Going to therapy was once something that happened in the shadows. It wasn't something you talked about in public, or even to your friends and family. Today, though, in some circles, the idea of therapy has gone from “stigma” to “something everyone should be doing.”
Therapyspeak is now common. “I'm in therapy” is something you'll see on dating profiles. Among some people, going to therapy is as much a part of being healthy as exercising and brushing your teeth.
Therapy has indeed helped countless numbers of people make sense of themselves and the world around them.
But should we be thinking about our mental hygiene with the same stick-to-itiveness that we think about, say, dental health? What if you're not getting anything out of therapy? What if you're retreading the same terrain over and over – or maybe it's even making you feel worse?
What if … it’s time to quit therapy?
Melissa Dahl, a health journalist and the author of “Cringeworthy: A Theory of Awkwardness,” recently asked that question in a now viral article in The Cut.
In the piece, she speaks with psychologists and patients who have given up therapy or advocate doing so. Dahl talked to Kousha Navidar on a recent episode of “All of It” about her reporting, quitting and more. An edited version of their conversation is below.
Kousha Navidar: Melissa, how would you characterize the trajectory of our cultural attitudes about therapy that I touched on in the intro?
Melissa Dahl: It's been so interesting – even just in my adulthood, and really I'm not that old – therapy went from something that wasn't talked about. Maybe you were a little bit embarrassed about it. It had negative connotations ... to this thing that people post on their dating apps. They only want to date someone who is in therapy.
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It's just become something that was in the shadows to being pretty ubiquitous in certain in certain circles.
I would love to talk about the different kinds of therapy. Can you take us through a 30,000-foot view of these different modalities?
Dahl: For this piece, I really concentrated on the broadest definition when you hear the word “therapy,” which is just basic talk therapy.
That's what people refer to when they just talk generally about therapy. There's also things like somatic therapy that's more focused on the body. Or there are things like EMDR, which use these kind of like pulses that are supposed to really help with trauma.
But my piece really focused on talk therapy.
What did you hear from people who'd quit therapy?
Dahl: I talked to something like 15 to 20 people who had recently quit therapy. It was actually wild how easy it was to find subjects for the story. They almost all said to me they had entered therapy to talk about something specific, a breakup or a family crisis or something like that. And then they just kind of stayed. They just kept going for years and years and years.
And it was helpful until it wasn't – until they found themselves retreading the same old subjects or maybe like getting worked up about things they weren't really worked up about.
Most of those who had quit therapy said they would go again. It's not like they were anti-therapy. But they would go again with a different mindset. They would go in with a discreet problem they wanted to talk about, they would talk about it, and then they would go back into their lives without the therapy.
We have a caller. Hi, Lee. Welcome to the show.
Lee: I have gone to therapy. I think everybody should try therapy at least once, especially if you need it. It was really great, very helpful. I started thinking, “Well, when, when does this end? How do I know it's over?” I was brave enough to ask that question. And she said, “Oh, you're just at the very beginning.”
And that was the day I quit. And I have done great ever since.
I'm sure that you have heard a lot of stories like this, Melissa. I mean, it's an interesting dynamic, right? Do therapists have an incentive to keep it going?
Dahl: From the clinician's point of view, I suppose there is the incentive of a client that brings in reliable money every week. But the psychologists I talked to and most therapists you talk to, will say that the goal isn't like indefinite therapy.
The goal is to give you some tools to apply to your own life and then go out there and use those tools.
Something that people said to me a lot is that they would be in therapy. They would talk about these tools with their therapist, but then they just wouldn't apply them. But there was something about ending the therapy that took away that safety net and made them feel like, “OK, I’ve got to figure this out on my own. And hey, I know how to, because I've been in therapy. I've learned all these things.”
Do you have any insight from talking to all of these clinicians about the ways to navigate that conversation about an end date?
Dahl: It’s just something you can bring up! A lot of times you're in therapy, maybe to work on communication.
I think it's actually pretty important not to just ghost your therapist and stop going. I think that part of the point in therapy is to model the relationships and the communication skills you want to use outside of therapy.
I will say I tried not to ghost my therapist earlier this year, but I was like, “OK, like, I'm done.”
And she really insisted that we come back for just one more session to talk things through. From the therapists I talked to, I think most of them will have a similar approach. Like they'll help you ramp it down. A lot of them are really excited that you feel ready to graduate.
I would think it's just something to bring up pretty straightforwardly.
We have a therapist on the line right now. Gio from Queens, welcome to the show.
Gio: I just want to say real quickly: Freud said that therapy is over when you are able to love, be loved, and to work. That's it. It's over and done with.
No therapist should keep you on longer than is necessary. And they should check in with you once in a while. And when the relationship becomes equalized, when you and the therapist begin to feel more on an even keel, then that's a sign that it's beginning to come to the end.
And then when you say it's over and done with, that's it. It's over and done with. They can ask if you'd like to come back and have another session. That's it. As soon as the patient says it's over, that's the end of that.
Melissa, you write about how ubiquitous the idea of therapy has become after being so intensely stigmatized.
Dahl: It is funny how it's just worked itself into, you know … I think there's been a lot of chatter about how, frankly, annoying so-called therapyspeak is, especially when it's misused.
I want to be clear though. I think it’s a net positive that we, as a culture, are more comfortable talking about mental health and talking about our desires to improve ourselves and figure out the way we work.
It just reaches a certain point where maybe the self-examination is no longer as helpful as it was in the beginning.
There's actually a lot of research that ties excessive self focus to depression and anxiety. So that's not exactly the goal there.
We've got some more callers. I'd love to go to Kathy in Manhattan.
Kathy: Hi, thanks. So here's my story. I had a really good therapist for several years who helped me with family issues, with illness in my father, with work-related issues, giving me the courage to quit a job that I wasn't happy in anymore.
But then I felt like I reached a plateau and was in good shape and could take a break. I'm someone who's been in therapy on and off over the years because I think it is useful. But it was time for me to take a break. She acted like I was breaking up with her, that I was being irresponsible.
And I was like, “Well, I'm done.” I think that's so unprofessional. Then fast-forward some years later when my husband was diagnosed with stage four pancreatic cancer and was going to die and I thought, “Oh, I could use a therapist again.”
And I would have liked to have gone back to this woman because she knew me and we had a relationship already, but I just felt like I couldn't go back to her because I thought that was so unprofessional.
So what did you do?
Kathy: I found someone else.
And that new therapist worked out for you?
Kathy: Yes. Very much so.
Wonderful. Thank you so much for that call. Let's go to Doris in Trenton, New Jersey.
Doris: My question, in listening to Ms. Dahl is: in order for you to make up your mind whether or not to continue therapy, I think it has a lot to do with the specific goals that the therapist has for you. That seems to have been really unclear in a lot of instances where I have seen a therapist. I just want your feelings about that.
Melissa, what do you think?
Dahl: It's ideally something that, if you have a good relationship with your therapist, if your therapist is a well-intentioned clinician who wants what's best for you, it could be something you work on together, that you off-ramp the relationship together.
That also reminds me when the last person was speaking about their disappointing experience, trying to end that therapeutic relationship. That’s so disappointing, but that reminds me a little bit of something I heard from one of the therapists I spoke to for the story.
She said, “We've put therapists up on this pedestal.” And she was like, “I'm just a person. I can’t – I don't know everything. “ So I think maybe there’s some room for just remembering this as a person you have a relationship with, just like any other person you have a relationship with.
