How to decide if you need a therapist

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I receive about fifty career questions each week. The questions have a predictable diversity, but not my answers. My answers are almost always the same advice: Know yourself better.

Watch:

Problem: My boss is a jerk. How can I fix it?

Advice: Understand what you can do differently to make people act differently around you.

Problem: My coworker got promoted instead of me but she does not work.

Advice: Understand why you are not as likable as your coworker and make yourself more likable.

Problem: I've been out of the workforce for three years and I want to reenter. What’s the best way?

Advice: Understand the unique things you can offer your network and an employer, then craft a resume that shows those things.

Do you see the pattern? Self-knowledge is what helps you solve your problems. Sometimes we can get it on our own. But if your problem persists, and you can't solve it, go to therapy. Therapy speeds up the process of gaining self-knowledge.

I can tell you that in my own experience, people who have been to therapy are more interesting than those who haven’t. (Which is the genesis of today's poll — I have a hunch that many of you have been to therapy.)

I will admit that I am probably biased about therapy. I have been going since I was five. My parents knew I was weird but didn't know what to do about it, so they took me to a therapist, and we sat at his desk, because play therapy had not been invented, and I wondered how he could have had such a boring job, and then he told my parents I didn’t need therapy.

But they kept sending me. Sometimes it worked: like when i was throwing up five times a day, on purpose, and I was in the mental ward with a great psychologist. And sometimes it didn’t work, like when I was depressed in college and my therapist made a pass at me, in his office, while I was paying him, and I couldn’t tell him off because he had prescribed me what was then an experimental dose of Prozac and I was hallucinating and I needed him to fix it.

Sometimes you don’t know if it works. Like when I went to marriage counseling with my not-now-husband. That counts as therapy even though you go together and usually there is not someone else in the room to distract you. Counseling worked because it forced us to look at what we would need to change to save the marriage, and my husband said forget it. He didn't want that change. So therapy helped us face the inevitable, faster. That’s what I mean by speeding things up.

Of course, in business, you don’t always want to work with those interesting, in-therapy people. My favorite people to do business with are actually the types who would never go to therapy unless their wives dragged them (a common reason for men to be in therapy, by the way).

But in NYC and LA, going to therapy is something to brag about. It’s like going to the gym. You are telling everyone, “Look! I take care of myself.” Really, going to a therapist serves like a good personal ad: “Look! I understand how to be with myself and other people.”

But now that I live in Wisconsin I realize that most of the world thinks therapy is only for people who are messed up.

Understanding why there is widespread misunderstanding about the usefulness of therapy is easy, though.

Just think: in general, the people who do well in therapy are very interested in understanding themselves and interesting in changing themselves to more effectively meet their goals. Then it makes sense: people in big cities are generally optimizers wanting things to be better and better and not generally content. People in smaller cities are generally content with what's in front of them.

So look at your weaknesses and ask yourself how much they bother you. If you have not been able to overcome them (and you want to), then see a therapist.

Remember those men I love to do business with—the steady, strong performer types? They've always had coaching. So if you don’t want therapy but you don't know where your weaknesses are to begin with, see a coach. But know that the people who cannot implement a coach's recommendations should see a therapist next.

Of course, maybe not everyone needs therapy. Maybe lots of people would prefer a more relaxed pace of self-discovery. In this vein, I'll leave you with a great poem by Hal Sirowitz, who writes about therapy:

Taking a Slow Train

You shouldn’t keep telling your girlfriend,

my therapist said, that she needs to be

in therapy. You might think that you’re

trying to help her, but she sees it

as an insult. Not everyone needs therapy.

Just like not everyone likes to take planes,

Some people prefer to take their time

& travel by train. And she may not want

to get rid of her anger right away. It

seems like she’s getting too much enjoyment

out of it by directing it at you.

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  1. curiously random
    curiously random says:

    I was seeing a fantastic counselor for a while. Made great progress, got my life on track, etc. Our sessions were very effective but it was a small town and he didn’t get a lot of business. His was not a lucrative practice.

    Then he started going to marriage counseling to make things work with his incredibly insecure and manipulative wife. Despite all the potential clients I sent his way, he closed up shop and got a regular 9 to 5 job working for someone else.

    I miss him. And no, I wasn’t screwing him. That would have taken all the fun out of our sessions. I preferred the mystery and “what if’s.”

  2. Kim Avery, Mental Health Counselor, Certified Career Coach
    Kim Avery, Mental Health Counselor, Certified Career Coach says:

    Speaking from a therapist’s point of view ~ therapy is beneficial for everyone. Our society lacks ‘truth-tellers’, people who love and respect us enough to lend insight into our difficult places. Some people are all too eager to cut us down, others to give us false praise ~ a therapist gives you the opportunity to gain genuine insight.

    We all have blindspots. If we knew what they were, well, they wouldn’t be blindspots.

    Love yourself enough to learn and grow as a human being. You will be glad that you did.

  3. IMK
    IMK says:

    I’m originally from Eastern Europe, and I don’t get the deep appeal of going to therapy to “discover yourself”. In Eastern Europe, you go if you are suffering unusual stress (marriage counseling, trauma, grief from losing a loved one) or if you have been diagnosed with behavioral/phychological problems. I can’t imagine that a person who discovers herself through therapy is any more interesting than a person who discovers herself through travel, books, or any other new experiences. I’m pretty sure that it’s the other way around.

  4. MJ
    MJ says:

    I have to qualify agreement on this with the note that sometimes it is NOT you – i.e. if your boss is a jerk, and the company culture encourages jerkdom, your self-knowledge will be better used in getting into a non-jerk setting than in being a narcissist’s victim.

    And if you are not getting ahead because you are in the wrong field or niche, don’t waste your time learning to conform to what you are not – again, use that self-knowledge to get to a more appropriate fit.

    Too many employers are too heavily invested in letting employees know that all problems are due to the employees not trying hard enough to be doormats, take the boss’s car for an oil change etc. – that is your classic manipulative abusive relationship. Ees should use the self-knowledge to strip the Emperor naked and flee to better places.

  5. xJane
    xJane says:

    I’d like to weigh in about my vote, since I voted “I have been to therapy and it sucked.” My husband has been trying to get me into therapy for some time, on the grounds that it’s good for just about everyone – he was in therapy after his parents divorced & thinks that everyone should have a bout of therapy under their belt. I am leaning ever closer to giving it a second shot, since he’s such a proponent, but my experience is that it’s just a place to vent. I have friends who do this by punching a speed bag, I do it with judo, and I really did not enjoy doing it with some random person with a degree. I hope that my next experience will be better.

  6. Rachel
    Rachel says:

    It’s interesting that Tiffany above says that her therapy is in writing and talking and teaching. Because therapy is talking, isn’t it. I think at the beginnings of self-discovery and learning is paying attention to other people and talking to them. Just like communication is the core of a good, functional relationship, it helps to talk things out in order to see them more clearly.

    So I wonder then why such a stigma is attached to therapy. Essentially, going to therapy just means having the balls to talk to someone who knows something about how the human mind works, rather than talking to a person who may need more therapy than you do.

  7. Diana Maus
    Diana Maus says:

    I’m surprised that no one has talked about the relationship between the patient and therapist? Many people need to uncover some blocking issues with other people (and life) through the transference with the therapist. Therapy is not just talking to someone who knows more about stuff than you do. It’s uncovering your feelings toward the therapist as a stand-in for your mother and father that lead to understanding why you react to the world the way you do (as angry, compliant, etc).

    I think it’s the first few months of life they say set the tone for how you feel about the world (mom and dad) and how you think the world (mom and dad) feels about you! Of course, everyone doesn’t go to therapy to understand how their parents’ affected their ability to attach, etc, but I bet a significant number do.

    Your ability to attach, trust, be truthful with and even have empathy for the therapist, are all clues as to your ability to tolerate relationship.

    That’s why therapy isn’t usually accomplished by do it yourself methods. It takes a skilled and compassionate person to decode your issues, one by one, over time, until you feel able to do this introspection and interpretation yourself. And even they have to see other analysts to make sure they are not projecting their own issues onto you. So it’s a dance, and a skilled one. That hopefully leaves the patient a little better able to “be” with others more comfortably.

  8. Dale
    Dale says:

    The ones we love or those who love us usually know us best. If the thought of using a therapist is repugnant or if it is too expensive, one should listen to what these select people have to say about us and pay it heed.
    The important thing though is to take the information objectively. Do not get hurt by someone honestly answering a question you asked. Take the criticism analyse it, and then work on fixing the negative issues. I have problems taking my own advice, but I know it to be sound.
    A therapist isn’t always a professional in psychology, your mom, dad, sibling, spouse, best friend or boss can serve just as well.
    My2centsworth

  9. Jennifer
    Jennifer says:

    I think family or couple’s counseling can help with communication issues, etc. But I have never found that individual therapy for anything but serious depression or clinical issues has helped much.

    I have a family member who has been in counseling for the better part of 40 years and, while I do not know what it discussed, it really has not helped her work on her own issues. If anything, she uses her counselors as paid best friends who tell her that she’s OK just as she is — which then gives her the license to tell everyone else that she’s fine and it’s everyone else that is negatively effecting her life.

    On the other hand, counseling can be helpful for a relationship, as a third and neutral party can cut through the crap and give the hard, cold truth better than two people with their own agendas can do themselves.

    Personally, I like Oprah – free, recordable, non-judgmental, exposes me to knew ideas and experts in various fields, makes me think about things differently.

  10. JimSerra
    JimSerra says:

    I just wanted to point out a small grammatical error. It should be interested and not interesting. No one is perfect. :-)

    ……very interested in understanding themselves and interesting in changing themselves to more effectively meet their goals. Then it makes sense…..

  11. sfordinarygirl
    sfordinarygirl says:

    Therapy helped me overcome my fear of men, dating and gave me the tools to become a strong, happy and healthy adult.

    Before starting therapy I lived clouded in fear and suffered from mild-PTSD. I couldn’t let go of the violence I witnessed in my family. It took 2 years of opening up about those fears, allowing myself to let go and free myself did I start to really become happy and more aware of my environment.

    A therapist provides you with a neutral unbiased opinion. Who else can provide an honest assessment of your flawed thinking? A best friend even as close or trustworthy can’t provide the same guidance.

    I’m a savvier, smarter and better person for therapy. It’s knocked some sense into my brain while I dated the wrong men for quite some time. I would’ve stayed in aggressive relationships if therapy didn’t question or ask me if that’s what is defined as “healthy.”

  12. Raina
    Raina says:

    Some of my friends swear by regular therapy as ‘maintenance’ (which is great) while others, like myself, have trouble opening up to a stranger about personal issues. It’s obviously just an individual preference. There have been times when I needed to manage my stress or overcome negative emotions, particularly during my divorce. A friend recommended the book It Can Be Done
    to me during the breakup with my husband and I’ve found it to be very helpful in rebuilding self-esteem and maintaining mental stability and good mental health. For those of you out there who might need some help but aren’t comfortable booking time with a therapist, this book might help you out too.

  13. blandspace
    blandspace says:

    I actually check myself into emergency room for depression 3 days after daughter born. I then went to doctor 4 times got meds. Quit going to doctor. Don’t want to be on medication. Took direct action to systematically work on the problems affecting me. Use blog as the couch. We normally know what we need to do to fix our problems sometimes.

  14. Bruce
    Bruce says:

    If you are reading this article, you need therapy, and I do NOT mean that facetiously. I believe that there is not a person on this planet that couldn’t use therapy. But of course the majority of them would deny that and therefore therapy wouldn’t help them. One must be open to it. So if something drew you to read this article based on the headline, and you are open enough to be reading it, then try some therapy.

  15. Bob
    Bob says:

    I am always trying to figure myself out, then I go through long periods of not wanting to know anything. Therapy unless you’re really sick and hanging from the chandelier seems like a narcissistic endeavor. It’s like, “I’m paying someone to listen to me. It’s my hour and only mine”

    Probably because everyone else is tired of listening to you. I was beat up and ridiculed by neighborhood kids when I was a child. I’ve never really gotten over that. Do I really want a therapist to ask how I feel about that. I feel bad, so now what?

    “Let’s explore how you are feeling bad, and how that might connect to your current situation of having no job, no wife, no kids, and no family to speak of.”

    Boy, I just saved 300 bucks. I should just end it now. Say I do come to terms with why I am feeling bad. Now what? There’s now a line forming of all the other people I’ll need to solve my problem. Why not just line up cash registers in a row? Better, is there anyone I can pay one lump sum to and problem solved.

    I say do some work at a food bank ladling out soup…and certainly before you’re IN that particular line. I can make a argument that life is all about lines. And which one you’re in. Excuse me, that’s what the therapist is for.

  16. Howard
    Howard says:

    Ms. Trunk is a bunch of hogwash. She is self-congratulatory, and seeking only money, notoriety, and bragging rights.

    Just listen to her radio bits or read her “stories”, and you’ll understand what I write this. Her attempts at being humorous are no more than some rip off of Howard Stern the shock jock.

    I listen to two radio shows that offered nothing close to any career advice. It consisted of only bathroom humor, and some other non-sense about her needing a date.

    I felt cheated of my time, and I hope to inform readers here that if you are seeking career guidance, go elsewhere.

  17. Steve
    Steve says:

    I am in therapy, and I have probably needed to go for a very long time. But, I was ready now, and I went. At the same time, I don’t think I am especially interesting. So, nice try. ;)

  18. Luke S.
    Luke S. says:


    Although I did enjoy your narrative, life just isn’t this simple. Sometimes the problem has way more to do with other things than what you, yourself, can do.

    • Luke S.
      Luke S. says:

      I was referring to this:
      Problem: My boss is a jerk. How can I fix it?

      Advice: Understand what you can do differently to make people act differently around you.

      Problem: My coworker got promoted instead of me but she does not work.

      Advice: Understand why you are not as likable as your coworker and make yourself more likable.

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