[shakespeare47]

Have you ever considered this? What would you add to my list?

Benefits:
Talking with another person about problems and concerns does have benefits

It is comforting to know there is someone on your side

A therapist can help me see things from a different point of view



Costs/concerns:
I have sometimes felt worse

I have sometimes gotten the sense that the therapist has no idea how to help with my particular concerns

The therapist isn't always "on my side"

There may be other, more objective ways to handle my problems and concerns

I have a hard time trusting therapists (and rightly so. I've had some bad experiences)

[gloamingone]

I think a benefit of therapy is that the T can help you learn coping skills.

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[stopdog]

There are cheaper things to do and any number of ways to get better depending upon one's needs and definition of better. I consider it a very expensive hobby. The therapist has never been on my side as far as I can tell, and I am not sure what that would even mean.

[shakespeare47]

Originally Posted by stopdog

There are cheaper thungs to do and any number of ways to get better depending upon one's needs and definition of better. I consider it a very expensive habit. The therapist has never been on my side as far as I can tell, and I am not sure what that would even mean.

I have had a few therapists that really did help... I got the sense that the therapy they provided was an attempt to help me develop better coping skills, and gain some perspective on what I identified as my problems.

But, there were also times when therapists were just plain wrong, sometimes unhelpful, and a few even did more harm than good (even though their motives might have been good).

[gloamingone]

Out of all the therapists I've had, only a few were truly helpful. Most of the time it felt like I was just droning on about myself. But finding a good one is totally worth digging through the bad ones!

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[stopdog]

Originally Posted by shakespeare47

I have had a few therapists that really did help... I got the sense that the therapy they provided was an attempt to help me develop better coping skills, and gain some perspective on what I identified as my problems. ).

I don't disagree that therapists are not always incapable of being of some assistance.

[NowhereUSA]

Well. Mine keeps me from doing something permanently drastic. I think that's why I keep him around. Also he's got a good sense of humor.

[Sprintalk]

My experience as T says that healing procedure includes the things you, as P or C (Patient, Client), believe about that relation and how that mirror the way you behave and suffer in real world with real people. Therapist is a role, obviously.
Hope this help to full the picture you are making about therapy P&C account.

Benefit: I got to experience a non toxic relationship

There are no negatives as I have found..

[SnakeCharmer]

The first time I sought out the help of a T, I was screaming myself -- and everyone within hearing distance -- awake several times a night from night terrors and nightmares. I was driving everyone crazy, including myself, and I was given an ultimatum -- either get some help or be ejected from my living situation.

I was 19 and living away from home with the disapproval of my family, friends, the people I lived with and just about everyone else. Different reasons for that disapproval, but the general feeling was unanimous.

On a very basic level I had a problem that was so obvious, troubling and out of my control that I was about to lose friends and a roof over my head unless I did something about it.

I felt really angry at the ultimatum. I actually expected some sympathy and I wasn't getting any, which I understand -- rationally -- because everyone within hearing distance was having their sleep disrupted and that tends to make people short-tempered. I'd been dealing with this alone since I was about 12. My parents dealt with it by making me sleep on the other side of the house in a non-bedroom so I didn't disturb anyone else's sleep.

I actually did a cost/benefit analysis because I'd just learned about it in a class about decision-making. It looked something like this.

Costs:

1. Having to admit I had a problem (shame)

2. Having to feel the rejection and anger of my living mates (resentment)

3. Having to face the Really Unpleasant Things that were triggering the screams (fear)

4. Having to admit vulnerability (fear)

5. Having to trust (fear)

6. Having to show more concern and consideration for the people who were being negatively impacted by my problem instead of demanding they show concern and care for me because my problem was so bad (reciprocity and empathy)

7. Having to change my point-of-view from helpless victim to resentful volunteer who refused to get help (stubborn self-image)

8. Having to demonstrate to others I was making an effort (resentment, how dare they)

9. Hating to admit I wanted my living mates to like and approve of me and care about me (defiance, stubbornness, embarrassment, fear of rejection)

10. Having to admit my parents had hidden my problem and ignored it as long as it didn't bother them instead of trying to help me deal with it (sick to my stomach with feelings of rejection, shame, anger, abandonment and fear)

Benefits:

1. Possibility of better sleep without terror (relief)

2. Possibility of lessening of the negative emotions listed above (serenity)

3. Possibility of feeling okay with being rejected and having to figure out how to move with so little money (acceptance)

The short list of benefits far outweighed the costs. I found a therapist who helped me tremendously in just a few sessions. Through deft questioning, he helped me identify and name the problem and to see certain patterns that contributed to the night terrors. He also told me to see a neurologist.

Then he died suddenly.

I screamed every night for a week and then slowly it tapered off to maybe once every two - three weeks as I continued to use techniques he had taught me.

The most important thing I learned in that very brief therapy was that, for me, it's best to face my problems head on. I grew up being trained to hide everything and it was completely freeing to have this T tell me I didn't need to hide or feel ashamed or feel less-than. Yeah, I had problems, but there were reasons and I could deal with them without pretending nothing bad had happened to me.

That C/B analysis changed the direction of my life.

[Petra5ed]

I've never thought to do this. I suppose I just want to see my therapist, so everything else is kind of a mute point. It's expensive, but in my mind happiness is worth more than money. I'm not sure all the time I'm getting better, but I'm trusting the process at the moment.

[guilloche]

My therapist is a bit expensive, and really based on the cost, I probably shouldn't have even done an initial session. But, so far, he's the only one that's been able to adapt to me... so I have some hope.

I think the problem is, the benefits aren't always clear, immediate, and guaranteed. You invest a lot of time, money, and emotions - for *potential* benefits. Potential benefits for me are things like understanding myself better, being better at setting and keeping boundaries, feeling safer in the world, and improving my life and relationships (ha! these all sound so sane and positive when I write them like this, but day-to-day that's not how they really feel!)

But, it's not like buying a jug of milk. You don't put your money in, and get what you are asking for. It's sort of like:
- If you find a competent skilled therapist
- And if you click with the therapist and can develop a relationship
- And if the therapist doesn't leave, move, die, retire, quit
- And if the therapist knows how to work with your issues
- And if you are able to be open, honest, and vulnerable
- And if you are able to adequately cope with the disruption that therapy brings and stick it out
- ETC.

It almost seems like it's a miracle that therapy ever works at all.

And, honestly, no I'd rather not be doing it. But I hate my life. I've tried other things to improve it, and those weren't effective enough. Therapy is sort of the expensive, last ditch "what the heck, it can't get any worse!" option.

[ManOfConstantSorrow]

Here treatment is provided free at point of delivery funded through taxation so value for money is a pressing matter - many studies have been done such as this one for moderately depressed people: No significant difference between the mean observed costs of patients randomized to antidepressants or to counseling (£342 vs £302, p = .56 [t test]). Source: Cambridge Journals Online - International Journal of Technology Assessment in Health Care - Abstract - COUNSELING VERSUS ANTIDEPRESSANT THERAPY FOR THE TREATMENT OF MILD TO MODERATE DEPRESSION IN PRIMARY CARE

[Partless]

SnakeCharmer, nice detailed analysis of cost benefit analysis. Also I'm so sorry your T suddenly died on you, must have been quite traumatic, the way you describe your reaction.

shakespeare47, my view is that the cost benefit analysis is, on one level, quite personal. Which is why therapy is useful for some people and not for others. It depends on the person, on the problem, the time, the financial situation, etc. For instance, apparently a big enough reason therapy works for some people is that they really want to change. They are ready for change. It's hard to know when that is. But when a therapist is able to ascertain that, their work is much easier. They don't have to motivate you, you're there already half way there, just need guidance.

One of my therapists, she was my best one in my view, often brushed off my admiration for her ability to help me. It was no false modesty. I was a big part of the reason therapy about the issues I had, was successful. I was so darn motivated! Therapy takes work. Therapy asks you to go back and face the monsters you've run away from your whole life, abuse, trauma, fears of all sorts. I went to quite a few therapists since my teens and sometimes I just sat there because I did not want to change. Couple of them were actually great therapists. One was a Harvard educated psychologist that my dad paid and arm and a leg for. But nothing!

Now of course therapists do try to motivate you and some can, but ultimately if you don't have that deep motivation for major change, therapy won't work. This is strictly my view, but I have called it the "I'm so ****ing sick of this ****" mindset. That's the scientific name for it btw. It's not a depressed state but an angry activating state. When I've been there, I could go many different directions with it and some take longer or are more dangerous or less successful. So a good therapist notices I'm ready to take off and goes: NO wait, not that way, this way, I give you the tools, go face your daemons!

p.s. you made my high school miserable, I hate you Shakespeare, you literary genius you!

[stopdog]

I completely disagree with the blame the client mentality if therapy is not working someone. Therapy can fail or not win the cost benefit idea even if the client is working and does want to change. Plus any random change is not always useful to someone.

[Partless]

Originally Posted by stopdog

I completely disagree with the blame the client mentality if therapy is not working someone. Therapy can fail or not win the cost benefit idea even if the client is working and does want to change. Plus any random change is not always useful to someone.

It perplexes me how you read blame in this thread though when I read it again I can see how you were able to make that reading.

Stopdog, I'm sure as a lawyer you are well aware of how logic can be used in different ways to reach very different conclusions. My post can be seen as client-empowering or client-blaming, as you noted.

I think clients are the ones doing most of the work of the therapy, and that many motivated people may do well even without therapy (depending on severity of issues of course), given good social support and resourcefulness and other forms of guidance. So therapy is not the only way and when it is, the client plays a major role in the success.

I assume your view is different, so therapists are the ones with the power, and when it works, therapists gets most of the credit (meaning client had little to do with improvement) and when it goes wrong it's mostly the therapist's fault?

But a negative spin could be put on the latter view too, assuming that is closer to your view, as it can be seen as disempowering of clients and exaggerating the power or ability or authority of therapists.

I don't like to use blame language and I don't think acknowledging person not being ready for change is the same as saying a therapy's failure is his fault. Have you dealt with court-ordered therapy? How successful were they in making deep lasting changes? You can't force people to want to change. Person's own will and desire and motivation is a big part of it.

[stopdog]

Court's in my jurisdiction or area of law rarely order therapy. Drug compliance is an issue, but for most of my clients therapy is not the thing the mds or the courts try to force.
I do not think the therapist has power except that which a client hands them. I do recommend not handing over one's power to them. I don't believe in giving therapists credit for anything. I don't think they do anything.
For some the motivation for change may work. For others, it may be something else.