Is It Possible to Become Dependent on Therapy? I’m Not Rich!

I feel like I am probably clinically depressed, I've never been diagnosed but I have never gone to see anyone about it, either, so who knows. I just feel blah all the time and unmotivated to do anything. You are probably going to tell me to just go get it checked out, but my fear is that I will end up in therapy and become dependent on it. Is that possible, to become dependent on therapy? I don't want it to be my only way forward. Can I get through this without going to therapy, you think? I hear that certain depression medications can be addictive, too. The last thing I need is to become addicted to medication AND therapy. I'm sure therapists make more money when you have to come back, so where is the incentive to help? I'm not rich. —Don’t Hook Me
Dear Don't Hook Me,

Thanks for the letter and your thoughtful questions. I am very pleased that you reached out, seeking advice on what to do.

You ask if it’s possible to become dependent on therapy, and as much as I would like to offer a simple answer, the honest answer is much more complex. Many people come to rely on the insight of their therapist and the relationship they foster in the safe confines of the therapy room. However, it is the responsibility of the ethical therapist to create conditions that do not foster or encourage dependence, and to do his or her part in helping a person in therapy learn to function and perhaps even thrive without the therapist.

The point of therapy is not to keep people in therapy indefinitely; if a person is not getting better or otherwise seeing desired results, the therapist has an ethical obligation to stop working with that person. Therapists are also bound by an ethics code that does not allow them to benefit financially if the person isn’t benefiting therapeutically. Additionally, you are always free to choose when you end therapy, unless you are court ordered to attend. On the other hand, many people maintain a relationship with a therapist long term and go in for “tune-ups” when needed—which, of course, is not the same as being “dependent.”

Beyond any ethical obligations, please know that good therapists thrive off of people getting better. If it was about making money, most therapists would chose a different profession. Most therapists truly care about the well-being of the people they work with. That’s why they do what they do.

As for medication, yes, some meds can be addictive after long-term use. I am not a psychiatrist, so I can’t speak to which medications specifically. There is certainly a lot of fear about becoming dependent on medication, and I understand that fear. However, if you were to seek out therapy and/or medication, the clinician or physician you work with can discuss with you, at length, which medications might work best without being addictive. Also, you have a say in your treatment, so if you want to change or eliminate medication (should you decide to use it), that is always your choice. It is imperative to remember to only make changes under a doctor’s supervision, however.

You ask whether you can get better on your own. That is a question I can’t really answer. There are anecdotal accounts of people who defeated depression without the use of therapy and/or medication, but there are a lot more who did it with the assistance of a mental health professional and/or medication. I believe the best and fastest healing of the things that ail us comes through relationships. Research has consistently shown that people who go to therapy and use medication have better and long-term recovery from their mental health/emotional concerns.

I’m curious, though, whether your desire to avoid therapy has less to do with cost and more to do with stigma. There’s nothing wrong or bad about needing therapy; many people do, including therapists themselves. Even just a session or two of therapy often yields insight and healing that can help a person move forward. I challenge you to view the possibility of therapy in such a light.

I suggest that you interview some therapists; ask them about their methods, how they feel about the use of medication, and how long the people they see usually remain in therapy. The foundation of a good therapeutic relationship is trust, and trust is fostered through honest communication. You can begin building that bridge immediately simply by openly expressing your concerns and sharing your fears. You have every right to ask as many questions as you have, and a good therapist will do his or her best to address and alleviate your concerns. Even if you decide ultimately not to pursue therapy, at least you will have explored all your options.

Sincerely,
Lisa

Lisa Vallejos
Lisa Vallejos, PhD, LPC, specializes in existential psychology. Her primary focus is helping people to be more present in their lives, more engaged with their existence, and to face the world with courage. Lisa began her career in the mental health field working in residential treatment, community mental health centers, and with adjudicated individuals before moving into private practice. She is in the process of finishing a PhD as well as advanced training in existential-humanistic psychotherapy, and provides clinical training and supervision.
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  • Theresa S

    Theresa S

    October 17th, 2014 at 6:30 PM

    Yes I believe you can become dependent on your therapist. A good therapist will do all they can to identify the problem, but I have had a few that I really wonder If they weren’t just using me for a paycheck by the time we got to the last sessions.

  • leslie

    leslie

    October 18th, 2014 at 5:52 PM

    There are so many avenues that you can pursue and you don’t have to have a ton of money.
    Online resoyrces, phone lines, even face to face therapy, all of these things can help you if you are willing to give it a try.
    And it doesn’t have to break the bank either!

  • John

    John

    October 18th, 2014 at 10:35 PM

    At 59, working with a helpful and effective therapist for the first time in my life. Reflecting on my previous experiences with graduate students getting their hours and with a psychologist (90+ sessions at $80/hr), I would estimate that I have previously spent well over $12K with little benefit. I find that while many a therapist may be right fit for specific people/issues, I think far too many are in it for the $$$ and are more than willing to keep taking your $$$ as long as you keep showing up. While some may fit the ethical profile, when $$$ is involved — far too many are content to collect it without helping you produce results in your life. Before working with my current therapist, I wanted my life to work! I could not define it in simple terms for any previous therapists and I never experienced any possibility of hope for improvement with any of them. I often felt I was spinning about and when I was in deep pain, I did not know what actions to take to improve my life. Yes, far too many therapists are lazy, comfortable, professionally protective of incompetent colleagues and OK with taking your $$$. I am wiser now, but I should have received the effective help that I was paying for and wanted 25-30 years ago. I can recommend effective therapy, but unfortunately I think there is too little of it out there!

  • Reginald N.

    Reginald N.

    October 19th, 2014 at 8:26 AM

    Please take one step at a time. I understand your concern but if you don’t seek help you are going to regret it. I still regret the time I lost debating whether to go for therapy or not.

  • Pat G.

    Pat G.

    October 20th, 2014 at 8:21 AM

    I believe we can be dependent on anything, including sponsors (AA & NA), therapists, our spouses, our parents, our friends.

    But I have been dependent on faulty thinking for a long time (coping strategies in childhood that no longer work as an adult), and I am now going to a therapist to help me create better coping strategies.

    The whole point of a good therapist is to help us grow and become healthy humans.

  • gage

    gage

    October 20th, 2014 at 5:22 PM

    And a good therapist will have the goal of getting you out on your own, whether that takes one session or 100, the goal will be to get you well enough so that you don’t have to depend on them to always be the one to get you through a rough patch

  • Cathy

    Cathy

    October 21st, 2014 at 4:22 PM

    You don’t have to feel ashamed of being in therapy!
    It can be such a wonderful experience for you, yes scary at times but mostly very enlightening. Please don’t let that fear of what you think that other people will think about you let something that wonderful and healthy for you slip away.
    If you are ready to change your life and become the person that you have always wanted to be then therapy could be a crucial first step toward making that happen.

  • Turner

    Turner

    October 23rd, 2014 at 11:13 AM

    You need to weigh your options and figure out what seems worse- coming to see someone as being an important figure in your life and relying upon and accepting their help… or being relegated to feeling crappy all of the time with no one to talk to.
    I am sure that I know which choice I would go with

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