Long-Term Psychotherapy and Psychological Health: Sparking Healthy Debate

Earlier this month, Daphne Merkin wrote a long first-person piece, published in the New York Times, on her almost-lifelong relationship with psychotherapy. Merkin was very anxious as a child, and her parents took her to see a therapist to address her stress and worry. She stayed in therapy for the next 45-plus years (and still attends), trying a number of different therapists with different backgrounds, specialties, and attitudes toward both therapy itself and also toward the therapist-patient relationship. Merkin describes her own self-awareness, and expresses doubt as to whether she has made any valuable discoveries—asking, directly: “What exactly is the point?”

Merkin’s piece has drummed up quite a bit of discussion among therapists, journalists, and the general public. What is the point? When does psychotherapy work? Is it worth it? Is it ever not worth it? Is there such a thing as too much therapy? There is no single answer to any of these questions, because therapy is a little bit different for everyone. The efficacy of therapy has been documented where possible, specifically in helping people overcome depression and anxiety. These are a bit easier to measure, by quantifying how frequent and how strong the undesired feelings are.

But what about grief counseling, marriage counseling, therapy for survivors of abuse, coping with post traumatic stress disorder, or anger management? What of simply talking through the complex emotions of familial or romantic relationships, vocational struggles, and hard times in general? These things profoundly impact psychological health, and the value of working through them on an individual basis can’t be measured in a collective “worth it or not” way. In short, whether therapy is valuable depends on the client, what they hope to get out of the therapy, and whether they can find a therapist who helps them grow in a way that is meaningful and helpful to them.

© Copyright 2010 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

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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  • Huge

    Huge

    August 19th, 2010 at 9:51 AM

    There may be many reasons for Merkin’s unresolved anxiety. Her story is certainly an interesting one. Has she been going to the same therapist? Is her problem heredity? What Counseling techniques were used?

  • chloe

    chloe

    August 19th, 2010 at 10:09 AM

    for someone to be in therapy for so long and still not be able to find a solution is very surprising, not to mention very unfortunate for her.
    the reason could be that she is not implementing whatever has been instructed to her or that her therapists are using methods that are not suited to her.

  • Upaya Psychotherapy

    Upaya Psychotherapy

    August 19th, 2010 at 11:51 AM

    Interesting to see how much interest and response the article has sparked.

  • seeker

    seeker

    August 19th, 2010 at 2:42 PM

    Therapy can be extremely useful for most of us. The clarity and perspective we can obtain from a disinterested part can be priceless. But in the end, all change has to come from ourselves. When therapy guides and assists a person to make that change, it’s good and probably won’t need to continue indefinitely. But when a person leans on their therapist like a crutch and doesn’t make the internal efforts necessary for change, that’s when therapy is not only ineffective, but sometimes even harmful.

  • adam

    adam

    August 20th, 2010 at 12:08 AM

    her case needs to be studied deeply.it may well lead to the discovery of some unknown things regarding therapy and its effects and how and when it should be utilized for an individual.

  • Jon

    Jon

    August 20th, 2010 at 4:41 AM

    Think that there are people for whom therapy becomes more about repitition and habit, rather than about the effectiveness that they may see from it.

  • TG

    TG

    August 20th, 2010 at 7:41 AM

    I’m all for therapy because of all the great things it has done to so many people over the years and all its advantages over pharmaceuticals.But then too much of anything is not a good thing,is it?!

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