There has been a lot of spirited discussion on the topic of whether or not psychotherapy is helpful or even necessary for people to participate in the long term. Some of these conversations involve concerns that therapy is generally over-relied upon, perpetually endless, or risks becoming redundant over time. These conversations are undoubtedly complex and highlight that we, as a culture, are deeply grappling with therapy’s role for individuals, couples, and families. It is important to acknowledge both sides of the argument while also providing a perspective that clarifies when, how, and why therapy is so crucial for many individuals to have in their lives. Below, I will cite some common concerns about the appropriateness of ongoing therapy and provide some responses that can help clarify these issues more effectively.
Concern: Therapy can become a crutch rather than a springboard.
Response: Whereas therapy is inherently an exercise in accessing support, it is intended to promote growth and not unhealthy dependence. Participating in effective therapy means finding a balance between the concepts that therapy is about “lightening our loads” and “strengthening our backs.” As with physical injury, there might be periods when an injury requires more support and frequent attention to heal and would, in fact, be worsened if too much load were applied too soon. However, as the injury heals and can increasingly bear more load, the effort of strengthening comes into play. Even if an injury reaches a threshold of healing, it might still require ongoing support (e.g., a knee brace or ongoing physical therapy) to remain in a healthy range. Mental and emotional health follow very similar tracks. It is worth reflecting on which parts of therapy are “lightening” and which are “strengthening” as you work to ensure that therapy has the effect of a springboard toward positive change.
Concern: If you start therapy, you’re never going to know when to stop.
Response: Navigating emotional and psychological health is ongoing throughout life. There are times when we need the support and guidance of a therapist to improve our lives in some meaningful way. The support and guidance required will vary greatly by individual, and the longevity of this work can largely depend on the starting needs and ongoing goals an individual has for sustainable health. One could attend therapy for six sessions, learn valuable skills or techniques, and then find that they can get by without seeing their therapist for years. Others could attend therapy every week for six years and find that this intensive level of work was very effective for them in terms of fully addressing the needs they had coming in and maintaining this progress over the long term. Talking openly with your therapist about your goals, needs, and hopes for preserving gains can help clarify what level of therapy is recommended and why.
Concern: Therapy will become redundant if you keep going for too long.
Response: For many individuals with severe and persistent mental health challenges such as chronic depression, Bipolar Disorder, PTSD, and others, ongoing therapy is a profound source of stability, structure, safety, and healing. Complex challenges related to attachment, abuse, abandonment, and neglect often require a long-term, healthy therapeutic relationship to enact sustained healing. Humans are inherently relational beings, and many of our deepest psychological and emotional wounds are sustained in relational contexts. It stands to reason that healing such wounds would require the opportunity to be witnessed, held, and accepted in perpetually stable relational spaces. Therapy provides this important source of relational stability, and part of what keeps this valuable is that it is intimate, safe, reliable, and accessible in an ongoing way. We never stop living our lives as long as we are in our lives, and thus, it can be beneficial to have a therapist who continually “holds our story” whether we are in active therapy or on pause. As clients heal and grow, they can certainly adjust the focus and/or cadence toward more of a maintenance phase, which might mean attending less frequently for periods of time. However, there is no ceiling for personal growth, and having access to an established, stable, therapeutic relationship can be a tremendous asset as you navigate the course of your life experience.
