A flurry of mental health-related articles have piqued my attention recently, many of which are worth writing about. We’ll start with one article from the New York Times’s new series, It’s Not Just You: A Times Opinion project on mental health and society in America today.
Huw Green, a clinical psychologist, writes in We Have Reached Peak ‘Mental Health’:
The contemporary cultural landscape’s recent zeal for mental health as an important good has been accompanied by a faith in therapy as the best way to obtain it. …
Therapy is important as a valuable health intervention for many, rather than a universal prerequisite to a good life. Most people simply cannot afford to have lengthy therapy, or it doesn’t fit with their cultural or religious worldview. Do we really want to suggest that this compromises their mental health or their ability to do things like parent well?
Recently, a man at work asked me if he should “get therapy”. A horrifying event happened in his life about six months ago. Someone who cares about him has been haranguing him to go to therapy. He wondered if he should heed that suggestion.
I have provided therapy. I’ve also received therapy myself, which I found both helpful at the time and since it ended. How did I respond to this man?
“The only person who can answer [if you should get therapy] is you.” (Which I realize is a shrinky thing to say that is also not helpful. I elaborated further, which is what follows.)
I don’t think there was ever a time that I thought that “everyone should go to therapy”. Can it be helpful? Yes. Can it improve your life in multiple dimensions? Yes.
Can it take a lot of time? Yes. Can it cost a lot of money? Yes. (Do you think about things you’d rather avoid? Often. Do you sometimes dread going to therapy? Absolutely.)
Could you do something else just as valuable and healthful with your time? Yes.
The thing about conventional therapy is that it has a heavy reliance on words. You have to be able and willing to use words to describe your internal experiences, whether they be thoughts, emotions, or behaviors. You have to be able and willing to sit in a room with another person for dozens of minutes, week after week, often for months, and sometimes for years while using words. (… though I personally believe that no one should be in therapy for many years: If you’ve been routinely seeing a therapist for five or ten years and your presenting concerns or symptoms have not improved, is therapy actually helping you?)
And you know what? Not everyone likes using words. Or using words is not one of their strengths. It is true that part of the task of therapy is learning how to use words as a skill and for therapeutic purposes. While some people will, in the course of therapy, learn to use words instead of drinking three bottles of wine a night or making superficial cuts on their limbs, some people will find using words difficult, uncomfortable, or artificial.
Therapy is often the most successful when people have clear goals (that they can express in words). It’s hard to say you’ve achieved a goal when you are unable to describe it through the specific medium of language.
Furthermore, much of the task of therapy is learning about yourself: How do you react to events in life? Do your reactions cause problems or difficulties for you? For others? Does your reaction serve other purposes in your life? (e.g., Are you always apologizing because you always believe that you’re doing something wrong, and this is how you absolve yourself?) What would happen if you viewed life events, whether internal or external, differently? What if you believed you could make different choices? What if the stories you tell yourself aren’t accurate or true?
Do you need to receive therapy to learn about yourself in this way? I don’t believe so.
People can achieve psychological wellness (note: wellness, not perfection, which is what the term “mental health” seems to suggest these days) through many non-verbal activities:
- playing a musical instrument
- listening to music
- dancing or other inspired movement
- walking alone
- walking with trees, mountains, and skies
- drawing, whether the process is seen or unseen
- running
- sitting, with or without spiritual practices like prayer
… and other things that don’t involve words.
People want to live healthy, meaningful lives. Huw Green is right: Therapy isn’t required for this.
Maria Yang, MD 