Why Do I Need Therapy?

Bill over at the Foster Care Blog posted on the topic of therapy yesterday. He shared his perspective on the question that many adopted children and their parents may ask, “Therapy: What is it and why do I need it?”

After reading his post and leaving a comment, I agreed to follow up with the discussion. Zheez. What was I thinking? This is a complicated topic and would take weeks to discuss. I’ll do my best to address central issues over the next couple of posts.

Let’s start with the first part of the question, what is it? I like this definition from Wikipedia

Psychotherapy is a set of techniques intended to improve mental health, emotional or behavioral issues of individuals, family members or a whole family’s interactional climate. Mental health problems can have both psychological, social and somatic dimensions. These issues often make it hard for people to manage their lives and achieve their goals. Psychotherapy is aimed at these problems, and attempts to solve — or help people themselves to solve — them via a number of different approaches and techniques.

The historical emphasis that psychotherapy has placed on emotional, behavioral, and social deficits is one of the reasons that many people today still shun therapy.

As Bill noted:

Many families, and individuals in families, will not admit that there is a problem, since that would indicate that they are somehow flawed, or that they are weak and can’t take care of themselves or their families.

Even the classic stereotypical imagery of how the process is carried out–with a patient lying vulnerable on a couch–is enough to make anyone skeptical at best and downright frightened at worst. It is no surprise then that classic responses from people recommended for therapy range from “Ain’t nothing wrong with me!” to “I ain’t crazy!” to “Hell no!”

As far as adoption is concerned, some of our children have histories that by definition make it extraordinarily hard for them to “manage their lives and achieve their goals.” Heck, some have backgrounds that leave them with not much of a life to manage and even fewer goals to aspire to. That fact alone points to one reason why therapy is sometimes needed.

I have a personal and professional bias towards resiliency in individual and family functioning. I have found that when I focus on my client’s strengths and successes, I encounter far less defensiveness and resistance about weaknesses and failures. That of course opens the door for addressing those very things, but without them feeling picked on and judged while simultaneously holding them accountable. This is particulary important in working with children and adolescents.

I wish more helping professionals approached psychotherapy and counseling from a strength-based perspective. The personal coaching profession has figured that out and people flock to it like birds flying south in the winter. However, simply endorsing a strength-based approach to therapy is not the magic bullet for helping children and their families to embrace the idea.

There are some basic assumptions in therapy that impact the willingness to participate in the process. Historically, therapeutic progress has presumed an ability to establish a therapeutic alliance or relationship with the treating professional. Trust is a core element necessary for forming any therapeutic relationship. Unfortunately, trust also happens to be the very feature of emotional functioning that has been severely damaged and sometimes completely obliterated in many of our children. That makes for a very rocky start and fuels the genuine confusion that lies behind the second part of the query: “Why do I need it?”

More on that part of the question tomorrow. Okay Bill, how’d I do?

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