Debunking Common Therapy Myths
I’m sure every professional feels similarly, but there is something about the way that therapy is portrayed in film and TV that can be almost comical. The reason I say this is that, in the service of creating entertaining drama, the portrayal of therapy is often rather distorted, to put it mildly. This can, unfortunately, serve to perpetuate some common myths about mental healthcare that may potentially turn some people away from it. So, with that in mind, I would like to go through a list of some of the most common myths, stereotypes, and questions I’ve encountered from media and clients over the years, and as I do, I’ll try to set the record straight on some of these.
Weakness
Perhaps the most damaging myth about therapy in Cinncinati, OH is that it’s for people who are weak and who can’t deal with life or their emotions. I disagree entirely. High-quality research done at Harvard has shown pretty conclusively that roughly half of the U.S. population will deal with a diagnosable mental health problem at some point in their lifetime. Ignoring this – or any medical need for that matter – doesn’t make one tough, so much as it makes them needlessly suffer. Would I ever say, “Yes, I have strep throat, but taking antibiotics is for wimps, so instead I’m going to wait until this becomes Scarlet fever?” Of course not! This is ridiculous. And so is the notion that there is something unique and special about behavioral health issues. Getting help for painful, annoying, life-interfering problems that have effective treatments is, logically speaking, as straightforward as turning on the air conditioner when my house is hot in the summer.
The Couch
For those who’ve been to therapy before, it will likely come as no surprise that I don’t have a couch in my office! Nope, just a few chairs, an end table, some books, and a Bob Ross bobblehead (but that’s another story). I think the notion that therapy involves lying on a couch with your eyes closed while some therapist sits behind your head diligently taking notes stems from the nineteenth-century practice of psychoanalysis (think Sigmund Freud). For one thing, just logistically speaking, many of my clients struggle with chronic insomnia and are sleep-deprived. Having them lie down and close their eyes might not be the best idea on my part! Nope, although you may see couches in some therapists’ offices, these are pretty much intended just for sitting comfortably and meeting face-to-face with a therapist in Ohio who talks back! Speaking of which. . .
The Silent Therapist
Many of the stereotypical therapy scenes in films and TV involve some old dude sitting utterly silent while some client goes on at length about something urgent. It often makes me laugh. In response to particularly provocative statements from said client, the movie editor cuts back to the stoic, nonplussed face of the therapist that contains about as much emotion as a coat rack. I don’t know about you, but this strikes me as the kind of thing that would feel roughly as helpful as talking to a bathtub. I think it’s important that a therapist in Ohio engages with you in a genuine, thoughtful way. The antiquated notion of the “blank slate” again is rooted in nineteenth-century psychoanalysis and is no longer a modern practice of the field. That’s not to say that therapy in Cinncinati, OH meetings will be an equal exchange of personal info – the focus is on you after all, but your therapist should handle themselves like a normal human being that has emotions, thoughts, and the capacity to form full sentences.
Therapists often provide feedback, ask questions, introduce concepts and coping tools, and even share a bit about themselves. Although I do hear from some clients that their previous, not so great, therapy experiences have included sitting with someone who mostly just says “mmm-hmm” repeatedly, this may be a sign that the person you’re meeting with isn’t the best fit.
The Unethical Therapist
At one point, I thought I had found a decent TV portrayal of therapy that really was fairly accurate (the HBO series In Treatment starring Gabriel Byrne – which is actually a pretty entertaining drama). And then what happens midway through? The bloody therapist sleeps with one of their clients! Oy, I hate this! OK, yes, I suppose it makes for more interesting TV, but this is a huge, career-ending, no-no in our field, and the kind of unethical practice that. Thankfully, you’re highly unlikely to encounter it. Instead, you will almost certainly work with someone who has a genuine, caring connection with you. Additionally, someone who also maintains professional boundaries and doesn’t try to fill any roles in your life other than being a therapist. The vast majority of mental health clinicians got into this field in the first place because they like to help people, not because they aim to be sleazy creepers.
Hospitalization
In all initial intake evaluations I have with new clients, I carefully assess for suicide risk and history of suicidal behavior. After all, ensuring that my clients are safe is of utmost importance to me. That said, I’m also conscious of the fact that asking these types of questions can make clients uneasy, as some may think that I’ll be likely to hospitalize them the moment they admit to ever having any thoughts of death. On the contrary, if I hospitalized every client who told me that they had thoughts of death or suicide at some point in their life, I would be hospitalizing the majority of my clients!
To this point, suicidal thoughts are actually a symptom used for diagnosing mood disorders! Nope, in my years of clinical practice, I have only once ever involuntarily hospitalized someone. It’s a pretty darn rare event. What would it take? you might wonder. Well, I would need to believe that someone is actually planning on following through with the completion of suicide in the near future. Just having thoughts about it, or even considering different ways in which one could hurt themselves, is not enough for a therapist to hospitalize a client. So please be fully honest with your providers about what level of suicidal thought you may be having. And, in the off-chance that hospitalization actually is warranted, this is short-term and done with the sole intention of keeping people safe and connected to care. It is not, really in any way, something that resembles One Flew Over the Cuckoo’s Nest. Which brings us to our next topic. . .
Lobotomies and Electroconvulsive Therapy
Speaking of One Flew Over the Cuckoo’s Nest, I sometimes get jokes or questions about the practices of lobotomy and electroconvulsive therapy (ECT). First, know that the former has long been out of practice (for many decades), and is looked at as barbaric by today’s medical standards. It simply isn’t done in the United States, nor in any other country in the world. In fact, many countries (Russia, Japan, etc) banned its use as far back as the 1950s. In fairness, I rarely get anything but jokes about this anymore. ECT, on the other hand, is still in practice today, but its use is limited to treatment-resistant, severe depression and, believe it or not, has some research support for its safety and effectiveness within this context.
Typically it is used as a “last resort intervention,” which is considered only after a multitude of other intervention and therapy options are tried first. It’s an infrequent practice and there aren’t a lot of providers who even offer it. On the other hand, other treatment options, such as Transcranial Magnetic Stimulation and ketamine prescriptions, which are far less intense and dramatic than ECT, are gaining more popularity for the treatment of resistant depression symptoms. Additionally, more research is being done on substances like MDMA. It will be interesting to see what future research examining these options ends up revealing
Medication
One of the most common and significant concerns my clients have about seeking therapy is the topic of medication. Often, clients are under the mistaken belief that I prescribe medications personally, or that I will be pushing for clients to use these when they don’t wish to. As a psychologist in Ohio (not a psychiatrist), I do not hold prescription privileges and am not legally permitted to prescribe anything. Although research does support the use of medications in a multitude of mental health situations, and while I have seen psychiatric meds make a world of positive difference for many of my clients, I view the decision to take them as a personal choice that one needs to make for themselves. I will say, however, that contrary to popular belief, psychiatric medications, like antidepressants, are not “happy pills” that change someone’s personality. Rather, they correct the imbalance of neurochemicals in one’s brain (which may be in chronic short supply due to genetic factors alone) and alleviate the presence of certain symptoms, like fatigue and rumination.
For many, taking a pill or two when they brush their teeth in the morning is worth the benefits that they derive from them. For others, they may have had negative experiences with meds in the past, or dealt with unwanted side-effects, and wish to explore other options. I completely get and respect that. So, while I’ll let clients know if medication management is an indicated option they may wish to explore, it’s certainly not something that's going to be “pushed” by any means.
Over Analyzation
Another comical stereotype about the practice of therapy in Cinncinati, OH is that therapists need to psychoanalyze and over-pathologize everything. Shoot, even Freud himself, the inventor of dream interpretation (which I don’t subscribe to incidentally), is famous for saying, “Sometimes a cigar is just a cigar.” Good therapy doesn’t involve digging around for problems that don’t exist. Rather, it involves identifying goals that someone wants to set for the therapeutic process and helping them reach these in an efficient manner that suits them. Perhaps given the history of things like projective tests (assessments like the Rorschach Inkblots that are supposed to reveal important insights into the mental health functioning of clients – an approach that I don’t use and personally find somewhat dubious), it’s easy to assume that therapists in Ohio are going to read into everything. Well, no, this is almost certainly not the case. If you wear a green shirt to a session, I’m merely going to assume that you own a green shirt. For the most part, we’re going to take what you’re saying at face value and ask for more disclosure if we feel like something is being glossed over or avoided.
“Therapist Noises”
Lastly, a common myth about therapy in Cinncinati, is that they’re prone to saying a bunch of cliché phrases, or what has been termed “therapist noises.” Classics like:
How does that make you feeeeel???
Mmm-hmm, mmm-hmm, mmm-hmm. Hmmm. . .
Ah, that’s very interesting!
It sounds like you’re feeling conflicted, tell me more.
To me, these phrases sound a lot more like someone trying to do a stereotypical impersonation of a therapist in Ohio rather than a real-life one. Again, well-trained clinicians are going to act and talk like normal human beings who react to what you’re saying in a natural way. You may even find that you’re able to form a genuine, caring rapport with your therapist and that you can relate to them on a personal level! Heck, they may even drop the “f-bomb” once in a while. Now, how does that make you feeeeel? Hmmm. . .Interesting! I think you’re conflicted. :)
So, yes, believe it or not, therapy has come a very long way since the late 1800s! It is very unlikely that you’re going to be lying down on a couch, having dreams about your mother interpreted, followed by inkblot cards, lobotomies, and forced trips to the psychiatric ER. On the contrary, the field has now accumulated decades of clinical trial research that tells us which therapies are safe and effective for addressing a wide range of emotional issues. Often, the best way to dispel myths and stereotypes is of course by having actual contact with the person, place, or thing being stereotyped. A good first step might be by committing to nothing more than a free, thirty-minute conversation over the phone! If you’re interested in doing just this, please feel free to schedule a consultation with me here.
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