The Stigma of Therapy

“Only crazy people go to therapy.”

“I don’t want to go to HR and tell them I’m getting therapy.  It’ll be all over the plant.”

 “Why pay someone to tell me what to do when I could just ask one of my friends?”

 “What would my family or neighbors think?”

 “The therapist will think I am crazy.”

 “I don’t want to end up on someone’s couch, talking about my dreams!”

 “I’ll just end up discussing my childhood and blaming my parents.  No thank you!”

 These are comments I frequently hear about coming in for therapy.

In truth, there is much less stigma today about seeking therapy than there was when I was a child (45 years ago).  It is estimated that 20% of Americans have seen a therapist and another 20% are on medication for anxiety or depression.* By the way, I am in both groups; I am on Prozac (for the past 16 years) and I have been in therapy over 10 times in my life.

Most people in therapy are average people, addressing average problems.  The American Psychiatric Association suggests that the average person will meet the criteria for Major Depressive Disorder (depression) approximately 5 different times in their life.

People seek therapy today for obvious and understandable reasons: to learn better ways to cope with stress, to help change a specific behavior, to learn more about themselves or why they do something or gain insight into a pattern they have noticed in themselves.  Sometimes, people go to therapy simply to get an outside view of themselves or a problem in their life.

Therapists are required by law to keep what is told them confidential (The only exceptions to this rule of confidentiality are if a child/elder is being abused or if a person is suicidal or homicidal.

Most Human Resource (HR) personnel are also expected to keep confidential an employee’s use of EAP or health insurance information for therapy.).  Larger employers will provide benefits to their employees called “Employee Assistance Benefits” (EAP).  These benefits can include paying for the first 3, 5, or even 8 therapy sessions.  An employee can access such by either contacting the human resources personnel or calling a number directly, usually found in the employee’s handbook or through the company’s insurance carrier.

Therapists don’t tell you what to do. You decide what to do. Therapists give you an outside perspective of the situation. My experience is that most therapists have been in therapy. They know what it is like to sit in that chair. Therapists help you look at your options and what each may lead to, understand why you chose the option you chose, explore how well it worked for you, look for patterns in your choices, etc.  What therapist’s sell is their experience dealing with life problems; their own and others, not solutions to problems. This is something you don’t/can’t get from friends.

The use of couches in therapy is rare today.  There are still some therapists that have persons lie on a couch but these therapists tend to be specialist in “Psychoanalysis” and are typically found only in larger cities.  It is always ok to ask a therapist how he/she conducts a session before scheduling.

Most therapy today is “goal-oriented” or “solution-focused”; short-term in nature, 5-10 sessions.  While there is validity to the re-examination of one’s childhood and/or relationship with one’s parents when addressing particular situation, this is not required.  It is similar to talking with your doctor about your healthcare; just as you may question your doctor if a test is necessary, it is also appropriate for you to ask your therapist if discussing your childhood or relationship with your parents is necessary.  I frequently ask the people I work with, “Did we talk about the right things today?”  I also encourage them to tell me if they think we are not talking about the right things during a session.

It is so important to understand that it is ok to call and talk with a therapist about what to expect before scheduling.  A good therapist understands this concern and will accommodate these questions.



* West Virginia University, WELLWU website.