s over and done with, that’s it. It’s over and done with. They may ask if you want to come back and do another session. This is. Once the patient says it’s over, that’s the end of it.
Melissa, you write about how pervasive the idea of therapy has become since it is so intensely stigmatized.
Dahl: It’s funny how it’s created itself, you know I think there’s been a lot of chatter about how, frankly, annoying so-called talk therapy is, especially when it’s misused.
I want to be clear though. I think it’s positive that we, as a culture, are more comfortable talking about mental health and talking about our desires to improve ourselves and understand the way we work.
It just reaches a certain point where perhaps self-examination is no longer as useful as it was in the beginning.
In fact, there is a lot of research linking excessive self-focus to depression and anxiety. So that’s not exactly the purpose there.
We have a few more callers. I’d like to go to Kathy’s in Manhattan.
Have you: Hello, thank you. So here is my story. I had a very good therapist for several years who helped me with family issues, with my father’s illness, with work issues, giving me the courage to leave a job I was no longer happy with.
But then I felt like I hit a plateau and was in good shape and could take a break. I am someone who has been in therapy all these years because I think it is helpful. But it was time for me to take a break. She acted like I was breaking up with her, because I was irresponsible.
And I said, Well, I’m done. I think this is very unprofessional. Then fast forward a few years later when my husband was diagnosed with stage four pancreatic cancer and he was dying and I thought, Oh, I could use a therapist again.
And I would have liked to go back to this woman because she knew me and we had a relationship already, but I just felt like I couldn’t go back to her because I thought she was very unprofessional.
So what did you do?
Have you: I found someone else.
And did that new therapist work for you?
Have you: Yes. Very much.
Wonderful. Thank you so much for that call. Let’s go to Doris in Trenton, New Jersey.
Doris: My question, listening to Ms. Dahl is: in order for you to decide whether or not to continue therapy, I think it has a lot to do with the specific goals the therapist has for you. This seems to have been really unclear many times I’ve seen a therapist. I just want your feelings on this.
Melissa, what do you think?
Dahl: It’s ideally something that, if you have a good relationship with your therapist, if your therapist is a well-intentioned clinician who wants what’s best for you, it can be something you work on together , to leave the relationship all together.
This also reminds me of when the last person was talking about their frustrating experience, trying to end that therapeutic relationship. It’s so frustrating, but this reminds me a bit of something I heard from one of the therapists I talked to about the story.
She said, We have put therapists on this pedestal. And she was like, I’m just a person. I can’t because I don’t know everything. So I think there’s probably room to remember that as a person you’re in a relationship with, just like any other person you’re in a relationship with.
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