Myth Madness: ‘Therapy Will Make Me Worse’

man looking painedMyth No. 4: “Therapy will make me worse.”

Reality: For those who have experienced childhood trauma, such as emotional or physical abuse and neglect, the thought of focusing attention inward and turning toward old feelings associated with trauma can be extraordinarily anxiety provoking. Survivors of abuse and neglect generally have parts of themselves that want to heal desperately, but because other parts of themselves have long prevented the individual from being hurt the same way again and feeling old, horrible feelings, the thought of going anywhere near the traumatic material—of remembering—is understandably frightening. Many people who have avoided therapy for this reason finally come to therapy as a last resort after trying other methods of coping and forgetting such as addictions, alcohol, and even psychotropic meds.

Whether one has experienced severe trauma or not, everyone gets hurt in life and can’t avoid harboring some amount of pain. So it’s safe to say that most of us have stuff that could benefit from therapy and, more to the point, the fear of going near anything painful is nearly omnipresent in our culture.

People dread the idea of showing weakness. But even if the fear of being vulnerable and weak isn’t present, the fact is most people have no idea what to do with their pain. People hold on to big feelings, and once the Pandora’s box is opened, if the therapist doesn’t know how to help a person to tend safely to his or her feelings, the person can actually get worse. Many survivors of abuse know this. They know how easy it is to feel overwhelmed when old pain or memories are triggered. It makes sense that many people are afraid of their feelings, and it explains why so many people never heal.

So what’s the trick to not feeling worse in therapy? First, a little clarification: Therapy is not easy, it will probably hurt at times, and the person in therapy will probably grieve, cry, and experience some sense of aloneness. However, therapy can be done without the client feeling overwhelmed and without making him or her feel worse in the long run.

Here’s the trick to not feeling worse in therapy: When a part of us is hurting, afraid, angry, shy, grieving, or having any other feeling, it helps to open our hearts to it in the way we do when anyone else is hurting. When a baby cries, we hold it calmly with love. When a child is sad and crying, we don’t send her to her room, we move closer, scoop her up, and hug her. When a friend is down in the dumps and struggling with a breakup, we listen with an open heart, let ourselves feel a bit of his or her pain, and express our compassion through words and actions. Some people like to be held; others don’t. Some want to hear back from us; others just want us to listen.

Well, the same goes for our own pain. Generally, the parts of us that hold pain want to be understood, felt, and witnessed. In the same way babies calm down when their mother holds them, our pain relaxes when it is cared for. A big part of therapy is helping people to be present to their pain in a loving and self-compassionate way. But a careful therapist never pushes a person into painful material, instead helping the person to stay calm, curious, and compassionate; letting the person to progress into the pain naturally.

When a therapist guides people through the process of opening their hearts to the parts of them that carry extreme feelings or beliefs, therapy proceeds safely at the pace best suited for the them, and people get through to the other side of their pain, release the burdens they’ve carried, and feel much better.

Editor’s note: For more articles examining common myths and fears surrounding psychotherapy, please click here.

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Alex

    Alex

    October 11th, 2013 at 3:41 AM

    I have very much enjoyed the therapy myth articles this week. I can see how someone afraid to face his fears and his past might think that therpay could make things worse- you know, damaged people spend a lot of time trying to bury the things that hurt them, and therapy goes and brings them all up again. Yeah, it’s gonna hurt, kind of like pouring salt into an open wound. But what better way to get those wounds to heal than giving them some fresh air? Those are the external and the internal wounds too. These are things that probably need to be talked through with someone who can give you some guidance along with some comfort, so yeah, you might feel a little worse in the short term, but in the end you are going to feel cleansed and renewed.

  • Caly

    Caly

    November 12th, 2014 at 3:48 AM

    People go to therapy for lots of reasons and for some people it really does make them worse not better. We aren’t talking about short term pain from processing something difficult, we are talking about much bigger dilemmas that occur in people’s lives. For me personally I had weekly therapy for 8 years with 3 different therapists and I can honestly say it was often more harmful than helpful and the effects are long-lasting. Research shows that 30-50% are helped by therapy but that’s still at least one in three that aren’t helped. This assumption that therapy should help every single person makes those that it doesn’t work for feel even more self-blame and hopelessness

  • Susan French

    Susan French

    October 11th, 2013 at 9:11 AM

    This reminds me of wannabe musicians saying that learning music theory, scales, harmony, etc, will inhibit their creativity. Great article.

  • Lou dalton

    Lou dalton

    October 11th, 2013 at 11:09 AM

    Come on! really? You think that this is what will make you worse?
    Trying to deal on your own? That’s what will make you worse, not actually talking and meeting with a therapist who cares about what is going on with you and who tries to help you make a difference in your life.

  • cheyenne

    cheyenne

    October 12th, 2013 at 4:44 AM

    You will be surprised at just how much your therapist is going to be willing to work with you ate your own pace and in a way that feels comfortable for you.

    Someone who is really good will very much be in tune to your thoughts and feelings and will know when it is safe to push and when it is time to perhaps back off just a little.

  • Frankie

    Frankie

    October 14th, 2013 at 3:53 AM

    Duh!
    Of course if this is the attitude that you enter into therapy with then it is gonna bring you down.
    What wouldn’t bring you down if you go in already with a debbie downer attitude?

  • Julie

    Julie

    January 18th, 2014 at 10:51 AM

    Therapy made me worse. It’s not a myth. I lost.

  • World Wide Max

    World Wide Max

    March 24th, 2014 at 4:05 PM

    It is absolutely NOT a myth that psychotherapy can make people worse. This has been well known since Allen Bergin’s groundbreaking work in 1966 (see link below). It is irresponsible and frankly dishonest to claim otherwise.

    Psychotherapy can change people’s lives for the better, but it can also destroy lives.

  • World Wide Max

    World Wide Max

    March 24th, 2014 at 4:07 PM

    Link to article discussing effectiveness of psychotherapy in terms of improvement and deterioration.

  • World Wide Max

    World Wide Max

    March 24th, 2014 at 4:08 PM

    Let me try this once more…..

    coping.us/images/Barlow_2010_Neg_effects_of_EBP.pdf

  • Noah Rubinstein, LMFT, CEO GoodTherapy.org

    Noah Rubinstein, LMFT, CEO GoodTherapy.org

    March 25th, 2014 at 10:04 AM

    Hi World Wide Max,
    Sincere thanks for the article. There is no doubt that negative effects occur in therapy, that’s the reason I started GoodTherapy.org. But, it would be foolish of anyone to throw out the baby with the bathwater, such would be a denial of all the good psychotherapy has contributed to the lives of millions. Indeed, some therapists can make people worse, but they are a very small minority. Also, many people in therapy feel worse temporarily and there is no changing that – it’s often part of the process. But most people in therapy get better, especially in therapy which focuses on self-compassion. Frankly I don’t think it’s possible to get worse from having self-compassion.

    Noah

  • World Wide Max

    World Wide Max

    March 25th, 2014 at 8:42 PM

    I think you are right to say that therapy can be extremely helpful, but to state that harm from it is a “myth” is very misleading. Myths are things that are not true or real and harmful effects from psychotherapy are very real for those affected. That is not throwing the baby out with the bath water; it is acknowledging reality. Up to 10% of patients who undergo psychotherapy get worse, not better. See thepsychologist.org.uk/archive/archive_home.cfm?volumeID=21&editionID=155&ArticleID=1290.

    Thank you for posting my comment and responding to it.

  • disequilibrium1

    disequilibrium1

    April 11th, 2014 at 9:34 AM

    Here are a few ways therapy can make us feel worse.
    . By setting up a fictionally intimate relationship that is unequal and limited. Time is up!
    . By encouraging the client’s alienation from her real-life community through self-pity and self-obsession.
    . By perpetuating the folklore that humans are just like machines, that bad feelings have a specific past genesis, and that simply accessing the memory and saying it aloud magically will poof the bad feeling away.
    . By magnifying the unfairness that is part of every life experience and encouraging clients to blame and label those who hurt them.
    . By focusing on negativity, failings and disappointments–a grand habit to encourage depression, powerless and stagnation.
    . By creating the fairy tale the client actually travels toward magical “healing” by fixating on life’s hurts.
    . By excavating trauma that the client successfully compartmentalized when she originally lived it.
    . By making the client feel more disabled through the paternalism and dependency of therapy.
    . By stoking an idealized, infatuated or even eroticized view of the therapist to which no mere mortal in the client’s life will compare.

    Therapy literature does little exploration of why clients might feel worse and a great deal of that–blames the patient. One has to wonder why mental health professionals appear so incurious about negative outcome.

  • Caly

    Caly

    November 12th, 2014 at 3:38 AM

    Thank you so, so much for this comment. It validates everything I’ve been thinking and feeling about my therapy experiences for so long. I thought it was just me thinking this way

  • ReThink

    ReThink

    August 15th, 2016 at 12:10 PM

    Very well stated. It is ironic how often when a mental health professional is challenged with doing a better job, or with some accountability for what they have done there is often the cliche “We are here to talk about you; not me.” Part of the problem is society has so many people graduating with some sort of soft science degree and therefore, there are plenty of people who have an inherent interest in defending this as a way to make a living. It doesn’t matter who it hurts on the other side. Then there is the stigma that the field has been very good at creating that pre-labels anyone who believes the field is ineffective as someone in “denial” without even considering the other side of the story. When society looks at anyone who challenges the field as though they have a disease, and views everything they say through that lens how can anyone ever see that maybe psychotherapy isn’t all it is cracked up to be?

  • Anon

    Anon

    September 13th, 2017 at 11:04 AM

    These are statements to think about before entering therapy. We used to hear you may ge t worse before you gt better. If you aren’t dealing with your problems with the right matched therapists you may get worse and not better.
    thanks for posting.

  • Nathan

    Nathan

    May 9th, 2014 at 8:11 AM

    perhaps saying “all psychotherapy will make me worse” is a myth, but it is disingenuous to say psychotherapy can’t regularly be harmful, as a significant minority of patients end up worse because of their experiences in therapy. This may not have to do only with “bad apple” therapists or “difficult” patients, but that when using potent interpersonal techniques in a charged relationship with steep power dynamics, things can go bad, despite the skill or intentions of the patients/therapists involved.

    So yes, most people experience some benefit from psychotherapy (though the extent of that benefit can be debated especially when viewed in conjunctions with the costs/risks of therapy), but it is also true that many patients will experience a worsening mental state. I wish therapists wouldn’t run from this fact and just acknowledge it upfront publicly and with their patients. . Therapy is an often painful endeavor that carries some risk, it wouldn’t be potent or professionalized if it didn’t.

  • Alexandre

    Alexandre

    October 21st, 2014 at 4:03 PM

    Hi World Wide Max,
    I read the article you posted and it actually doesn’t say much about how or why patients get worse, which I am disapointed of. Although, as you pointed out, it undeniably asserts that some therapies have bad effects on the patient.

    The second article is not available though. Would you be kind and post us a working link ?

  • disequilibrium1

    disequilibrium1

    April 8th, 2015 at 7:11 AM

    “But, it would be foolish of anyone to throw out the baby with the bathwater” is the kind of hubristic certitude that alienates some of us from the therapy industry. Not everyone can buy their authority figure performances.

  • Laurie

    Laurie

    June 6th, 2015 at 1:09 PM

    Thank you, this was helpful, I will try to remember to feel compassion for my pain. I had a childhood from hell, both parents insane and extremely violent. Therapy is really really hard, but the alternative for me is worse. I realize that my therapist is human and therefore not perfect. She does really well despite my endless litany of horror stories, she hangs in there despite the shocks. I know she really wants to help me, she is a trauma specialist. I am lucky to have found her.

  • ultraviolet

    ultraviolet

    August 6th, 2015 at 10:29 PM

    So…what am I supposed to do if therapy absolutely did make me feel worse? For some clients it is not a myth: supportingsafetherapy.org/clients/during-therapy/i-am-feeling-worse
    “From our current understanding, regardless of the therapy approach, any exacerbation or worsening of symptoms should only be short-term, be linked to exploring some difficult area that you were previously avoiding, and relate to the problem or experience that was the reason for entering therapy[…]Not everyone who undertakes therapy has a successful outcome, with somewhere around 30 – 50% of people leaving therapy with their problems largely unresolved and their feelings largely the same. Also, the majority of people who change in a positive way make somewhere between a 30% and 80% improvement in a helpful direction. “

  • Bea

    Bea

    August 24th, 2015 at 1:27 PM

    Calling it a myth is rich. Every therapist I met until now told me that at first you get worse, it is normal. Therapy might be helpful for some people, but others it can very well destroy. Unfortunately I am one of those who never got better. Besides, any time you will realise that the job of a therapist is mainly to tell you they are on your side, you did the best you could have done. They give you this idea that you have the right to be broken, and that you are okay the way you are, and then you leave their office and the real world people hit you right in the face, showing you that your therapist is just telling everyone the same story because it is their job. Digging around in the past is also terrible for someone who was severely traumatised, and by now it is not just my idea that therapists do not really know what to do and have no real way to heal you, no, they even admit to it. After years of therapy I am a welfare case, live completely withdrawn, I am alone, my future is gone for real, because now all I am is officially mental. I will never get a job again, I can forget about relationships, I have a problem with everything, even with talking to people or leaving the house. I wish I had not started therapy. I wish I had left my past alone. I wish I had not tried so hard to “heal”. It destroyed me.

  • ReThink

    ReThink

    August 15th, 2016 at 11:56 AM

    While the explanation in the article suggests the only myth is that therapy can make you worse because it can be painful, there are implied myths in the article itself. Just because someone believes therapy can make them worse, doesn’t mean they think that because it is painful. There ARE I believe a majority of therapists that are out there to make money and that is it. Convincing someone they have a “disorder” because they are in pain isn’t always helpful. There are some who have been benefited by therapy, or work in the industry, and their attitude towards anyone who challenges the field at all is almost cultic. Like a sick religion. I see it on this thread. There are articles about problems with the field. My biggest problem with the field, is it always wants to focus on everyone else getting better, but therapists themselves, are some of the slowest to admit maybe THEY need to get better at their approach. By the way, any cultic posters who want to discredit anyone who dares throw out the possibility that therapy can be detrimental will be greeted harshly; just a forewarning. Here is an article that is very well written showing how Mental Health professionals CAN make things worse. It isn’t a myth.
    madinamerica.com/2013/12/10-ways-mental-health-professionals-increase-misery-suffering-people/

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    August 15th, 2016 at 12:34 PM

    Thank you for your comment! This article is part of a series that covers many more myths that surround psychotherapy. Check out the rest of our series, as well as frequently asked questions about therapy in which we debunk many more myths and stereotypes, here: https://www.goodtherapy.org/therapy-myths-and-facts.html

  • Christine

    Christine

    March 27th, 2017 at 6:33 AM

    Hi I want to tell you about my grandson who is 13. His father was an alcoholic and died when my grandson was just 8. Inevitably, his parents had split up three years prior to his father’s death. My grandson is a very angry and troubled young man. He is recognised as incredibly bright but underachieving massively at school. He has no respect whatsoever for adults. Swears constantly and spends most of his time in isolation. He doesn’t hit other kids but he smashes things and is disruptive. Unbeknown, to my daughter the school arranged for him to have eight sessions of anger management. Since then he is utterly impossible. He will stand over you with his chin out and his hands behind his back, in total control of himself whilst you are frustrated to the very last degree. He will argue the toss with total strangers , for something as innocuous as bumping into his mum with a shopping basket, in fact he can’t go out of the door without finding an adult to argue with, and each time ends with him standing over them, or up in their face, saying nothing with his hands clasped behind his back. One day someone will either beat him to death or stab him. Anger management has certainly not helped him – he still has his anger, he still drives everyone to distraction, he still systematically winds everyone up – only now he is in total control whilst he does it and he uses his self control as a weapon.

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