What not to Hope For When Considering Therapy


It is important to set realistic hopes and expectations for therapy while you are in a process of searching for the right therapist who would match your needs. From my personal experience and after listening to the stories of others, I’ve got the impression that much disappointment and even harm in therapy can be avoided simply by adopting a realistic vision of the therapy process.I’ve discussed some general things one might expect to happen on the first therapy session. It is difficult, however, to give you a heads up about what to expect from therapy in general. Everyone’s therapy is unique as it has to do with one’s individual goals, with how a particular therapist works, with the therapist’s and the client’s personal compatibility, with the severity of the problem, with the therapist’s level of experience and competence, with the therapy settings (private vs. clinic), with the client’s financial situation and the number and the frequency of sessions they can afford and other factors. All those variable would be different for each person and their combinations would make everyone’s individual experience unique. Thus, instead of describing a typical therapy experience, it is much easier for me to say what is NOT going to happen in therapy and/or as a result of therapy so you could adjust your expectations accordingly.

The following are some of the things that are very unlikely to happen to you when you are in therapy, therefore, if any of those things is something you are hoping for, I recommend you to let go of the hope before your first therapy appointment or else you might set yourself up for a big disappointment or even trauma.

  1. You will not miraculously “heal” or “fix” your issues or become forever happy as a result of therapy.

Therapy is not a work of miracles. What’s more, to be brutally honest, often times it may not even drastically improve your mental conditions, at least not long term.

Given the big disconnect between the objective findings of neuroscience and the practice of psychotherapy, between the current trauma research on the one hand and the most common psychotherapy methods on the other hand, the actual therapy practice is largely experiential, and the experiments sometimes go well and, at other times, not so well. This is the reality that, most likely, won’t be disclosed to you by most therapists when it should be.

You may ask why get therapy at all then? If there is no guarantee of healing and resolving one’s problems, why waste time and money? And why submit to a risky experimentation that may not produce good results and may even be harmful?

Yes, therapy does carry a risk of harm, but, as a former therapy client, who has been both helped and traumatized by the experience, I will say that it is still worth going through the experience, even if the outcome is not exactly what you were hoping for.

First off, some degree of healing and problem resolution often does take place in therapy regardless of what else happens. If you decided to come back after the initial session that means you found it to be of value. As you continue, you may notice that therapy overall is a mixed bag of positives and negatives and it would be up to you to decide if the positives are important enough to tolerate the negatives and for how long.

While you won’t find eternal happiness as a result of therapy and while many of your life dilemmas will remain unresolved, you might learn better ways to approach problem solving and better ways to cope with circumstances you cannot change, and this is no small achievement. Some problems may be resolved completely. You might get new insights, new visions and perspectives that will enable you to see opportunities where before you could see none. You might find it possible to change situations you thought you couldn’t change or to expel them from your life completely.

If feel that therapy facilitated your personal growth, if it helped you to learn some important life lessons then it “worked”, even if some parts of it were disappointing or even traumatic. Important note: This is NOT to say that traumatic experiences in therapy are justifiable or should be accepted as normal!

2. Your therapist will not be competent enough to deal with all of your problems

This one has a lot to do with the subjective nature of therapy and also with the fact that we, as human beings, are extremely complex and the full picture of what’s going on in our mind-body system is too big for any practitioner to grasp entirely no matter how good they are at what they do.

Therapists. as human beings, have their limitations just like all therapy methods have their limitations, and, I have to say, those limitations are rather big. This will force you to deal with the fact that a particular therapist might be good at helping you to deal with certain things at a certain stage of your life for a certain time period, but, as soon as your needs change and you find other things you’d like to work on, that particular therapist may not be able to accommodate your news conditions. Hopefully, the therapist would be honest enough to own their limitations, to make a nice closure with you and, if necessary, to assist your transition to a new therapist. If this doesn’t happen, which is often the case, unfortunately, do not stay with the same therapist long after you realize that they can no longer offer anything of value to you.

3. Therapy doesn’t work like a pill

Despite what you hear about mental health conditions from the mainstream media, mental, emotional and psychological problems cannot be approached the same way our traditional western medicine approaches physical symptoms when it just tries to get rid of them by prescribing pills or procedures. It is ignorant to deal with physical ailments this way because masking the symptoms doesn’t address the root cause of the disease, but applying this approach to the field of mental health where objective data doesn’t get obtained is beyond ignorant, it is simply ridiculous.

I don’t want to get into discussing psychiatric drugs because this is not the main focus of Therapy Consumer Guide. This subject is big and always triggers contentious debates between the two sides of the argument, the one that advocates for the drug use and the other that advocates against it. I can just say very briefly that while I believe that psychiatric medications have their place in mental health services, as there are situations when taking care of the symptoms may be a priority, they are not THE cure of the problem just like any other drugs, as they don’t address the root causes of the problem.

The focus of this website, however, is non-medical psychotherapy, the so-called “talking cure”, which by design cannot have any procedure/method that would work like a drug that is in a predictable manner with a predictable outcome. When the service is delivered through the means of conversation, that conversation cannot be controlled and it’s outcome cannot be predicted. Therefore, any notion that a therapist would “know” any specific way of talking that would target and reduce a client’s symptoms in a reasonably predictable way, just like a drug works with physical symptoms, is nonsensical and, with that, the entire medical model is nonsensical when it applies to counseling aka talk therapy.

When considering therapy, please know that while it’s important to have clear goals for yourself the way towards achieving it will not be straightforward and linear as it often happens when you work with medical doctors. It may also happen that during the process you might discover new problems you weren’t aware of before and you might resolve something that you didn’t intend to address at all. It might also happen that your initial goals may change and your initial problems may not seem like a problem any more.

Our emotional lives are rich and complex and have many parts and layers that are deeply hidden from our conscious awareness while, at the same time, the objective factual data related to human psychology is very scarce. So, don’t expect your therapy to be a straightforward, linear process in which your problems will be resolved one by one by following the therapist’s instructions/suggestions as you proceed, in the same way you’d expect it to be done when you work with medical doctors.

4. Therapy will not help you change other people

The purpose of therapy is to work on yourself. It is not for you to learn how to change other people or how to manipulate them. If you go to therapy with the hope to change someone, you’ll be wasting time and money and you’ll end up disappointed.

If the therapist you’ve hired is wise and experienced, they would not engage in discussions of other people unless it’s related to your own emotional process and creates a context for you to better understand yourself.  If the therapist is inexperienced and not very mindful, they might go along with your agenda, which may feel good temporarily but won’t bring you what you are looking for in the long term and that’s because no one has the power to change other people. We can change how we relate to them, how we react to their behavior and how we feel about it, but we can’t change them.

This is a rather big topic that deserves a separate post because it has some nuances that are important to understand. But the main point is this: if you don’t want to change anything about yourself (and that includes how you feel about yourself), there is no point in starting therapy. 

The above are the most common unrealistic hopes and expectations I know of that people have about therapy before they get into the process and understand what it is. It is important to let go of them before you start therapy in order to spare yourself the wasted effort, time, money but most importantly potential emotional suffering.


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2 Comments  comments 

2 Responses

  1. Reader

    Thank you for this post, and I agree. However, there may be some psychotherapists who are so eager to gain a client that they exaggerate the benefits. While I believe that practitioners who do this are in the minority, I did encounter one once who really pushed psychodynamic therapy and even warned of the dangers to me if I did not commit to therapy with him.

    However, I think that it can be a great benefit to patients who are down-hearted to enter therapy with someone who is optimistic and hopeful about life and about the patient specifically, so yes, I think we should be realistic, but try to nurture and foster optimism at the same time.

    • Marina Tonkonogy

      If the person encounters a therapist who gives them false hope and creates false expectations, this is exactly the situation in which information such as in this post can be helpful, and so this is the reason why I think informational portals like this one are so important. I should’ve, probably, suggested to be wary of therapists who misrepresent the reality of therapy either through exaggerating its healing power or through misleading the consumer by omission of the important information about the limits of therapy. On the other hand, this is one of the major messages I am trying to convey throughout the entire website’s content.

      I agree that therapists in general should project optimism and a sense of hope, but real hope and optimism only come from accepting reality as it is, not from false ideas that have no basis in reality. When the reality is accepted as it is, it makes therapy goals more realistic and achievable and makes a person feel more capable of achieving them, which, in turn, strengthens hope and optimism. Despite the fact that therapy is limited in how much it can do for people, a lot could be done WITHIN those limitations, which is a REALISTIC basis for optimism and hope.

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