This is a great article that I discovered from anxiety center.
- Unhealthy underlying factors might be skewing the client’s perception of therapy.
We struggle with mental health issues because we have unhealthy underlying factors – those thoughts, beliefs, actions, situations, and circumstances that motivate unhealthy behavior. These same factors can skew our perception of the interactions we have with others and also our overall view of life.
As such, our unhealthy underlying factors can skew our perception of therapy. For example, over criticalness, impatience, black and white thinking, aggression and anger, unrealistic expectations, unhealthy boundaries, perfectionism, and so on, are examples of unhealthy behavior that can skew our perception of the effectiveness of therapy. If you believe therapy wasn’t helpful, it could be that there are unhealthy underlying factors skewing your perception of therapy.
Here are a few of examples:
- A person who is overly sensitive to criticism might perceive the therapist’s recommendations as criticism rather than highlighting areas for growth. Being overly sensitive to criticism might cause the person to quit therapy because of his dislike of criticism.
- A person who is a rigid thinker might be resistant to making the appropriate behavioral changes because she doesn’t agree with them.
- A person who has issues with unrealistic expectations and impatience might believe therapy isn’t helpful because he thinks he should make much faster progress than he is. So he quits therapy and believes it doesn’t work.
Therapy can therefore be perceived as unhelpful simply due to the underlying factors that the person is struggling with.[2]
- Having fears that pose resistance to therapy.
Unidentified and unresolved underlying factors can cause fears that pose resistance to therapy.[3] For example, the fears of judgement, rejection, assuming greater responsibility for yourself and your recovery, getting better, not getting better, success, and intimacy, to name a few, can cause a client to prematurely disengage in therapy, which only reinforces the fears and leaves the underlying factors unaddressed. This can make it seem as if therapy was unhelpful.
Anxious feelings during therapy generally indicate that there are fears at play. If you don’t address those fears, you’ll continue to struggle not only with anxiety but also with seeking meaningful help that can alleviate those fears and assist you on the road to recovery.
- Therapy needs to be specific to each person’s struggle.
There isn’t a one-size-fits-all approach to therapy. When I was looking for help during my struggle with anxiety disorder, no one understood anxiety symptoms well. Talking to me about perfectionism and low self-esteem (which was standard practice back then) was pointless to me. At that time, my symptoms were my biggest problem not my behavior (because I thought my behavior was normal). It was not until I met a therapist who had a better understanding of anxiety symptoms and why they could last a long time, that I found therapy helpful. Once I found good answers to my symptoms problem, I could more successfully focus and move on to the offending behaviors as I identified them.
The therapist needs to address the most important area of struggle first before moving on to the underlying reasons that may not be apparent to the client. Therefore, the therapist needs to tailor his approach to the client’s needs and not the reverse. This is especially true in the beginning until the main concerns are reduced. If your therapist didn’t do this, it can seem as if therapy was unhelpful.
- Goals haven’t been set that can be measured along the way to success.
It’s important for the client and therapist to set realistic goals and milestones so that they can be measured along the way to success. This is helpful for many reasons, including keeping recovery on track and providing encouragement along the way as each milestone is achieved.
If no goals are set, or the goals are unrealistic, it can make it seem as if therapy isn’t helpful. Goal setting can look different, depending on the client, and therapist. You do not need to have the typical ‘numbered list’ to set goals. As long as you and your therapist are discussing where you want to be and making plans to get you there, you can use whatever manner of goal setting you choose.
- There is a mismatch between the client’s struggle and the therapeutic approach used.
Just as each person has personal opinions and preferences about all topics in life, therapists will impart their personal opinions and preferences on the therapeutic approaches they believe are helpful. When you select a therapist, you are also selecting their personal opinions and preferences about the therapeutic approach they use.
During my struggle with anxiety disorder, I saw two psychiatrists who used two very different approaches, neither of which I found helpful. Because they weren’t helpful at that point in my struggle, I concluded all therapy was unhelpful.
In hindsight, it was not that all therapy was unhelpful but that the approaches those psychiatrists used were unhelpful to me at that time. Consequently, there was a therapeutic mismatch between the issues I was dealing with and the therapeutic approached preferred by the therapists. The last therapist I met with, however, met me where it mattered most to me at that time. He did it in four main ways:
- He addressed my main concern first – my symptoms. He explained why I had them.
- He explained why it could take some time for my symptoms to diminish, which was a question no one had previously answered.
- He encouraged me along the way until my symptoms finally nudged down and I felt like I was on the right track.
- He conveyed to me that my personality type didn’t fit with the career I was in.
We didn’t even talk about what we call Level Two recovery concepts because they weren’t relevant to my struggle at that time. Once we had addressed my most important issues, I was open to moving forward with the rest.
If you found therapy unhelpful, it could have been the wrong therapeutic approach for you.[4]
- There is a clash between therapist and client personalities.
The therapist and client form a therapeutic relationship. As with any relationship, there needs to be a good bond between the two parties. The therapeutic relationship can be difficult if there is a personality clash.
It’s always best to work with a therapist you connect with. If you don’t have a good relationship connection, it can seem like therapy is stressful and unhelpful.[5]
- The therapist wasn’t an effective therapist.
All therapists are not equal. While education can be an important indicator of the quality of the therapist, graduate degrees don’t automatically produce effective therapists. Often, education is not the best indicator of therapeutic skills. Therapy is a field in which experience matters. Having many life experiences, successes, failures, joys, pains, hurts, traumas, etc., enables therapists to be real and to truly integrate their academic knowledge, personal insight, and professional development. It is the multi-dimensional skill factors that increase the effectiveness of the therapist. Working with an inexperienced or ineffective therapist can make it seem like all therapy isn’t helpful. - The client is looking for a faster solution.
Therapy takes time, and often, a lot of time. In fact, usually much more than most people think. It takes time to uncover the offending underlying factors and then to make healthy change.
For example, even though our recommended therapists use a proprietary diagnostic process that effectively identifies the underlying factors associated with problematic anxiety, it can still take more time to dig deeper if some of the underlying factors aren’t readily apparent. This only occurs through discussion and time.
It then takes time for the client to internalize the information from the therapist and to make healthy behavioral changes to the point where success begins to unfold. Therapists can only move as fast as the client. There are many reasons why the therapeutic process can be slow. For instance, research has shown that for most people, change isn’t easy or quick. We often are resistant to change and the means necessary to achieve such change. That’s our human condition.
If you expected to make faster progress, this expectation can sabotage the reality of recovery. This is often an issue with therapy clients who struggle with impatience and/or unrealistic expectations, which are common behaviors associated with anxiety disorder.
- The client is looking for an inexpensive solution.
Professional therapists make their living helping people through sharing the tools and knowledge they have acquired through education and personal experience. Much like other professionals working in the helping field, therapists are not allowed to help people unless they have professional designations, such as education, certifications, registration, etc. That’s what enables therapists to help people full-time.
Professional designations necessitate education, which comes with associated costs. These costs are on-going as professional therapists are required to continue their learning and professional development.
Moreover, making a living requires sufficient revenue to do so. Since most therapists average four to five clients per day, the hourly rate needs to be suitable to make a living with. But this doesn’t mean they only work four to five hours a day. The rest of their time is taken up with record keeping, reviewing notes, planning, research, furthering their study, administration, and so on. Four to five clients per day is a fulltime job for most therapists. Consequently, working with a professional therapist is similar to working with any professional who needs to make a living at their chosen career.
Sure, there are less expensive therapists just as there are more expensive. But price doesn’t necessarily equate to the quality of care. A good rule of thumb is to work with those therapists who are priced in the middle range of pricing and then find the best therapist/client fit. This gives you the best value for the care received.
For example, a therapist that charges $40 per one hour session may not be well qualified, which is reflected in the hourly rate. Similarly, a therapist that charges $350 or more per one hour session may be well qualified but charges a high hourly rate because of cost of living and office expenses rather than based on the level of expertise r quality of care. $80 – $150 per one hour session is a good price range to stay within.
Yes, there is a cost attached to therapy. But that’s why professional assistance is available.
- The client’s recovery expectations are unrealistic.
Just because you can imagine how your recovery should unfold doesn’t mean it’s actually a realistic or plausible path you are imagining. As mentioned earlier, recovery takes time, and often, lots of it. If you are progressing slower than hoped, you can talk with your therapist about it. Maybe there is something the therapist can do to make your sessions closer to your expectations, or to let you know why your expectations are unrealistic. Just as with any relationship, we are proponents of open dialogue. If you have concerns, raise them with your therapist. Good therapists encourage honest and open conversation, and have your best interests in mind.
Furthermore, the therapy client is the one that needs to do the work. It’s not the therapist’s job to do the work for the client. Therapists convey information and provide guidance, encouragement, feedback, and support, while at the same time keeping the client on track to success. But all of the work required to make underlying factor and behavioral change is the client’s responsibility. If your expectations aren’t being met, it might be because they are unrealistic. As mentioned, therapists are often waiting on their clients rather than the other way around.
Unrealistic expectations are a common cause of disappointment with therapy. Unrealistic expectations are also a common behavior associated with anxiety disorder.
- Inaccurate preconceived notions about therapy.
If a client has not been involved with therapy before, he may have misconceptions about therapy and the therapeutic process, which can sabotage therapeutic success. For example, if the client believes it’s the therapist’s job to “fix” him, he may come away with a jaded view of therapy. Or, if the client believes he should be “cured” within a few weeks of therapy, again his misconceptions of therapy will color his perception of therapy.
Another aspect to consider is that some people have experienced therapy before, but due to an inappropriate approached used, they have concluded all therapy is the same, which isn’t accurate.
For example, traditional therapy often uses a roundabout question and answer dialogue over many sessions to uncover the core issues at the root of problematic anxiety. This approach can take months and even years to uncover the core issues, if at all. Then, the therapist will help their clients address their issues once they are uncovered.
In contrast, anxietycentre.com has developed a proprietary diagnostic system that quickly and effectively discovers the many underlying factors associated with anxiety disorder. Rather than spending months or longer trying to uncover the core reasons for a struggle with problematic anxiety, within an hour or two, our recommended therapists know exactly what the factors are, their mix, and degrees. You can then start working with your therapist on these factors right away, saving a great deal of time.
Furthermore, our recommended therapists use a “direct” approach to therapy. Rather than letting therapy clients meander through long conversations with the hope that the clients will find ways to address their own issues, our therapists provide their clients with pertinent information, recovery direction, homework (which helps clients work through the recovery process), and support during every session. This two-fold process – an effective diagnostic system and a direct therapeutic approach – helps clients achieve recovery as effectively and efficiently as possible.
This is not to suggest recovery is fast because most often it isn’t. What it does mean is that our recommended therapists can help you attain success using the most direct route possible.
If you have preconceived notions about therapy, it’s best to talk with your therapist about them up front. That way you can address them, which can clear the way to therapeutic success.
- The client believes she should be able to help herself.
Many anxiety disorder sufferers are ingenious, highly intellectual, analytical, creative, perfectionistic, and hard working. Therefore, it’s understandable to believe you should be able to overcome anxiety disorder on your own. That was the story of my life when I was struggling with anxiety disorder those many years ago. I thought, “Just give me the right information and I’ll fix myself!”
Yes, that works…to a certain degree. I believe all of us can attain Level One recovery by getting and applying the right information. But that doesn’t necessarily work for Level Two recovery, and there are many reasons for that, which you can read about in the answer to the question, “Why do you recommend therapy in order to overcome anxiety disorder?”
The more familiar we become with the reasons why we struggle with anxiety disorder, the more apparent it becomes why we need help working through Level Two recovery. But here is another example of where our unhealthy underlying factors can skew our perception of recovery.
The good news is you WILL help yourself recover. But you will do so with the assistance of a therapist. That is the most effective way to attain lasting success over anxiety disorder. Again, you can read why by clicking on the link above.
- The client believes his therapist is wrong.
Unfortunately, this is a common reason why some people conclude therapy is unhelpful. It’s true, your therapist could be wrong. But that doesn’t mean all therapists are wrong. If you’ve worked with a few therapists and you have concluded that they all have been wrong, either you are picking the wrong therapists or you have an underlying factor skewing your perception of therapy.
For example, black/white, all or nothing, and rigid behavior can cause a client to discontinue therapy because he may believe the therapist is wrong. Most often, it’s not that the therapist is wrong but that the client doesn’t agree with the approach the therapist is using to move the client away from their black/white, all or nothing, and rigid behavior. Or, the client is not yet ready to admit that these behaviors are not healthy and need to be let go. All despite the fact that it is these very unhealthy behaviors that are causing the mental health issue in the first place.
This is often an issue with therapy clients who struggle with black/white, all or nothing, and rigid behavior, which are common behaviors associated with anxiety disorder.
- The client believes she knows better than the therapist.
Similar to the above, this is another common behavior associated with people who use black/white, all or nothing, and rigid behavior. The reality is, if you knew better than your therapist, you wouldn’t be struggling with the issues you are struggling with. This is not to suggest all therapists are effective therapists, as mentioned earlier. There may have been times when you might very well have known more than the therapists you worked with.
But if you believe you know more than the therapists you worked with, it’s better to find a more knowledgeable therapist than it is to continue to struggle on your own. Finding the right balance between a knowledgeable therapist, a proven therapeutic approach, and a good relationship fit is the ideal to strive for.
If, after that, you still believe you know more than all of the therapists you’ve worked with, that suggests a different problem – that your underlying factors are skewing your judgment.
Again, black/white, all or nothing, and rigid behavior are common behaviors associated with anxiety disorder.
- Resistance is also a common reason why some people believe therapy doesn’t work.
For example, sometimes people hold on to dysfunction because they are used to it and would rather go with what they know than learning something unfamiliar. Another example is that some people find it too risky to let their guard down so they would rather remain safe than vulnerable. Other examples include:
- A depressed state can suggest change is pointless.
- They want to stay unwell to avoid dealing with a deeper issue, such as a relationship problem.
- They have subscribed to the label of “being unwell” or having a “disorder”.
- They believe the cost of being unwell is less than the cost of recovery.
- They believe nothing will be required of them if they remain unwell.
- They fear the obligation of being responsible for the wellbeing of their lives.
- They do not believe it should take a great deal of work to get better, or they are unwilling to do that work.
And so on. Resistance to becoming healthy can make therapy seem unhelpful.
There are other reasons why therapy can seem unhelpful. The above, however, should give you an idea why many people don’t believe in therapy and what they can do to rectify that.
These are our observations based on our personal experiences with anxiety disorder and the many years of working and interacting with fellow anxiety disorder sufferers. The above isn’t intended to assign blame but to help clients in coming to terms with common barriers to getting meaningful help.
It is our wish that everyone overcome anxiety disorder and go on to live the best lives they can filled with joy, great relationships, satisfaction, and peace. That’s why we do what we do!
To accomplish that, however, it most often requires accessing the right information, getting the right help and support, doing the hard work, and persisting until success has been attained. It’s our opinion that everyone can do this work if they are determined to succeed. While success generally isn’t easy or quick, it is attainable with the right help and hard work. Many have gained success by doing this work, including all of us.