Therapy, and therapists.

ETA: This was mostly written a long time ago. I think it was a reaction to something specific, but I'm not entirely sure what. I've come back to it several times, and only been able to finish it now because the experiences I've drawn on are more distant and less raw. I hope it's obvious, but I don't think counsellors and psychologists are bad people, and not all of my experiences with them have been negative.


There seems to be a perception out there that talking therapy is the 'good' treatment for mental health issues. Better then drugs. Not addictive, not side-effects. Not just a bandage or a crutch, but a real! solution! that will make you better forever. Yeah. Well. It works for some people. And for some people it's necessary. But when I see the instruction 'Just go get some therapy' it rubs me up the wrong way. It is not that simple.

Let's start with the basics - getting access to therapy in the first place. Obviously, this depends hugely on where you live and your financial circumstances. Luckily for me, therapy can be free on the NHS. Woot and yay. However, in most cases this does involve getting your GP to refer you. If your GP believes you, and takes mental health stuff seriously, then off you go. But that's not always the case. And it may involve a very long wait. Which is not a good thing if the mental health stuff is immediate. Not everyone's circumstances allow for them to stay in one place for long enough.


And that's just in a place where we have socialised healthcare. In places like the USA they are whole issues to do with convincing your insurance company to cover it, and if you're uninsured... Obviously I'm not an expert on this but I get the impression getting even obviously necessary healthcare can be difficult, and too often mental illness is dismissed as 'not real' or 'not urgent'.
The other issue here is that people in need of mental health treatment are often not in the best position to advocate for themselves, in terms of practical resources like time and money as well as the emotional resources needed, meaning that an additional hurdle, however small, can be a serious block to getting therapy.

All that's after someone has made up their mind to get therapy in the first place. Which is not necessarily an easy decision. Fear of it not helping, fear of having to talk about painful things, fear of being treated badly by a therapist, fear of the stigma associated with mental illness. None of these are irrational. None.

Therapy can work wonders. But it does put the patient in an incredibly vulnerable position. Psychodynamic and psychoanalytic type therapies ( the classic 'tell me about your father' kind) involve, by their very nature, revealing one's deepest secrets and insecurities. Of course, discussing those things openly can be incredibly helpful. But it means that if a therapist screws up they have the potential to do a heck of a lot of harm to an already vulnerable person. Therapists are human, and they will make mistakes sometimes. And it can be a rational, self-protective decision to not take that risk.


As well as being human, therapists have the same ingrained social prejudices as the rest of us. Which can be very worrying for those made most vulnerable under the kyriarchy, not incidentally those who are prone to mental health issues. It also means that they have expectations about how families and relationships and life in general are supposed to be.

Therapists are in a position of power over their patients - whether or not they are aware of it, whether or not they wish to be. To some extent, this is true of all medical professionals; there is a subtext of 'Do what I tell you or you will not get well'.

I have put with some complete nonsense because I genuinely believed, I had been led to believe, that if I did not go along with it I would never be happy again. At that point I had lived months at a time without happiness, and I had decided that I could not live years like that. The growing worry that the person to whom I had entrusted my mental health, and by implication my life, was incompetent was one of the most frightening feelings I have ever experienced.


So, yes, lots of people would probably benefit from therapy of some kind. But it is most certainly not without its risks or its drawbacks. It is not the superior option compared to medication, although of course also have problematic issues. The idea that therapy is an infallible cure for all mental illness that helps everyone is a myth, and a harmful one. It implies that mentally ill people have the choice of being well and are just refusing it, ignoring the very real boundaries to accessing counselling in the first place, and the risks involved.