Does Everyone Really Need Therapy?

People who love therapy often say “I think everyone should be in therapy.” I used to be one of these people, but I’m not anymore. Today, let’s explore what people might mean when they say this and why I agree with their rationale but I now disagree with the conclusion.

Why do people think everyone needs therapy? After thinking about this and discussing it with colleagues and friends, I’ve narrowed the categories of rationale into these four points. I have not reviewed literature or verified my thoughts with others outside of my own thinking, experiences, and discussions. (Let me know if you think I’ve missed something!)

1 - Therapy has been a nurturing and supportive place for them and they believe nurturing and support should be accessible to everyone.

I’ve heard it said time and time again that the most valuable component of therapeutic treatment is the therapeutic relationship. To me, this speaks of the importance of safety in connection that is such a vital component of a healthy human spirit. Thankfully, many people are privileged with having a steady and stable, emotionally available adult figure in their childhood experiences and so they may not be aware of how keenly that is a fundamental human need. When we don’t receive that as children, we never develop the steady and stable internal adult within us that allows us to not feel overwhelmed by life’s complexities. So, for people looking to heal from the not-enoughness of their childhood emotional experience, this is a delicate and dire need. But anyway our need for steady, stable, nurturing connection doesn’t end in childhood - it persists throughout our lives in a constant feedback loop of seeking, belonging, security, action, and connection. Life is hard and people are largely busy trying to swim, instead of sink, in their own existence. It’s not a given that the people who people ones life and community will have the financial, spiritual, and emotional resources - or skills - to show up consistently in a way that soothes the nervous system and creates safety. Herein lies the power of the fundamental truth of the therapeutic relationship - it is a contract of emotional stability and availability. I vow to you that when you come to me, I am going to show up resourced, steady, conveying caring, and sending all the subconscious signs that are in my power that you are safe here. The power of co-regulation. My regulated nervous system is available to you. Our nervous systems will communicate below our levels of consciousness and in their communication, there will be a sense of reciprocal safety and calmness.

So… do they need therapy? ^shrug^ If you’re lucky enough to have a consistently regulated figure or figures in your life, you’ll get many of the same benefits.

Be aware that there is no explicit contract with someone in your life, so you can’t expect them to be regulated on demand! But that’s all the more reason to be grateful for the gift of someone’s time and emotional labor.

2 - Therapy has been a place of getting guidance and help for really tough problems and people should have access to help.

Therapists can be highly trained in specialized areas of guidance, education, and intervention for specific complaints. This could be understood as the medical professional component of therapy. Hey doctor it hurts when I do this… One can consult with a therapist for their professional opinion about how to handle commonly understood mental health problems - defining and clarifying what is clinical anxiety (for a highly simplistic example) and how it’s affecting you personally. Providing education and resources on commonly used methods for treating the kind of anxiety you’re presenting with. For example, helping you identify the connection between thoughts, feelings, and behavior and suggesting exercises to challenge rigid ways of thinking through solo try-it-at-home activities or through an experiential intervention in the session.

Okay, so maybe you can see the benefit if you’re suffering from a mental health symptom, like clinical anxiety, but how does this translate to “everyone” because by its very nature clinical anxiety is not considered a normative life experience - it’s a symptom or a mental illness. Yet, clinical anxiety could be understood as an extreme experience of what IS normative. Life is complex and confusing, there’s unknown in all of our experiences and worry is normal and ubiquitous. We know this, if not from personal experience, then from the spiritual writings and teachings of religious texts! Herein lies the overlap of therapy with the realm of spiritual teachers and guidance. There’s some universal truth here and certainly everyone is affected by the connection between thoughts, feelings, and behavior - just to varying degrees.

So… do they need therapy? Another ^shrug^!

Wisdom and guidance aren’t the property of therapists, there are a lot of places to gain access. I’ve heard it said there are many ways to the top of the mountain.

3 - Therapy is a holding of space for turning in and tuning in to the experience of the self, something that is valuable for cultivating self-directedness.

One of those pieces of guidance and wisdom is itself the space and time to self-reflect. Self-reflection supports people cultivating intentional goals and values in their lives and experiences. I like this old proverb -

An old Cherokee is teaching his grandson about life. “A fight is going on inside all people,” he said to the boy. “It is a terrible fight and it is between two wolves. One is evil – he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.”

 He continued, “The other is good – he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. The same fight is going on inside you – and inside every other person, too.”

The grandson thought about it for a minute and then asked his grandfather, “Which wolf will win?”

The old Cherokee simply replied, “The one you feed.”

Space for intentionality and reflection is also a key tenant in time management teachings and guides to excellence and goal development.

So… do they need therapy? Contemplation predates therapy by a great deal. I’d say this one is a resounding no.

There are a lot of ways to build in contemplation into your life - prayer, journaling, meditation, planning, or a good old fashioned mulling over. It’s a good solo or group activity.

4 - Therapy helps people hear challenges to their behavior and helps facilitate behavioral change, resulting in a more pleasant community.

Ahhh… so this one touches my heart and I believe speaks to the helplessness of living in community with other people. Other peoples’ behaviors are some of the most challenging things for us to deal with and we so wish people would make choices that were more comfortable for us! Yet, we know that the only way that other people change is when they want to change. I think this speaks to the desperate wishing one can have that someone else could see something from their perspective, could hear their pleas, could heed their advice. And a sense of well, if I can’t do it, maybe a therapist will have greater powers of persuasion than I!

Such is the nature of being alive and in relationships near and far. From this end, I can completely sympathize with the fantasy of running off to the forest to live alone with the animals, books, and something cozy! A topic I’m sure to discuss in future essays.

So… do they need therapy?

No. I can’t change someone any more than you can. Change truly only comes from inside someone and mandated therapy is not nearly as effective as we might long for.

So, I’ve covered the four categories of rationale I find behind why people want everyone to be in therapy. The first three, I believe, come from a recognition of value in and a longing for more stability, emotional freedom and safety, and access to wisdom and knowledge about how to take care of ones self and live well. I support this entirely, these are values I’ve built my life and my practice on. There are a lot of cultural shortages in creating this kind of richness and kindness in the world and its lack is keenly felt. The lack doesn’t necessitate that everyone should be in therapy, however. Frankly, there aren’t enough therapists in the world to provide for that. We want a world with more of these things, it is going to take a lot more than therapists meeting with individuals to make it happen - perhaps an exploration for another essay.

And as for the fourth reason? I’m sending a deep sense of recognition and compassion for those holding this need. I believe it’s a reflection of the very same problem outlined above - a lack of emotional skill, stability, and freedom in our world. In the meantime, we always have the wisdom that we can - be the change you want to see in the world. And while therapy is not the ONLY way to meet these very real needs, it is certainly A GOOD way. For those of us who are best helped by the combination of these four components woven together and offered in the context of a one-on-one relationship.