Is talking to a therapist enough?

It’s enough for some people.
However in more severe cases, medication can alleviate the symptoms of depression while therapy can work at addressing the root causes.

Therapists will not talk to their friends about what you said in confidence. Friends are not limited to this restriction.

I dunno. For me… It’s because they’re not a friend. Friends aren’t listening to you because it’s their job, I guess. Friends are listening because they actually know you, and actually care about you.

I didn’t find much to like about the therapist I went to, and as soon as I get him paid up, I’m looking for someone new. He doesn’t have the empathic manner I expect in a person I am paying to listen to me. He has a sense of humor, but it seems forced. I want a therapist that can enjoy a good joke, and not look down their nose at me when I break into tears, because the truth be told (and as some of you have surmised) I am one fucked up, irrational, damaged and wounded creature with more baggage than the Lost Bag Dept. at Heathrow Airport. The anger is often a self-defense mechanism.

As for the confidentiality of the doctor patient relationship, don’t take that for granted. I found out the hard way that doctors talk, and that what they say can come back to you.

Therapists aren’t there to talk, they are there to listen critically to what you say, and then help you design effective cognitive and behavioral strategies to assist you in dealing with daily life in a less maladaptive way. Talk therapy went out with wife-swapping at Esalen.

I’m actually thinking of talking to my therapist about an issue I have that is bothering me. I don’t think I want to talk about it with my friends because I am anticipating they will be judgmental, though loving. I have built up a very trusting relationship with my therapist over many years and while I don’t go regularly any more, I do go for a tune-up occasionally. I trust her not to be judgemental but to have good judgement.

and yes, pd – I admit it – I’m nuts.

Also, people going to therapy need to let go of this idea that they’re crazy. Most people who go to therapy are just looking for help with a problem or problems. That doesn’t sound very crazy.

Therapists have no bias either. They won’t feed into your emotions the way a friend will.

If may be enough for some people, but definitely not all. I’d rather talk to a therapist than a “friend.” Therapists should be more knowledgeable and unbiased. Hopefully they also don’t bullshit you.

@DrasticDreamer I gotta agree with you. I’ve never been to a therapist & I never plan to. It’s not because I’ve never needed it, maybe, LOL. But I just could NEVER bare my soul to a stranger. To them, you’re just another patient. Another boat payment. Get the file, listen for an hour, & you’re out the door. Big deal. With the issues I have, I’ve found a good friend who actually listen to me. It’s silly, maybe, but I think my problems are none of their business. I know it IS their business profession, but I would never divulge personal things to a stranger. I want to talk to someone who knows me, understands me & truly cares about me. I’ve been lucky. When I need to talk, I know exactly who to go to. Actually, I have 2 who I can go to. Neither one has ever let me down.

A good therapist teaches you to talk to yourself, while you oughta be your own best friend anyway.

I have been to several therapists, and concentraited on one who was very helpful.
Therapists are much better than friends at listening to troubles, because of their training, and also because they don’t have the baggage most friends carry. I have friends I can say the same things to, but the therapist is the one who actually guides me thru the pain and judgement, and gives me direction.

Friends can tell you what to do, therapists can’t. Or at least they’re not supposed to.

I didn’t like talking to a therapist because I felt disconnect. I don’t do disconnect.

Just talking to a therapist would not be enough for anyone. If you have a good therapist that actually encourages therapeutic practices, then you have to put what they tell you into action.

Talking to friends/family can be beneficial unless they are the reason you need therapy.

I think it depends on what you’re looking for.
I go to a therapist when I want to vent with no biased judgment on the other side. And sometimes to discuss the larger issues I notice developing within me. Or ask questions about it from a psych standpoint (very handy when my roommate was suicidal).
I go to my friends when I want to cry, when I want them to hug me back, when I’m looking for advice. Basically when I want something more intimate and responsive.
You can ask your therapist to go about your sessions differently if you can put a finger on the problem, but if it’s a matter of intimacy, friends really are the better way to go.

I agree that having both is very helpful. Especially when I need to vent about the friends in question.

Therapists are trained in skills that help you move towards certain goals. They are unmotivated by selfish needs as are your friends (who are not trained).

I have some therapy training myself and can tell you it is quite complicated and very client-centered. It is absolutely nothing like talking with a friend for so many reasons you’d hate me if I started listing them.

However therapists have to keep personal boundaries. They cannot let you get too close to them personally and they cannot get too close to you personally. That is one reasons friendships are so valuable. Because you get to establish mutual boundaries that are often much closer in relational (not therapeutic) terms. You can never have a personal relationship with a therapist and because the work you do with them is so personally close to the heart that can often be very dissatisfying. Another benefit of friendships is that they take place in multiple settings and often just having someone with you in a certain setting can be therapeutic. One move I would like to see the therapy field make is towards establishing boundaries that allow for community-centered work. For example in the Native community sometimes therapists accompany their clients to SweatLodge ceremonies and this has been found to be very helpful.

On a broader note: You can say anything to a therapist and, by law, they can’t pass it on to anyone. You likely already know this but this isn’t always true. Therapist have to pass along certain information although must info. they have to keep confidential. I can’t tell you how strongly they define the differences and train employees to recognize what is reportable and what is confidential.

I went to a pastoral counselor for many years. He was a Methodist minister who became a counselor. HE never injected religion into the relationship although I think he personally was still a very religious man.

I think he saved my life or at least helped me figure out how to live it without pain, guilt or shame. It was an absolutely invaluable experience.

He encouraged me to attended 12 step meetings as well which are also extremely valuable and sort of fulfill the “friend” part.

Friends from real life tended to repeat cliches like the pull yourself up by your bootstraps and while somewhat emphathetic, really didn’t have the answers as to how I could change what was going on inside.

They both have their place, but if you can only have one or the other, a good shrink is preferable in my opinion. BUT you have to find the one who is right for you, just like meetings, you have to shop until you find one that feels like home.

Some people find that talking their problems out with a therapist works wonders, because they have to actually verbalize what is bothering them, and the simple act of bringing it out in the open gives them the incentive they need to solve it. For these people, a process called “peer counseling” is useful. (There are a lot of internet sites with helpful information)

For many of us, the act of talking to and receiving some helpful tips and ideas from an experienced, licensed psychologist is a better way to go.

Some people are in need of a full-fledged psychiatrist, with the extra medical and psychological training necessary to treat severe psychosis and other issues that could require medical intervention.

@Iclamae put his/her finger on it for me. You can cry with friends. You can get a hug. They can express that they care. Therapists can’t do these things. With therapists, it’s all mental. You get analysis, but not really support. Maybe that’s why support groups are an effective part of therapy—the people in a support group can provide what therapists can not.

There are times when I need someone to care, and all I’ve got is a therapist. I think that’s what really bothers me about therapy. All I can say is that if you have friends you can share anything with, you are a very lucky person.

@daloon Maybe I’m just unusually lucky but I always get a hug from my therapist.

@janbb – Now that you mention it, I often got a hug too. It was nice.

I do think you have to shop for the right person. After my association with the pastoral counselor (he died at 53 of a massive heart attack), I tried many different types, psychologists, another pastoral counselor and assorted therapists. I never found another that really fit so from then on, I just went to meetings. If I felt the need, I would again try to find one with whom I felt comfortable.

@daloon The right therapist for you would give you a hug or a hand on your shoulder.

Maybe so. I like my therapist. She’s been really helpful, and I feel lucky to have gotten the right one the first time.

I am not interested in a hug from her—or any therapist, for that matter. I am willing to pay someone to advise me, but I am not paying anyone to like me or care for me. If I get a hug, I want it to be from someone who likes me for me, not because I’m a client.

Friends can be enablers since they are not trained in therapy. When I lost my father I first looked to my friends for help. I told my best friend that I was having trouble thinking about the idea of losing him (denial) and wanted to talk about it. Most of the advice I got was utterly the opposite of what would have helped me overcome my problem. It is wonderful to have a person that can be close in friendship and trusted to listen, but in this case you are missing the therapeutic part that is needed. The bias associated with friendship can ruin the chances of getting real therapeutic help from your friends.

It may be that we seek enabling from therapists and that’s what seems to be missing. In friends the simpler answer to make you feel better is almost always not the long-term health answer. We may subconsciously seek the simpler answer when we are confronted with a more complex and involved solution requiring more patience from a therapist.

A lot of what a therapist has/is able to provide for you depends on where you are seeing that therapist. In a private practice, people are able to tailor to the client more than in a setting like Behavioral Health. In other settings, therapists are able to make different connections based on their personal comfort level as well as the organization they’re working with.

I didn’t like working at BHS because of the list you had to get through. Since I’ve had more than a little post-grad training in therapy, rather than just a BS Psych, I’ve become accustomed to the differences. My favorite thing was working in the homeless shelter that I worked in doing parenting group and individual sessions as necessary. The setting really has a lot to do with the way someone connects with a client (and they were all considered my clients there) as well as the requirements of the place that the therapist is working at. The more informal the easier it is to connect, the more the organization requires generally the less connection is possible.

The main thing is that the job of the therapist is not to give advice, but to guide you into thinking about things differently, finding new solutions to old problems, and developing skills that someone can use in the future. Friends are able to give advice, not follow a checklist of “things to get done this session,” not have to worry about audits and reviews of what was done and why wasn’t this (and on and on), and a host of other things that therapists are simply unable to do.

Suspected harm to self or others, abuse of children, elderly, disabled, and under subpoena from a judge are the times when a therapist must step into their mandated reporter role and/or break confidentiality.

@Iclamae and @Shuttle128 make some great points on this topic.

I’ve seen therapists on and off for a few years, and for me, it’s usually been a pretty positive experience.

I’m the kind of person who puts the needs of others before my own, which sometimes makes it hard to talk to people, even my closest friends. I often feel like I’m burdening them, or that I might make them upset/uncomfortable by telling them about all of my problems and insecurities. With therapists it’s different, because that’s what they’re for: listening and helping with your problems. They are trained with dealing with others’ problems and making good suggestions on how to find solutions for said problems. Because of that, I find it fairly easy to open up to a therapist (once I’ve gotten to know him/her) and tell them things I wouldn’t tell other friends. The confidentiality thing is also a plus, especially when I start discussing things I don’t exactly want spreading through the general populace.

Like you, @daloon , I don’t want a hug from my therapist. I want someone who can give some perspective on my issues, not just an “I’m sorry you’re unhappy” sort or response. That’s what friends and loved ones are for.

That’s why I think that depressed people should use both friends/loved ones and therapists for support. Each can provide types of help that the other cannot, as long as they (both the therapists and friends) are people you can really trust.

Some patients have to complement their therapy by using medication.

@mattbrowne Is there a difference, really, between therapy and medication? It is my understanding that medication is actually part and parcel of the treatment process, also known as “therapy”.

@YARNLADY “Therapy” is talk therapy. Drug therapy can be a part of it, but is most often not a part of it. “Drug therapy” is referred to as “medication” or “meds” and is only necessary in some cases. Most definitely not all cases.

Part of the stigma of receiving mental health care is the idea that all people who do have to be drugged up zombies spilling their innermost everything to someone. And part of the problem is people who push that idea.

@YARNLADY – Well, biochemically speaking there might be no difference. Talk therapy sometimes changes the brain more permanently, while medication wears off. However, there’s interesting research on trauma treatment using experimental one-time drugs. When the traumatic event happens during the day victims supposedly can take a pill which changes the mechanisms of the hippocampus during sleep. I think I heard about this when watching some tv documentary, but I can’t find any web resources on the subject.

@avvooooooo – Not all drugs turn patients into drugged up zombies. An example are the classic tricyclic antidepressants.

@mattbrowne I’m very, very well aware of that. Not only because of my expereince in mental health, but my personal experience with anti-anxiety use of SSRIs and NDRIs.

What I was talking about was the public perception of psychotropic meds and therapy and the stigma that’s attached to mental health care, as stated.

We intrinsically need to be known, understood, cared for, and it doesn’t always feel authentic when we are paying someone to fill that need. Therapists have emphathy; they seek to understand our feelings and the reasons for them. Friends have sympathy; they share/reflect our feelings. At the same time our self-worth is reinforced when someone gives their time and risks their own emotional state to listen to us.

@avvooooooo – Thanks for the clarification.