What’s Really Outside the Realm of Therapy?

People find a therapist or counselor for lots of different reasons. Some of these reasons fit neatly within labels that we clearly recognize: depression, anger management, anxiety, OCD, PTSD. These labels rarely describe an individual’s whole experience, and many people’s problems don’t fit the criteria for a specific “diagnosis.” But they’re just as real. Browse a list of common therapy issues and you’ll find everything from irritability, isolation and emptiness to shame, midlife crisis and worthlessness. These aren’t disorders or conditions, but they’re real psychological and emotional challenges faced by real people.

Take worthlessness as an example. In a recent piece for CNN, researcher professor and author Brené Brown addresses worthlessness by exploring our society’s shared drive for the unattainable: perfection. There’s no question that perfectionists can do great work, and that challenging ourselves and setting high goals can be healthy. But as Brown notes, we’ll never feel good enough if we use “perfection” as our finish line. We can never attain perfection in ourselves, so if we tie our feelings of self worth to our ability to meet impossible expectations, we’re just setting ourselves up for psychological and emotional damage.

So, is “I have unrealistically high expectations” a good reason to see a therapist? Yes! The purpose of therapy, of good therapy, isn’t to slap a label on everyone. The role of a therapist is to help patients understand how they work and what they can do to get to a better place that helps them thrive. In some cases, this means looking at thought patterns and road blocks that do have well-known names like “depression” or “anxiety.” But just as often, and even in cases with clear labels, the therapist and client talk through a lot more than that. A therapist can help analyze expectations and values, failures and achievements, and thought and behavior patterns that are tied into the mix. If it’s a thought or feeling that’s disrupting your sense of well-being, it’s well within the realm of therapy. That’s what therapy is for.

© 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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  • jess


    November 19th, 2010 at 9:51 AM

    Yes! having too high of expectations just sets you up for disappointment. learned the hard way, it’ll ruin your relationships and give you low self-esteem

  • KS


    November 19th, 2010 at 2:59 PM

    Therapy can be helpful for a variety of reasons and no real psychological problem is out of the realm of therapy in my opinion.

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