#1: Nope, you don’t need to lie down on that couch.
Each year, around 16 million adults in the United States are diagnosed with major depressive disorder, and an astounding 40 million U.S. adults experience some type of anxiety disorder, according to the Anxiety and Depression Association of America (ADAA). Furthermore, a 2014 study by the American Psychological Association found that 48 percent of surveyed Americans report having high stress levels that negatively impact their personal and professional lives.
Despite these common challenges, many adults are hesitant to seek therapy. For example, less than half of U.S. adults with anxiety disorders are receiving treatment (which may include therapy and medication), according to ADAA.
A possible explanation is that many myths about therapy still persist. Misunderstandings might prevent people from seeking the help they need or want, allowing their stress or relationship issues to fester and potentially become an actual mental health disorder.
These are some of the most common myths about therapy—and why mental health professionals say they’re just not accurate.
MYTH: You have to lie down on a couch.
Seeing a client lying down on the couch and staring at the ceiling is common in movies and TV shows, but it’s not really how therapy works. Lying on the couch was a strategy used in traditional psychoanalysis (made famous by Sigmund Freud). “Psychologists used this position as a tool to reduce the social constraints of eye contact,” explains Sal Raichbach, PsyD, of Ambrosia Treatment Center.
Today, therapy is much more conversational, and lying down is rare (but allowed). “The way you sit (or lie) is really a matter of personal preference,” says Dr. Raichbach. Most clients and therapists “prefer typical face-to-face discussion. Therapists don’t expect you to lay on the couch, but it is a tool that is available if you feel more comfortable sitting that way.”
MYTH: You need to have a severe disorder to qualify or benefit from therapy.
“Many clients start therapy to address a single issue in their life—career questions, relationship issues, adjusting to living in a new city, or just wanting to do some self-discovery,” says Lauren Rigney, MS, LMHC, who runs a private practice in New York City. “Anyone can benefit [from] therapy even if they are not diagnosed with a mental illness.”
Plus, attending therapy if you don’t have a disorder may help prevent you from actually developing a disorder. The longer you wait to address certain problems in your mental health, the more difficult it will be to treat the issue.
“People don’t think twice about preventative care for their car, but they will have their mind with them for much longer,” says Kevon Owen, MS, LPC, clinical psychotherapist and counselor in Oklahoma City. “Severity of the disorder comes from neglect and lack of insight, [and] both of those things can be avoided with therapy.”
MYTH: All therapists are the same.
“Not all mental health professionals are equally qualified, and not all specialize or have experience in the same areas,” says Jamie McNally, MA, LLP, LPC, CHCO, at Sycamore Counseling Services.
Some people may benefit from certain types of therapy more than others. For example, cognitive behavioral therapy can be useful for people with OCD or eating disorders, and exposure therapy is common for treating PTSD or other anxiety disorders. Therapists may focus on a specific approach, or some use a blend of approaches depending on the situation. Plus, all therapists bring their own personality into the room.
“You may have to contact several therapists before you find the right one based on your particular struggles, budget, schedule, and personality fit,” says McNally. “Do not give up looking for the right therapist because when you find that person, the reward will be invaluable, and you are worth that effort.”
MYTH: Therapy is only for people who like to discuss their feelings.
The reality is kind of the opposite: Not being able to discuss your problems and emotions could be fueling the strain on your mental health, and therapy may be able to help.
“Therapy is a great place to learn how to open up,” says Heather Lyons, PhD, professor of psychology and licensed psychologist in private practice at the Baltimore Therapy Group. “A supportive therapist will help you learn why it might be hard to open up and overcome these barriers in the right situations.”
Even if you think attending one session will be futile because you keep your thoughts and feelings tightly guarded, remember that therapists are trained professionals who have worked with a wide range of clients.
“Therapists are trained to help people with different personalities: It doesn’t matter if you are quiet, loud, you laugh a lot, or cry a lot,” says Ibinye Osibodu-Onyali, LMFT, of The Zinnia Practice in California. “We have seen and heard it all. An experienced therapist meets you where you are at, and does not come at you with judgment.”
MYTH: After a few sessions, your problems will be "solved."
Human relationships and experiences are “complex and multidimensional,” says McNally, and there’s no such thing as a “quick ‘cure’ for emotional, psychological, and relational difficulties.”
Each therapy session may provide you with new skills, coping mechanisms, or powerful insights into yourself, and you might notice some relief right away. But dealing with symptoms in the short-term isn’t the same as tackling the underlying causes, which may continue to cause problems in the future if not fully dealt with.
Focusing on underlying causes “is the deeper work of therapy that can take significantly more time,” says McNally. “It is not unheard of for a client to begin to experience relief early in the therapeutic process, which causes people to terminate therapy, only to fall right back into old relational patterns and ways of thinking.”
Addressing your inner needs and fears, traumatic events in your past, or family influences takes more time—not to mention a lot more emotional work. The payback will be that you may feel empowered to not let issues in your past continue to affect how you interact with the world in the present and future.
For more information, here are myths about anxiety disorders to stop believing.