How does talking to a professional about your problems help you in any way? I’ve been in and out of therapy for years and I simply don’t find any use in it. I just tell the therapist about my emotions and my life, they try to be understanding and offer some very basic advice I already knew about. Why is therapy often recommended more than medication and thought of as a better solution when it’s literally just normal discussion that can’t change brain chemistry?
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It absolutely can be more effective than medication, but depends on the problem. I myself suffered from severe depression and anxiety from childhood through to my early twenties. I had been medicated for nearly ten years and had been prescribed most anti depressants, almost all of them made me feel worse. There was only one that actually made me feel any better but unfortunately made me have multiple seizures. Talking therapy at the time was almost impossible to access unless you could afford it and waiting lists were years long. Self harm was one of the things that helped me cope until it all got too much and I tried and failed to kill myself twice in 24 hours. After the first time I managed to convince the nurses it was all a big misunderstanding and discharged myself, the second time I was sectioned and placed under 24 hour observation. It was the best thing that ever happened to me as it gave me immediate access to a psychiatrist and psychologist. I started having regular CBT and CAT sessions and was prescribed a medication to help with my anxiety rather than depression. At first I was completely skeptical about it working, especially as some of the ‘homework’ just seemed ridiculous. After a while I started to learn why I felt the way I did and that I had learnt to have certain thought processes because of how my brain had reacted to events in my life. At the time my brain saw these reactions as ways to protect itself and they became reinforced, only over time they had an extremely damaging effect on my sense of self worth. Once I could identify it happening in real time it started to make sense how I could choose to change my reaction to situations. It takes a hell of a lot of work to undo a decade of negative thinking patterns, but once you start it becomes easier to do until it just becomes natural. That was 20 years ago and I’ve not had any relapses since then even when shit has hit the fan. Sorry for the essay, that’s just some of my own experience.
No-one can ever erase the trauma, but therapy should help you to manage the impacts of the trauma. It helps manage the emotions associated with trauma and can provide better coping mechanisms to help people live their lives without the trauma overshadowing everything.
Therapy helps people process what happened to them, which medicine can’t do. The trick is to find the right therapist, who helps you do the real work. Like any profession, there are people who will be ineffective in helping people, and its a process of elimination until you can find the right one who can help you implement the basic advice. Often people don’t realise that is happening, until time has passed, and they re-evaluate progess. Hope that helps.
1) because brain chemistry isn’t the sole cause. Harmful thought patterns are less chemical and more just bad habits, and therapy can help teach you to recognize and overcome them.
2) because what you’re describing is only one of many kinds of psychotherapy. If this one isn’t working for you, I suggest you read about other methods and try to find providers familiar with them.
You can also ask your therapist to try a different tack. Understanding + basic advice is the sensible place to *start,* because anything more demanding or confrontational than that might scare off newcomers who are unsure about the whole “therapy” thing; doesn’t mean that’s where you have to stay.
Throwing one more analog:
Let’s say you get into an accident and seriously injure your leg. After getting the leg out of a cast, it keeps hurting when you walk due to issues with muscles.
Option 1: Take painkillers. They alleviate the pain, but the pain starts again when the effect wears off. You also risk side effects and having to need a bigger dose in the future.
Option 2: Go to physical therapy. (Or rather, first go doctor, who checks if the physical therapy is a solution for this case, then if yes, go to physical therapy, prolly you also get a recommendation what kind of physical therapy.) In physical therapy, you are given practice to strengthen your leg and adjust your walking so that it doesn’t hurt as bad. It may be more expensive in the short term, it is unpleasant, it takes a lot of work. However, over time, your leg adjusts so that it doesn’t hurt (at least not as much as before). You may still need pain killers, but not as much.
I don’t think I need to explain how this compares to antidepressants and psychotherapy.
You need a better therapist. A good therapist will respectfully challenge you and your ideas. They will not help you accept that you are good or good enough as you are, they will teach you that you can be better than you currently are, that you can improve and be a better version of yourself, slowly, day by day.
Sometimes simply getting things off your chest and coming to terms with the reality of your life actually is progress. Some people just need that outlet, but it should never stop there. You should have/make definable goals with your therapist, much like a psychiatrist will have definable goals as to what should be achieved through medication (such as the stabilisation of brain chemistry).
It is like exercise with a personal trainer. You literally will only get out what you put in, and a good personal trainer or therapist will guide you and help you get to where you want to be, and further, faster.
If you do not challenge yourself or put the effort in or set goals, you will get a proportional amount of benefit.
Think of it as building your mental traits as you would build fitness, with your therapist akin to a personal trainer. The medications are like nutrition, or finding an optimal hormone level. There are good and bad therapists and personal trainers. At the end of the day it absolutely all comes down to you, what you want out of it, and if you are willing to try
Speaking from experience, one thing I’ve found that isn’t spoken about enough is emotional dysregulation caused by addictive behaviours or substances. Therapy can only help once the persons brain has enough executive function to regulate their thinking and emotions. Otherwise the brain falls into a cycle of reacting strongly on impulse and therapy strategies can’t really be implemented until some level of self control is reached.
It’s particularly troublesome for hidden addictions as executive function erodes further with each blast of dopamine.
Talk therapy won’t make an improperly developed brain stop being depressed for no reason any more than physical therapy will help an amputee’s leg grow back. But physical therapy WILL help someone who’s been in a car accident with both legs learn to walk again, so I think the answer to your question lies in another question: Are you recovering from a traumatic experience or experiences, or is your mental illness chronic and without any triggers (i.e. otherwise great life with good housing, friends and/or family, steady job, hobbies, decent physical health, no real traumatic experiences, etc but still feeling hopeless and depressed)
Medication does not fix anything about your past or the way you perceive it or yourself. Medication merely attempts to stabilize imbalanced chemical processing. A good way to look at medication when dealing with past trauma is that medication can *get you* to a place where your mind is stable ***enough*** to actually apply what you learn in therapy, and thereby heal the root issue with a clear mind, but it is not and never will be a replacement for the healing work we all must do after painful experiences.
Therein lies the crux of alcoholism, actually. Alcoholism, gaming addictions, or hard drugs are all attempts to numb the pain and try and survive the thoughts and feelings we don’t want to remember or process. Anti-depressants, when used under the guidance of a medical professional, and used in conjunction with therapy, are more likely to produce sustainable long term results. Medication can also produce negative side effects as well, so it is not always a desirable path for some people. But if your brain consistently does not produce the correct chemicals for reasons entirely unrelated to abuse/trauma, then medication may be the way to go.
Talk therapy however is helpful for people who do not have a chronic, developmental issue and are the kind of people that merely need to reframe a traumatic experience or series of events in order for their subconscious mind to take over and heal from the events. Sometimes people experience something awful and then as a form of survival (or due directly to the abuse suffered) will form destructive thought patterns to mask/justify/perpetuate the painful state of thinking. It’s not logical and that’s why therapy can help people in that kind of trap. Sometimes all it takes is good friends you can talk to who can do the same thing. But in short, talk therapy is most beneficial for people whose depression/anxiety/pain is rooted in the paradigm they have about the trauma, and the thoughts they have about it, and if those thoughts can change, the pain can largely dissipate and heal over time.
For people who have don’t have negative thoughts about themselves, and/or are just angry something happened to them and feel like they’ve lost control of their lives, talk therapy might not be helpful and may only confuse it. People in this situation typically fight back against the trauma by doing small things they *can* control, like working out, running, taking up a new hobby and excelling at it, etc. Most men tend to fall into this category because, typically, men are psychologically wired to be more action oriented (or have been socially conditioned to not process their emotions, as there are emotionally aware men as well) and if they can fix/improve something else in their life, it will give them evidence they don’t have to repeat the traumatic experience they just went through. This kind of “therapy” is honestly helpful no matter what camp you fall into, and people in this camp usually end up having some form of talk therapy once they face the emotions driving this behavior, though it’s usually like tying up a loose end instead of the lengthy process of a typical talk therapy pathway.
Talk therapy is recommended before medication because some people think they have a chronic illness when in reality they’ve just been abused/neglected for so long that their mind adapted and it needs to un-adapt to work right again (look up neuroplasticity). Medication can be risky, and so for people who don’t appear to be in extreme danger to themselves, therapy makes sense as a first line of effort before getting into medication.
Hopefully that helps. And, of course, I am not a mental health professional and you should seek help from licensed medical professionals for help with whatever you’re dealing with.
You have to work through your fight or flight mechanism. Pills numb the response, therapy helps lessen the mechanism activation by teaching you how to see the situation differently. If you do it long enough, well enough, you can actual break a chest-tightness-inducing situation down while it’s happening. Your anxiety will spike, and this is where a combined therapy and medication approach is advised, but you most likely won’t be throwing up at 3am or whenever based on your brain betraying you.
Medication can’t solve the problem 100%. You need to learn ways to live with your past baggafe. If you think you can rely solely on medication you are setting yourself up for failure.
Most would recommend medication AND therapy at the same time because as your brain chemistry improves (theoretically) on the meds, you will be more easily able to work thru problems through talking with someone who can help you navigate it.
I say again, you can not solve your problem with just a pill, or just therapy, or just lifestyle management. You need to use all tools at your disposal. There is no easy button, don’t expect that because it’s not reality.
It helps to talk to people about what you’re feeling.
It helps,also, to speak with people who are not associated with you’re situation.
It helps to speak with people who are not associated with your situation who have a skillset to provide real objective advice and solutions to help you.
All three of these options are incredibly valuable.
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