Hi DRM,

Thank you for your question. It’s a good one.

Self-improvement of any kind is a complicated, individualized and often messy process. In many ways, it is a lifelong endeavor.

However, what you are really asking, is about the process of therapy — which is perhaps even more complicated, individualized and messy. Depending on the therapeutic orientation, the process is long- or short-term, more general or more focused, past or present oriented. For example, Psychoanalysis typically consists of a long-term, in-depth exploration of one’s defense mechanisms and complexes, rooted in childhood. It’s a lengthy, circuitous journey through the psyche. In contrast, Brief Therapy is, as the name indicates, more short-term, and it is typically focused on a specific set of practical goals. It is meant to address functioning in everyday life and is not necessarily concerned with examining the whys and wherefores of how the dysfunctional behavior developed. And there are many orientations (and variations) that fall in between these ends of the continuum — Behavioral, Cognitive, Gestalt, Humanistic, Rational-Emotive, etc.

That said, ALL forms of therapy have (or should have) the patient’s well-being as the primary focus. Therapy is a one-sided relationship. The patient’s needs are paramount.

So, I would say, you first have to determine some clear definitions of what you want out of therapy — to understand yourself better, to feel better, to be able to function at fill in the blank better, to control a behavior? Do you want a safe place to explore your inner psyche for an indefinite period or do you want to combat your anxiety so you can function better at work? I know that we all want all of these things all the time, but the process of really determining what you want out of therapy will help you focus and make progress. It doesn’t have to have the perfect clarity of a business plan and it can change over time, but it helps ground you and is a place to start. When you have some of those answers you can begin to see what form of therapy would be a “best fit.” If you really don’t want to hash out all the drama of your potty training and its long-term effects on your need to please, then Psychoanalysis is probably not for you right now. Ok, that was terribly tongue-in-cheek and cliché, but you get my point. I love the Psychoanalytic perspective and truly value its contributions to mental health and the field of psychology, but it’s definitely not for everyone.

Regarding the question of quitting therapy . . . all patients question the value of therapy at some point in the journey. After all, it’s not easy and it ebbs and flows. Everyone has times when they don’t feel they are making any progress. It is important not to ignore these feelings. They too are part of the process.

When patients ask the question about discontinuing therapy, that needs to become the focus of the session (or sessions). It is a signal to reexamine where we are, how far we have come, where we are going, and if, perchance we are off track. It may also be a time to ponder whether our journey together is, in fact, done. Have we gone as far as we can, or as far as the patient wants to together? And beyond that, is the patient done with therapy, or do they need to move on to another form or another therapist? In any case, if you are feeling some level of discontent or confusion with your current therapy, you owe it to yourself (and your therapist owes it to you) to examine those feelings. While no therapy is a guaranteed fix-all, it needs to be a fulfilling part of your life in which you feel that you are making progress, even when that is uncomfortable and messy.

I wish you the best in your journey.

Dr. Donna