Like most adults participating in any sort of small talk with someone you’ve just met, I often am asked what I do for a living.  It’s curious to me that some individuals seem to struggle with my answer.  I say “I am a therapist” and they say “oh yeah?, like physical therapist?” or “cool, my sister is a massage therapist” or “I thought about going in to speech therapy too”.  Then I usually say something like “no, no, I am a psychotherapist”.  “Oh, okay”, they reply.  And, then, this is usually the end of the conversation.   So this leaves me wondering – are we still not comfortable, even in 2016, with the idea of tending to our mental health? Is there still such a strong stigma attached to mental illness or even just emotional struggle that it’s a conversation ender or a small-talk buzz kill?  Unfortunately, it seems like the answer is still yes. 

According to the National Institute of Mental Health one in five individuals struggle with a mental illness.  Yet, despite years of national campaign attempts to reduce the stigma attached with mental illness, recent research by the NIMH indicates that 68% of American adults do not want someone with mental illness marrying into their family and 58% of adults polled reported that they were unwilling to work with someone with mental illness.  In this same study, it was reported that 56% of adults were unwilling to spend an evening socializing with someone with a mental illness.  What?!  Does that mean that over half of adults in this country are only willing to spend their free time socializing with those individuals who appear to have it all together?  This sounds like a boring evening to me.   I wonder if false assumptions about mental illness are to blame for this ignorance.  And, further, if these negative beliefs based on false assumptions are the foundation for some folk’s lack of understanding of psychotherapy. 

Understanding the origins of these false, negative assumptions surrounding mental illness is a complicated endeavor and requires exploration in the history of mental illness, current cultural norms and attitudes, accessibility to mental health care, recent media events, and a handful of other topics.  But, because this is a blog entry and not a doctoral dissertation, I will spare you the thorough report.  But, what I will do is write about what I know and what I believe to be one contributing factor into the misunderstanding of mental health and psychotherapy. 

My feeling is that if one has not experienced first hand what it is like to sit in a space with a therapist, create a secure and safe relationship with that therapist, and explore internal emotional struggle and/or external environmental struggle, then that individual has no real understanding of what actually goes on in the therapy room.  It is a mystery to them. And, because we are human and hardwired this way, we tend to doubt and steer away from situations and experiences that are unknown.
In my practice, I actively attempt to take the “mystery” out of psychotherapy.  It is not mysterious or magical or even hard to understand how it works and why it can help if we really simplify the process. 

I’ll start by telling you a secret, but you have to promise to not tell anyone!  We therapist, don’t actually do much work at all and we certainly don’t do anything to or fix anything for the client.  Instead, we create a “space” within the therapeutic relationship where the client can do his or her own work.   Of course we offer clarification, challenges to distorted though patterns, objective reflections and interpretations, and, most importantly, support while the client does his or her “work”.   

Another important factor in helping to demystify therapy is making sure the client knows that there is not a “secret” agenda on the part of the therapist.  This work is actually client driven – the client sets the pace and the tone.  The therapist walks along side the client while exploring issues and concerns rather than “lead” the client.  I like to use the metaphor of exploring an old and sometimes dark house.  Together, the client and therapist open doors and windows, explore main levels as well as attics and basements.  The client chooses where to explore and when to move on while the therapist “holds the flashlight”.  

Of course, the house in this metaphor can represent different things for different folks.  Perhaps the house can be about revisiting past hurts, grief, or even trauma.  The house can be something concerning in the present – coping with loss, life transitions, or struggles in a relationship or marriage.  We can use therapy for preparing for future events as well, like preparing for change or learning how to cope differently with stress and anxiety in upcoming situations.  Again, this is for the client to decide; the client directs the therapist as to what “house” or area of concern they are ready to explore. 

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“In wisdom gathered over time I have found that every experience is a form of exploration.”
Ansel Adams

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I agree with Mr. Adams reference to “every experience” actually being a form of exploration.  If you will grant me the liberty, I would expand and clarify further on this idea to say that our life experiences, good, bad, boring, ugly, etc. are in fact, an opportunity for self-exploration and self-understanding.  Only then, when we really understand ourselves and how our experiences shape us over time, can we change and feel more in control of our lives. 

As a therapist, I would like to support you while you do your own work of self-exploration.  Therapy does not have to be mysterious and it is certainly not scary – especially, when we do it together.   I’ll bring the flashlight.

Kate Fisch

Kate Fisch is a licensed psychotherapist and founder of Northside Mental Health. Kate’s clinical experience and area of expertise is in the field of eating disorder treatment and substance abuse treatment.