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
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