On therapy

Why do people need therapy?

Asked in a weird general way because I get it’s deeply personal, and my therapist asked in our consultation like I should know what I want from the experience before I’ve had it.

Maybe I’m jaded by my experiences so far but keeping the bar low and seeing what they’re offering is fair, right?


Okay. I’ve noticed some interesting changes in the past couple months. Not only do I have a shit ton of new readers, but I’m getting well over twice the number of submissions.

This is a wonderful thing to watch happen, but there has also been a rather fascinating trend as of late. For whatever reason, I’m suddenly getting an overwhelming number of questions that relate directly to therapy.

I’ve gotten a huge spike in people who are in therapy asking for my opinion about something specific to their treatment. I’ve also gotten a massive spike in questions from people who are considering therapy and want to know whether they should try it, how it works, and what to expect. I’ve also gotten a tremendous spike in the kinds of questions that are very serious where the only responsible answer I can give is, “you should really talk to a therapist.”

I can’t explain this phenomenon, but at the same time, I can no longer ignore it, and I feel like I need to put this out there: I am not a psychologist.

I have tons of thoughtful opinions and personal knowledge about therapy, and I certainly know more about the process than the average person, but that’s all I have to offer you. When it comes to serious questions that need to be addressed by a mental health care professional, the best I can do is point you to the nearest mental health care professional.

I welcome all your therapy related questions, and I’ll always give you my thoughts and opinions, but please don’t ever construe that as professional medical advice.

Okay, that being said, the question here is, “Why do people need therapy?” The simplest answer is that good therapy can provide life-changing insights into who you are as a person that have a dramatic and positive impact on your relationships, your patterns of behavior, and ultimately your well-being.

Good therapy improves the human condition. I’ve said it before and I’ll say it again. If every individual, couple, and family in America would spend an hour in therapy during the hour a week that they’d otherwise spend in church, this country would find itself ushering in a new age of enlightenment in less than a year.

Not that it’s possible, of course, but I really believe that.


25 thoughts on “On therapy

  1. Anna says:

    People ask you about therapy Coquette, because it’s easier to trust a stranger that seems incredibly insightful and genuine on the internet than an actual person. (Now I’m not saying you’re not so dang smart or honest, but I reckon you have a knack for editing, as any good author should)


      This is going to come off as condescending or antagonistic, but I’m asking sincerely: what exactly do you mean by your comment? Since you mentioned editing, I’ve edited your comment in a way that makes sense to me:

      “People ask you about therapy, Coquette, because it’s easier to trust a stranger who seems incredibly insightful and genuine on the internet than an actual person. Now, I’m not saying you’re not smart or honest, but you, like any good author, have a knack for editing.”

      Are you saying she needs to do better job of editing or are you trying to say her method of editing somehow makes her seem more intelligent and insightful? If it’s the latter, how so? If an author is editing her own posts, where do you draw the line between writing and editing? What does honesty have to do with editing- would you consider lack of editing to be a betrayal to the reader? Finally, what do you mean by “actual” person and in your opinion, why are people more comfortable talking to a stanger on the internet?

      If you’re just suggesting she needs to do a better job of editing, I must add that us members of the Spellcheck Patrol Squad are quite proud of our status!

      • Anna says:

        Oh the Spellcheck Squad…
        Why do you have to go and make things so complicated?
        I see the way you’re acting like you’re somebody else
        Gets me frustrated..
        Sorry I digress.

          • The Coquette says:

            The SONG PLAYED ON THE RADIO person who you said, “I see the way you’re acting like you’re somebody else.” I hope that wasn’t directed at me, because I don’t do shit like that.

          • Anna says:

            Naw the only bit of the message that counted was “Why do you have to go and make things so complicated?”. That reminded me of the Avril Lavigne song “Complicated” and overcome with nostalgia I decided to recite another few verses.
            I told you I have an odd sense of humor: this misunderstanding fills me with glee.
            Btw I’m not the type that takes particular interest into double guessing people’s internet identities.

  2. Ouitney says:

    I work in a mental health facility and our intakes and new client appointments absolutely soar around the holidays but we’ve significantly slowed down around this time of the year.
    As far as the writer’s therapist asking this question during their initial session- this is probably just a rapport building technique. I doubt she’s expecting you to come up with a detailed response or a bullet point list of therapy related goals for yourself. It’s just nice to have a jumping off point when meeting with with new clients. Broad questions like those helps foster a therapeutic relationship during those often awkward beginning stages. I feel like people expect their therapist to ask a lot of gotcha! questions when that is rarely the case.

    • J Lynn says:

      This is a helpful post! I found the seasonality part very interesting. Not at all surprising that the holidays would bring in “business,” but why would it drop off so soon after only 2 to 3 months? Do people just do short-term therapy or is it more because people lose motivation and drop out (like at gyms after “resolution season”)? Or do you just mean there’s fewer new intakes?

      • Ouitney says:

        There are fewer intakes. However, I find that when a client is no longer in crisis the are less interested in the maintenance part of therapy and therefore much more reluctant to keep coming to their appointments. Of course I normally hear back from them a few months later, desperate for another appointment. We serve a low-income, high need population in sort of a mental health desert area so these experiences are hard to compare to a clinic who services a more “typical” population.

  3. Alicia says:

    As one of the people who’s sent in a therapy-related question somewhat recently (mine was one of the ones asking how to know if it’s a good idea to try it or not), I remember that I did it because you referenced therapy in one of your posts. I wouldn’t have thought to ask you about it otherwise. (See also: a question I sent in about online dating that I wouldn’t have asked if you hadn’t mentioned it on Twitter.) That may have something to do with why more people are asking you about it lately. Or, hell, maybe people are just bummed out by winter.

  4. z says:

    How many sessions/much time do you give it before deciding whether it’s a good fit or not?

    I once stuck it out with one for a few months. But the “therapeutic connection” was just not there. (My therapist before her was AMAZING but moved away, so the bar was set pretty high.) This one wasn’t bad…but honestly I stuck it out far too long and it burned me from seeking therapy again for several years. Simply because it wasn’t a good fit, the methods weren’t working, and I didn’t like going because of that. Eventually I put it all together.
    I’ve learned a lot since, like what I need in a therapist and types of training/background, thank the gods.

    • Barefootsie says:

      There are a lot of colleges that have a free-to-sliding scale where you work with students who are learning the trade. I was able to get weekly therapy for $10 a week, which then switched to free because I was couchsurfing and had very limited funds. It’s worth looking into, for sure – changed my life.

    • Strangely Rational says:

      I’m below poverty level, and I do. Even my state insurance covers it, but if I didn’t have that, I’d be getting affordable therapy on a sliding scale. It’s not limited to colleges, either. There’s a community mental health center I go to.

      They’ve had high turnover lately, so I’ve only been able to get in once a month. On the bright side, they also offer weekly groups, and I’m currently in the DBT one. It’s been the single most life-changing thing I’ve ever done, no exaggeration.

      • The Coquette says:

        I highly recommend dialectical behavioral therapy. It’s like CBT with Buddhism and a to-do list. (If none of that makes sense, just trust me. It’s a fantastic approach for people who want to seriously change their behavior.)

  5. UnderTheGun says:

    I believe it too..but how can one find a good therapist?…I’m looking but if your friends don’t go to therapy how do you know who’s good?

    I’m not sure I could even tell if someone is good to quickly either.


    • Sketchee says:

      I’ve read time and time again that referrals are helpful. I found my excellent therapists through referrals. Is there a free support group that you could join? If the support group turns out to be worthwhile, then it’s members may be able to provide guides.

      There also is personality match as a concern. You can call or write various therapists and ask for a one off session. Then you can ask how they think of things, what their methods are, their general availability. There may be a cost, but it’s worth it.

      It honestly is harder than it needs to be. The barrier to entry kept me out of it for years until a friend. If you have anxiety or depression, these steps can feel daunting.

      You can also enlist a close friend or family member to help you in the process. “Hey I really would like to confide in you. I’m looking for a therapist and your moral support would be amazing right now.” They agree go with you, even if it’s just to wait in the waiting room. Make a few calls, send a few listings.

    • J Lynn says:

      I haven’t tried this myself, but people have told me that it’s common for therapists to let you do a +/- 15 minute phone, Skype or in-person consult for free which can give you at least a little feel for potential rapport and a chance to ask questions. (You can prep by looking at their website, many also have an entry in psychology today’s listings.)

      I think if you wanted a half hour or more you would probably have to pay, but it might be worth it. If you have insurance that would only kick in for the person you ultimately select … unfortunately I don’t think you can get reimbursement for “shopping” consultations with more than one person, but my info may be out of date/not universal.

    • Faith says:

      The link below can help narrow down clinicians in your area by speciality. If they can’t help you, they can usually offer others who may help. Indicate that you’re paying out-of-pocket due to finances…most providers have reasonable income-contingent sliding scale fees. Some may help you to apply for insurance.

      During the intake appointment, ask as many questions as you want about the clinician’s experience and areas of expertise. You’re paying for this service, you should feel some confidence that they can and will help you. A good clinician will welcome these questions. If they give you shit for asking questions, discontinue treatment with that provider and run back to the referral list.

      Good luck 🙂

  6. Sketchee says:

    LW, ask this very question to your therapist. Your concern about how it works, what to expect, that you’re not sure if you know what to expect. Your therapist likely doesn’t know that you felt that you should know the answers. After all, just because a question is asked doesn’t mean that you will know the answer. It’s okay to say “I don’t know” =)

  7. ken says:

    I agree with your last paragraph to a point. But I feel like you are discounting religion completely. I have read a lot of your posts and I understand you absolutely see no value in it and I can understand how you would feel that way, but it works for a lot of people. I am one of them. I have found a tremendous amount of love and support in small religious groups and they have helped me through difficult times. But in the interest of full disclosure, I went to a different church to talk about my daemons than the one I attend. I feel like this is more of a people problem than a religion problem. Of course, I’m more of a “feed the poor and love your neighbor” kind of christian vs. “kick all the Muslims out of the country and make everyone work for food stamps” kind of Christian.

  8. Mellifluous says:

    “Why do people need therapy?” Because we are all, every single one of us, messed up. We just are. The people who pretend like they aren’t scare the crap out of me and I avoid them like the plague. We’re screwed up and we screw other people up when we aren’t brave enough to own it.

    We’d all be better off if we’d embrace that everyone has junk and we’d start viewing other people through a kinder lens. Everybody has had shitty things happen to them; things we never tell anyone else. You tell that crap to your therapist. You get it out. Then, you start to heal and figure yourself out. It’d be great if we just had the tools to figure it out, but we don’t. Go get your therapy.

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