Therapy can make stress and anxiety disorders worse.

By David Joel Miller.

Traditional talk therapy may make your problems worse.

Pain, Anxiety, Depression, Stress

Pain, Anxiety, Depression, Stress.
Photo courtesy of Flickr (marsmet481)

Don’t get me wrong; talk therapy has been helpful to a large number people.  But occasionally I encounter a client whose condition has been made worse, not better, as a result of being in therapy.  One predictor of whether therapy will work for you is the fit between you and your therapist. If the kind of therapy they’re doing or the way they’re doing it is not helpful, begin by talking with the therapist about this. A good therapist will work with you to find helpful solutions. If you find you therapy making things worse, you may end up needing to switch to a new therapist. Below are some ways I have seen therapy be unhelpful and some suggestions for making it more helpful.

Repeated talking about it can retraumatize you.

Some therapists were trained that the way to be helpful to people, was to do a thorough biopsychosocial assessment before they began treatment.  This historical approach often means beginning with the first event in your life and move things forward one event at a time.  Therapists with this orientation may well believe that the key to fixing your current problems, is to thoroughly deal with your childhood issues first.

More than one client as told me that their therapist’s insistence that they needed to talk about past abuse in detail, became so painful they had to discontinue therapy. We often hear from victims of trauma that the having to go over and over the details was more painful than the initial experience.

There’s some truth to the idea that you can’t heal injuries, physical or emotional, that you deny exist. The problem comes from efforts to dig up the graveyard to get at the root causes before the person is even able to cope with life today.

What is often more helpful is a “solution-focused” approach to your problems. This approach means beginning at the top with the problem that is affecting you today. If today’s problem is unemployment or a bad relationship, that may need working on right now. Keep in mind that early life experiences may be impacting today’s issues. As you get today’s problems under control, you may decide you want to work on those old long-term problems, or you may decide that having solved today’s problems you need to move on with your life.

Talking in therapy can turn into co-rumination.

Sometimes therapy can perpetuate problems.  It’s easy to stay stuck, week after week, reviewing the exact same problems.  When this is done with a friend, it is sometimes described as co-rumination.  The same process can be harmful when done with a therapist or counselor.

Narrative therapists described this as staying stuck in a problem-saturated story. Repeating the same story over and over can magnify its control over you. The challenge is to stop the pain and begin to create a story of how the future can be better than the past.

Being in the wrong group therapy can make your problems worse.

We see this often in substance abuse treatment.  A young adult gets caught with some marijuana, which is illegal in his particular jurisdiction.  This person gets referred to drug treatment and placed in a group made up largely of heroin addicts.  Not only is this group not helpful, but there is an increased risk that this person will develop a worse problem than before.

An equally bad problem can be created when a woman with a history of domestic violence ends up in a PTSD group with some returning military veterans. Group therapy can be extremely powerful, but only if you’re in the right group.

Sometimes the symptoms become the problem.

Many of the things that are described as symptoms of a trauma-related disorder are in fact ways that people adapt to having survived that trauma. When therapy focuses too much on ending symptoms, it can become unhelpful.

For example, a victim of trauma may begin drinking, trying not to have to remember the painful experiences. Someone notices the person’s drinking, maybe because they’re drunk at work or they get a DUI. They may end up in treatment for alcohol use disorder. The difficulty here is that for this person the alcohol is not their problem, it is their solution. The problem is the recurring intrusive memories of the trauma.

Using “unhelpful” behaviors to manage your current symptoms can become a habit. Rather than focusing too much on the unhelpful behaviors, many therapists will work with you on creating new helpful behaviors. Under stress, humans tend to revert to their habitual way of behaving. The therapist will want you to continue to practice your new helpful behaviors until they become your new automatic way of coping.

Don’t give up before the healing miracle happens.

I hope this post will help you understand the ways in which therapy can be helpful, and the times it may not be. If you’re currently coping with the results of trauma and stressors or you have high levels of anxiety that are interfering with your day-to-day life, know that there is therapy out there that can make your life better. If you have been for counseling in the past and it was not helpful, seek out a therapist you can feel comfortable working with. If you’re currently working with someone and it’s not helping, talk to them about this issue.

One other thing you need to keep in mind is that when you’re in severe emotional pain, you may feel like you’re stuck and nothing is getting better. It’s very common for people to make large amounts of progress and not realize they’re getting better. Sometimes your counselor, family or friends will see the changes in you long before you do. Please don’t give up.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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