Do You Have What it Takes to Be a Psychotherapy Client?

It’s time to take a second look at some of the lingering stereotypes surrounding psychotherapy clients.

What does a psychotherapy client look like? Weak? Wimpy? Undisciplined? Unsuccessful? A pathetic mess? Are they endlessly rehashing problems in session that they should be attacking in their everyday lives?

I’m going to argue that this image of the client is diametrically opposed to many of the people I see in my office each week. While they do have problems that fit into some of the stereotypes described above, none of the problems they face makes them inherently weak or unworthy.

It can be instructive to compare therapy clients to some other pursuits. If you join, say, the Marines, you might do so because you’re not sure of your abilities, or because you want to better yourself, overcome fears, develop new skills, and thereby protect and serve your countrymen, then you’re roundly praised and saluted for your brave choice. As part of your brave decision, you acquire a drill instructor who will push you to transcend your limits — whether you want to in the moment or not!

Should you have the misfortune to develop cancer and enter treatment in hopes of overcoming the disease, then you acquire a team of doctors and caregivers to help you battle the disease. Should you survive the initial rounds of surgery, radiation, and/or chemotherapy, not to mention the overwhelming emotions that come from facing a possibly fatal illness, then you are counted as a “cancer survivor” and worthy of charity benefits in your honor.

But, should you suffer a mental illness, and rather than ignore the problem, medicate yourself to make the feelings go away, or struggle alone, you start working with a licensed, qualified therapist to help you fight through your issues, then you may be counted as neither a hero nor a survivor, but as a damaged, odd person who goes to therapy because of how “messed up” they are.

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Everything I’ve described so far can be captured in one word: stigma. Mental health problems are, for many, private, embarrassing, and shameful. I’m convinced that countless potential clients suffer alone because negative beliefs about mental illness keep them from getting the care they deserve. If only we could adjust the way we view mental illness and the struggle to overcome it, not only would more of us seek treatment, but those in therapy could feel appropriate pride at taking decisive action to overcome mental illness.

Being a psychotherapy client has a lot in common with joining the Marines or other military service. In both cases, your drill instructor/therapist cannot make you improve. They can motivate you, give you information or strategies, but ultimately your progress in either domain depends on your willingness. You have to do the work. Therapy, like military training, is rarely short or easy. It takes daily, sustained effort to turn a civilian into a soldier or to break out of the habits of thinking that sustain and reinforce a mental disorder. The outcome of therapy, as with any battle, is not guaranteed. Both war and the struggle in our heads force us to contemplate realities we might otherwise avoid.

Yet the rewards of undertaking therapy can be rich. Unlike medication, therapy creates a solution that becomes part of you. You need not depend on any substance or external reference to win against your personal demons. Therapy has no debilitating side effects. The outcome of therapy is a self-transformation that becomes part of your core and that can never be taken away from you.

If we take in fully the idea of therapy as a righteous struggle and a means for self-discovery and self-improvement, then we would see those in therapy in a new light. If you were a boss, and you had an employee who was in a key position and under a lot of stress, you’d jump up and cheer if you knew they were in therapy because in therapy they’d learn ways to cope with stress without lashing out or giving up. If you had a friend, you’d be relieved that you wouldn’t be the only one he could talk to when they had a problem. And if you were looking to get into a relationship, you might favor the suitor who’s done some therapy because chances are they’ve worked out at least some of their problems before they ever met you.

• in practice
• public health
• society
• therapy