By Alice G. Walton
Some people are under the misapprehension that therapy is for wusses. This couldn’t be further from the truth. As Richard Taite, founder of Cliffside Malibu and big proponent of behavior change, told me earlier this year, “Not only do successful people not fear therapy, they embrace it…. Psychotherapy is a tool that creates success. Smart people use it.” And therapy is not just something that smart people use, it’s something that most everybody should probably try during at least some point in their lives.
Here’s why: Many of us grew up under the impression that internal stuff shouldn’t be discussed – it should be swept under the rug. This is perhaps the single worst thing you can do for yourself. Stamping down your emotions and not working through your psychological issues – especially serious pain or abuse in the past – can culminate in a host of problems. If you need a numbers-based reason to convince you, depression alone is a major player in the global burden of disease, the leading cause of disability worldwide, and responsible for billions of dollars a year in lost work.
To discuss the benefits of therapy, I spoke with Marian Margulies, PhD, a psychologist in New York City and candidate in psychoanalysis at the Institute for Psychoanalytic Education at the NYU Medical Center.
The beauty of “talk therapy,” especially forms like psychodynamic, is that it addresses not just the symptoms but also the causes of one’s problems. Antidepressants, though essential for some people, don’t exactly get to the underlying source. “If you’re not getting to the cause of the pain,” says Margulies, “you’re essentially chained to the past. Psychotherapy gets to the root.”
#1. Therapy’s effects persist over the long-haul
A huge benefit of talk therapy is that its effects are long-lasting. This is because you’re not only working through stuff, but you’re also developing the tools to help you deal with future stuff. “Psychodynamic treatment is durable over the years,” says Margulies. “The positive gains continue and grow over time as though some of the work gets further consolidated after therapy stops. This makes sense to me because it suggests that we continue to use the reflective lens in thinking about, talking about and expressing feelings about our inner lives after we end treatment. The whole talking-with-the-therapist process gets internalized so that self-therapy picks up where the actual therapy leaves off.” Though medication may be essential for some, it does run the risk of relapse after it’s discontinued. The “getting-to-the-cause” aspect of therapy is a big reason why antidepressants and therapy together are believed to be most effective.
#2. Physical symptoms get treated, too
Psychological trauma, or even general ennui, can trigger physical symptoms – and depression and anxiety are well known to have significant, and sometimes debilitating, physical effects. Going to therapy, assuming it’s successful, can help these issues fade away. “There have been some studies that show that many physical ailments are ameliorated when someone engages in therapy,” says Margulies. “When people do not express feelings but swallow them and keep them buried and out of conscious awareness, one’s body often reacts. It acts as a barometer that reads: danger! Something is amiss and needs attention. Somatizing via stomach aches, headaches, sleeping problems, and ulcers are just some of the ways our body reacts to stress and psychic pain.”
#3. Repressed emotions will come back to haunt you later on
The most serious drawback of not talking about things may be that unexpressed feelings and traumas can pile up and explode later. “Lots of people avoid talking about their feelings about a whole host of things,” says Margulies. “But repressing or damping down one’s feelings doesn’t make the feelings go away. If anything, they linger and fester, only to explode when an innocuous comment is made.” Even if you don’t have a full-on breakdown later on, not fully processing events and emotions often creates negative thought patterns that can inform every area in your life – your relationships with your spouse, parents, kids, coworkers, and even yourself. So learning how to process them can change how you maneuver in many different ways.
#4. And the passive-aggressive shtick will fade away
When you work through ancient (or recent) anger, it actually gets processed so that it no longer has to seep out passive-aggressively. “Angry feelings are often expressed in a passive aggressive manner rather than a more direct and less aggressive manner,” says Margulies. “Someone who feels slighted might make a sarcastic remark in return, or not show up at an agreed upon time, ‘forgetting’ the appointment.” So get rid of the passive-aggressive form of expression – your loved ones will thank you.
#5. It will give you a whole new perspective on other people, too
An awesome benefit of therapy is that it not only helps you understand yourself better but it helps you understand other people. When we hold negative thoughts in without processing them, they become ingrained so that we see the world through that lens – and we make lots of assumptions that may or may not be true. “In my work with people in psychoanalytically oriented therapy,” says Margulies, “they come to see how they often make assumptions about what the other person intended. Then when they actually do a reality check by asking a friend what they were thinking when they said something, they are often surprised to hear they had a totally different take.” Without the clutter of your own (often mistaken) assumptions, it’s a lot easier to understand others’ intentions and motivations.
#6. It helps you deal with future curve balls
Since big and small problems are going to come up from time to time, knowing how to deal with them in a healthy way is an essential skill. “Conflict is a part of everyday life,” says Margulies. “It’s helpful to be aware of one’s feelings around conflict. If, for example, you are angry with your boss who is piling up work for you when you are getting ready to go away, you are bound to feel resentment and conflict. By reflecting on what’s going on outside (your boss’ demands) and inside (your mounting anger, irritation, and fear of losing your job if you say ‘no’), you are in a better position to resolve the conflict. Talking things through with someone and reflecting on what feelings are evoked, and why, leads to a greater understanding of oneself. Then one is freer to think of ways to respond in a more proactive way.” Learning how not to get swallowed up by events, but instead how to form a game plan to deal with them, is the key (and it takes a lot of practice).
#7. Talking about things gives them shape
Have you ever noticed how turning a problem around and around in your head often gets you precisely nowhere? It’s so easy to feel dwarfed by a problem when it’s just an amorphous blob in your head – but talking about it gives it a beginning, middle, and end. And that helps you wrap your brain around it. “When I think of the process of engaging in talk therapy, I think of the analogy with writing,” says Margulies. “The more you write, the more you know what you are trying to say – it clarifies your thinking. Similarly with talking and with talk therapy, one becomes more aware of what is making one feel anxious, sad, angry or frustrated. And then one is freer to decide how to manage these feelings or take action to alleviate them.” Even if you can’t get to therapy, just talking about a problem with a friend can be helpful: Lay out the issue, and it will become clearer, more logical, and therefore more manageable.
#8. You know you’re not alone
Seeing a psychologist can be a huge relief in-and-of itself since you know you’re taking action against what ails you. It also comforting just knowing that you have a built-in support structure that you can go to once a week. And, if you’re so inclined, joining a support group for people grappling with similar issues as you – say, divorce – can be very helpful. “If one, for example, is newly divorced and feeling sad and lonely, then joining a support group might help alleviate some of the painful feelings.” Not that misery loves company, but it is true that being with people who are dealing with similar issues can be very reassuring.
#9. It will rewire your brain
One of the coolest things about therapy is that it can bring about change at the level of the brain. We think of medication as changing the depressed brain, but there’s very compelling evidence that talk therapy does the same. With brain imaging methods, psychotherapy has been shown to alter activity in the medial prefrontal cortex, the anterior cingulate cortex, the hippocampus, and the amygdala. These areas are involved in self-referential thoughts (“me”-centered worry thoughts), executive control, emotion, and fear. (For some interesting research and reviews, see here, here, and here.) One very effective method, cognitive behavior therapy (CBT), helps people identify the negative thought patterns they fall back on habitually – which are no doubt wired into the brain like deep ruts – and replace them with new and more positive mental habits. In addition to helping people experience fewer symptoms of depression and anxiety, it, too, seems to bring about brain changes that are measurable.
#10. You won’t have to self-medicate anymore
Self-medicating to “deal” with psychological stuff is incredibly common. But it doesn’t do anything to actually address what’s going on – it just masks it. It also creates an addictive cycle, which may exacerbate the real problem. Getting to the root of your past stuff in therapy will, with time, obviate the need to self-medicate. When you’re no longer living by the negative things in your past, the need to avoid them – and yourself – will disappear.
#11. It enables you to teach the next generation a better way
The best thing about dealing with your own stuff is that, if you have kids, it helps you teach them a better way. For those who grew up in households where stuff just wasn’t talked about, look how many decades later we’re still dealing with the fallout of that method. “Parents can help their children learn a vocabulary of feelings early on by modeling it themselves,” says Margulies. “This gives children the feeling that it is not only okay but healthy to express themselves through all the colors of their emotions. That it is important to express anger when they feel they’ve been ignored or unfairly treated or when someone says something hurtful. The alternative is to repress the feeling, feel resentful, perhaps act out one’s anger in defiant behavior. The time to start talking about feelings is as early as possible.”
People are starting to open up more about their personal struggles and mental health issues. The stigma seems seems to be fading, if slowly. If you feel therapy would benefit you, go for it. And if you can’t, talk with friends – they will be grateful you opened up and it may give them the green light to do the same. Chances are it will help kick off some important dialogues.