By developing a deeper understanding of what the pros and cons of therapy might be, you can better prepare for what to expect out of the process before your session.

In general, there are many benefits of therapy, and very few disadvantages or cons of therapy, with a few notable exceptions.

Pros of Therapy: The Benefits

Let’s start with a clear statement: therapy is effective.  The American Psychological Association adopted a resolution on the recognition of psychotherapy effectiveness, based on numerous research meta-analyses studying therapy.  These studies found that therapy is effective across for a variety of issues across a large range of populations. (even therapists go to therapy.)

Here are 3 pros or benefits of therapy that help explain why it is effective:

1. You are talking about your issues, instead of holding them inside.

It is difficult to appreciate how much better you will feel simply by beginning a process of talking with someone about concerns you may have previously held inside.  Many of my new clients will tell me after a first session what a relief it is to get out of their heads and into a meaningful dialogue with an empathic professional who is listening carefully.

2. You are speaking with a professional who is trained in understanding mental health, and providing treatment to improve it.

Let’s answer a common question – “is a therapist better than a friend?” – with a simple and resounding answer.  YES.  Most therapists are skilled (to varying degrees, depending on training and competency)  in sophisticated aspects of emotional presence, relational attunement, and empathy.  They should be good listeners, and just as importantly, use that listening to help you reach levels of understanding about yourself that you previously did not have.

Therapists are also trained in different types of therapeutic questions and interventions to help you identify and revise problematic thought patterns, understand and manage overwhelming feelings, and modify maladaptive behaviors.

Obviously, there are a range of techniques and approaches that were just outlined, and what you “do” in therapy will differ vastly, depending on the training and philosophy of the therapist who you are working with.

Although the first two reasons have benefits in and of themselves…

3.  Working with a therapist with whom you have a good alliance, connection, rapport, and bond will help you!

Each of these words explain the way that you feel aligned with your therapist.  Research finds that this relationship connection is established early in treatment, on an intuitive level, and that this bond has a huge impact on treatment outcomes.  Relationships matter!

If you feel like your therapist ‘gets’ you, that is going to take the treatment a long way.  Although your relationship with your therapist should be a professional one, with an established framework and boundaries, it is also comparable to other types of relationships in that there are varying degrees of fit.  For example, we all have different degrees of close friendships and dating relationships.

Cons of Therapy

The process of therapy really can’t ‘hurt’ you, unless it’s perhaps an exceptionally poor fit with your therapist.  From this perspective, I would reframe ‘risks’ of therapy, as disadvantages.  So what might those disadvantages of therapy be?

Let’s start by going back to benefit #3, having a strong therapeutic alliance.  The flipside would be not having a good fit with your therapist.  Lets explore this.

1. Sometimes you don’t have a good fit with your therapist.

When the fit is poor, therapy can feel like a waste of time.  All of this comes down to what style works well for you.  Here are some examples of poor fit:

The overly passive therapist

While there are some treatment approaches that encourage therapist neutrality – and this can be beneficial – some therapists take this to an extreme and say very little in sessions.   This can leave clients feeling unheard or alone.

The robotic therapist

This is a therapist who overly uses cliches like “how does that make you feel?” and doesn’t seem particularly imaginative or skilled.

The overly active therapist.

Some therapists may feel too active.  There are treatment approaches that involve skills-building, homework and other task-focused activities.  Some people love this type of structure in the treatment.  Others chafe at the amount of action, and feel that it detracts from being more deeply heard and reaching new levels of understanding.

The overly self-disclosing therapist

There is healthy disagreement amongst therapists about what is the appropriate amount to self-disclose in treatment.  In general, most therapists focus on their clients, and make limited self-disclosures related to the treatment process (e.g. what it feels like to be together, how it feels at certain key moments in a session).  Sometimes when a therapist and client have been working together for a while, the therapist may – in an appropriate manner – share a bit more about their lives.

This has been more highlighted in the age of online therapy where therapists may be working from their homes.  This is also true when a therapist has a home office for in-person sessions.  However, with that said, there are definitely therapists out there who are either poorly trained or disregard their training (for their own unaddressed psychological needs) and make the session more notably about themselves.

While this tends to be a rarity, if you start to notice a trend where your therapist is relating everything back to themselves, that could be problematic and is worth discussing and, if not positively resolved,  switching therapists.

2. Sometimes the fit is good, but as you get deeper in the treatment, you may become disappointed in your therapist’s response (or lack of response).

Let’s face it, therapists are human.  Sometimes there is a difficult issue that may unwittingly push a therapist’s “buttons” based on their own life experiences.  It could be anything, including timeliness, money, health, existential issues, relationship issues, etc.  Therapists are trained to recognize when they are having stronger-than-usual reactions.  In such situations, they are encouraged to seek professional consultation about this issue, or therapy to address underlying issues which may be getting activated.

However, it’s also important to recognize that these types of situations are also a tremendous opportunity.  The late Jeremy Safran, a psychologist who specialized in ‘rupture and repair’ in the therapeutic relationship, remarked that therapy doesn’t truly begin until there is a rupture (e.g misattunement, misunderstanding, disagreement, conflict, etc.).  Such moments allow therapist and client a chance to process what happened and come to a shared understanding that deepens the relationship.  It also may provide clients with a chance to talk about their feelings in a way that has not been possible in other relationships.  So while this is on the ‘con’ list of therapy, it also has the opportunity to become a ‘pro’  as well.

Which brings me to #3 in our list of disadvantages of therapy…

3. Shame can really be an obstacle to therapeutic growth (and intimacy in any relationship, for that matter).

If you’re someone who chronically feels like you’re not enough, and if you’re uncomfortable looking at yourself openly,  you may experience the process of therapy as a threat… even if you have a good reason for doing it.

Because therapy involves a therapist who is listening closely and empathically ‘mirroring’ you, if your own internal mirror is distorted with shame to begin with, you may mis-perceive that mirroring as reflecting something bad about you. We see only what we allow and believe ourselves to see.  Part of what therapy does is change these perceptions in healthy ways.  But it has the potential to feel exposing to someone who struggles with shame.

Therapists working with underlying shame issues (as is often the case with depression) should take things slow, provide emotional containment, and most importantly evoke curiousness (and even playfulness) to defuse the experience of shame in the treatment.

Read More: Where is Shame Held in the Body?

Therapy works… now make it work for you!

Hopefully, we’ve given you a feel for the pros and cons of therapy.  We could have elaborated on the benefits of therapy, but they speak for themselves.  We spent more time exploring possible risks of therapy because they are really interesting to think about – and because they can actually become benefits!

In a nutshell, the takeaway from this article is do your homework, talk to a few possible therapists, trust your instincts and pick someone who you feel confident is a good fit for you.  That will go a long way towards predicting the outcome of your therapy.  But if for some reason, it feels like something difficult or complicated is coming up in therapy, talk about it with your therapist!  Chances are your therapy will actually improve and you’ll learn more about yourself.  In what other endeavor can ‘pros and cons’ of therapy actually become ‘pros and pros’?