WTF Monday: “Good Therapy Has Got to Hurt”

Only a little while ago someone told me “good therapy has got to hurt”. She had been through therapy herself. Her statement seemed to imply that the level of pain might be a measurement for the quality and success of the therapy. And while I kind of get where she came from . . .

I don’t agree. In fact, I could not disagree more. I find that put that way the statement is actually dangerous.

It is true that good therapy can involve painful moments. In most certainly will, in one way or another, if struggling with painful things is the reason why you see a therapist in the first place. But that is not the same as saying it “has got” to hurt.

To my ears that statement promotes an attitude that encourages people to disregard the fact that they are hurting, in order to endure it for the sake of “good therapy”. That’s dangerous. Especially for people who are traumatized.

To my mind easy does it. Learning to be sensitive towards my emotional pain and to take it seriously. Learning how to gradually expand what I can take, sure, and facing difficult things, too, but not to the point that I go on, maybe even looking to hurt, feeling like it has to hurt in order to be effective. Or even feeling like it is okay for other people to deliberately induce pain in order to “help”.

I believe that pain, inner resistance and feeling defensive, that all those have a reason. That it is important to look for them in therapy and in recovery. That it is important to listen to what they have to say. And that it is important to find a balance between the challenges of therapy, the facing of things and the working through issues on one side, but also periods of rest and periods of recovering one’s strength. And that it is important to listen to what I feel ready to face.

But most of all, I believe that the whole ‘good therapy has got to hurt’ nonsense makes way for mistaken (or worse: sadistic) therapists or other do-gooders to push people more than is healthy for them. The “you have to face this / endure this / experience this, in order to get better” reasoning.

Sure, it might be true that facing, enduring or experiencing things will help me get better. But I find it more than a bit unhealthy when other people want to control the pace, when they push, when they try to be in charge of when or how that happens. I have met a lot of therapists or other well-meaning folks who tried to do that in the past. Who tried to manipulate me during therapy. Who tried to convince me of things I allegedly “had” to do or face, never minding my inner resistance to go there. But this attitude that ‘good therapy has got to hurt’ makes, in my opinion, way for a whole abusive mindset. The whole ‘don’t talk back, do what I say because it’s good for you’ reasoning. I am allergic to that. Seriously allergic.

Easy does it. I wish people would realize that in order to recover and heal, my wanting it and my feeling safe and strong enough and ready to face is key. I don’t want anything if I feel pushed or manipulated. Seriously, who would? Would you buy from a salesman who you feel is manipulating your thoughts and feelings, who is pressuring or pushing you and who is imposing his idea of what you should buy on you? Or would you rather buy from one who helped you understand the characteristics of what you are about to buy, gave you their opinion about the advantages and disadvantages, but then left the decision to you?

Easy does it. Especially in therapy. It doesn’t “have” to hurt. Sometimes it does, sometimes it doesn’t, sometimes it’s in between, but it should never be the point itself of therapy to cause pain. The level of pain is not what determines if the therapy is good. It’s just something that can come with it, but at the same time something that should never surpass a certain level and certainly is no value in itself. Whether therapy is good or not depends on how well it is tailored to the needs of the person who receives it. And on how respectful it is. And how well the therapist manages to take me, my feelings, and my thoughts seriously as an equal partner in my journey towards betterment, and who needs to CONSENT, before therapy goes anywhere. Period.

I really dislike quasi-abusive mindsets and stupid, pseudo-educated attitudes masked in ‘wanting to do someone good’. Shove the pain up your ass if it’s so wonderful, but don’t tell anyone they need to do the same! (Or, more sensibly, be my guest to review the necessity of shoving anything anywhere. Whichever pleases you more.)

Just wanted to get that off my chest.
*Steps off soapbox.*  😉

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24 Comments (+add yours?)

  1. Stefanie Neumann
    Jan 14, 2013 @ 11:41:37

    Hi Lola!

    I don’t know the person who said that nor the reasons why they did say it and am far away from putting any judgement into anybody’s direction.

    That said, I can say that I fully agree with the feelings you expressed about what a sentence like the one mentioned above can trigger. It pushes the same buttons within me.
    I belong to the people who are not exactly afraid to face painful experiences. I know that it does help me to face the pain that happend to me in order to heal. But I never was good in dealing with others provoking to trigger those painful buttons in order to make me face something when they thought it would be right. Frankly I, for myself, experienced it as a waste of time.
    I always felt like therapy was supposed to support me so that I can be the one who is in charge of my own life, again. For me that includes that I choose for myself when I am ready to face the “less joyful” parts of my life and it also includes to give myself a chance to feel the strength to do so before I step into it.

    As people are different it might be that both ways do work, just for different people. Which would also mean that no general statement about what therapy has to be like is possible.

    Thank you for sharing your feelings about this. It surely is a wondeful reminder for staying – and getting even more – aware of that each path can be different and we all are on a delicate journey to find out which one works for us. 🙂

    • Lola
      Jan 14, 2013 @ 14:21:45

      Thank you for sharing your thoughts, Steffi! 🙂 I can empathize a lot with what you said about finding it a waste of time when others tried to trigger those painful buttons, and feeling like therapy was there to support you, not to push you (or your buttons) around. It helps me, too, to look at the painful things, but everything has a time and I like to feel in control of what happens when. Guidance is okay when it comes from someone I trust and feel safe with, but saying something “needs” to hurt in order to help, that’s just awful. My birth mother used to say that when she hit me, that it needs to hurt so that maybe I learn something. I really doubt that kind of attitude is getting people to a place where they are more healthy. Sounds more like what abusers say to justify their behavior. That’s why I found it so weird to hear it out of the mouth of someone who claims to have gone through a succesfull therapy herself. Kind of weird.

      • Stefanie Neumann
        Jan 14, 2013 @ 17:54:45

        I believe the most important thing is that you get clarity on what you need and where you want to go on the journey of healing. And to my perception what you have stated, here, is pretty clear.

        I understand how that sentence (“It has got to hurt”) sounds like a justification for abuse in your ears and that it must be weird to hear it from somebody who went through experiences of being abused, themselves.

        And I understand very well that you want to be in control of your own life and lead the way. In my oppinion therapy is there to support you in that – to find out what works for you, what is healthy for you – including the pace in which you go through the painful parts. It is true, everything has a time – and you know best when that is for your own path.

        • Lola
          Jan 15, 2013 @ 07:20:36

          I agree with all of that. And yes, hearing it from someone who has been through therapy herself and claims it has done her so much good, that was the weirdest part. To me it sounds a little like she might have had one of the rather insensitive therpists who pulled her through all the pain and now that she came out on the other side, she feels like it HAS to be that way to avoid having to realize that maybe all the hurt was not so cool after all and stuff. I don’t know, that’s just me guessing, but I found it weird. Why would anyone who knows therapy and the issues involved, of all things advocate the pain?? I mean okay, healing can be painful, but pain in itself is hardly healing. I found that a wee bit creepy. (Okay, more than a wee bit…)

          • Stefanie Neumann
            Jan 15, 2013 @ 10:03:39

            Well, I don’t know her. And I have not been there when you had that encounter. So I cannot say much about this person you talked to.

            But you know her and you have been there. If it feels to you that she might accepts the way she went through her therapy because she does not want (yet) to face the pain of noticing that it was maybe not the most gentle way to go through it, you are probably right. And it sounds reasonable to me, too.

            Furthermore I learned for myself through my own path that in situations like you are describing, here, I can usually trust my perception. So, as this is about your life and your experience I do trust your perception about it, as well. 🙂

            • Lola
              Jan 16, 2013 @ 07:06:00

              Thank you. 🙂 The ‘trusting my perception’ thing is a real challenge for me, because often I’m way off target with my perception, because I feel hurt or deceived or put at a disadvantage so easily. But I guess in this case, where there was not much of a personal element involved, my perception might be okay. It’s always easier when no big emotional response is triggered.

            • Stefanie Neumann
              Jan 16, 2013 @ 13:06:16

              Yes, I agree with you on that, Lola.

              That part when emotions from my past experiences get triggered was one that took a while for me to put it into a healthy perspective, too. But it is something you can learn – in a pace that is right for you. 🙂

            • Lola
              Jan 16, 2013 @ 16:15:09

              Yes, I hope that it’s something I will eventually learn. Little steps, I guess. 🙂

            • Stefanie Neumann
              Jan 16, 2013 @ 16:48:52

              Little steps are steps, too. 🙂

            • Lola
              Jan 17, 2013 @ 10:49:41

              True! 🙂

  2. nobodysreadingme
    Jan 14, 2013 @ 16:14:50

    Get back on your soapbox, Lola!
    I agree. Therapy will only work when you take it at your pace, not one imposed by someone else, however well meaning.
    Anybody can say ‘You have to face this.’
    A good therapist will ask if you’re ready to face it yet, or better still divine from your actions and reactions just how far you can go ON THAT PARTICULAR DAY.
    Doesn’t take a genius to know that everyone has good days, and everyone has bad days. Don’t make my bad day worse by pushing me into a corner.
    Fortunately I never have experienced any professional pushing me that hard. Maybe I’ve been lucky
    ;-l

    • Lola
      Jan 14, 2013 @ 17:33:50

      You’re right in saying that a good therapist keeps in mind how far I can go not only in general, but especially on the particular day, all things considered. I’m glad you never experienced a professional pushing you that hard. I can’t cope with this kind of pushing at all in a therapist.

  3. prideinmadness
    Jan 14, 2013 @ 16:17:32

    Therapy doesn’t have to hurt but when I enter therapy I do expect to experience something that will possibly make me cry, feel uncomfortable, make me angry and possibly make me want to quit. There is obviously a difference between painful learning and just plain painful. Everyone’s therapy experience will also be different.

    I am aware that trauma therapy for PTSD is one of the most painful therapies because it requires a person to go back and talk about what caused the PTSD in the first place. A friend of mine went through this therapy and both of us struggled to determine if this was something she had to go through to recover or if it was too much. In the end it came down to not wanting to experience that painful road with that particular therapist.

    • Lola
      Jan 14, 2013 @ 17:41:00

      Yes, I expect things like painful moments, or crying or feeling uncomfortable in therapy, too. And I think that’s not bad, as long as I still feel safe and reasonably in control, like that if things got too bad, I could stop what’s going on. It’s also real important for me that I feel like my therapist understands where I’m at, both emotionally and with my coping skills, and that she is sensitive to those things and doesn’t push me where I really don’t want to go.

      I think what makes trauma therapy especially tricky is that there is a fine line between struggling with the pain of the trauma but being okay, and getting re-traumatized by the traumatic content AND yet another out-of-control situation in therapy. I think the attitude that therapy “has got” to hurt, makes it easy for the latter to happen, because the patient is made believe that the pain must be endured and that the pain is what the therapy aims at. I think especially for traumatized patients this attitude comes with a big risk for retraumatization in the name of “helping”, when people think they have no right to object to the pain, because that’s what good therapy is supposed to do. Hm… I feel like I’m babbling. Am I making sense? :-/

      • prideinmadness
        Jan 15, 2013 @ 00:06:58

        You are making total sense. I don’t think people realize that the client therapist bond is VERY important and unique. It’s impossible to go on such an emotional journey with someone if you do not feel they understand and support you.

  4. daylily2011
    Jan 14, 2013 @ 18:33:17

    Wow, how well-written and truthful. You are wise beyond your years! I am confused and struggling with this very issue with my therapist. I honestly can’t trust myself as to whether my therapist unnecessarily crossed a line. I am hurt by what I feel is her judgmental reaction and displeasure over a behavior and event that I confided in her about. But, I question whether I am overly sensitive, emotionally immature and easily get hurt so it is my reaction that is wrong.

    Thanks for writing about this topic. You’ve given me a sense of justification for feeling hurt.

    –Daylily

    • Lola
      Jan 15, 2013 @ 07:52:10

      Thank you for the kind words, Daylily. I’m at my most mature when I write for my blog. (It’s kind of the only time of the day when I’m in my mature mode on most days, but hey, it’s a start.)

      Anyway, I’m really sorry you are struggling with this issue with your therapist. See, and this is exactly why I think that such crap as ‘therapy has got to hurt’ is dangerous: us people who receive therapy, we’re usually not in the best place to trust ourselves and our judgements in the first place, and now if someone comes and tells us it’s SUPPOSED to be real uncomfortable, that just makes it all the more likely we get even more confused about our feelings. I can relate quite well to what you wrote. Do you feel safe with your therapist and like you have a secure relationship to her in general that leaves you room to discuss your hurt feelings (no matter if they are objectively justified or just justified in the way you experienced the situation) and have your view respected and maybe even gently evaluated with the therapist?

      What helps me a lot in those situations is that my therapost F, who’s one of the good ones, takes it seriously when I feel hurt and uses those situations as opportunities to understand more about the way I think and feel, and that she helps me detect errors in my thinking if I made them. But not in the way that she shoves them under my nose and practically says “see and that’s why you were wrong, I was right – ha, told ya!” but just in a way that helps me see them for myself and correct my thinking, while she is very understanding of the fact that my thinking and feeling is easily misled, because that’s the way I needed to think in order to survive in a hostile environment.

      I wish you all the best for this situation with your therapist, Daylily, and hope that there will be a good solution for it soon. It sucks having unresolved issues with a therapist.

  5. vwoopvwoop
    Jan 14, 2013 @ 18:45:21

    this is all so true and relevant. it’s confusing to me because i think my therapist falls somewhere in the middle. she is an older woman and very kind, spiritual, aware. she understands that healing can take many paths and sometimes doing sand play therapy is as effective as talk therapy. at the same time, i have often heard her say “we need to deal with the big issues soon” and “we need to deal with some of those early memories next session” which i can see from both sides. on the one hand, is it just supporting me in moving forward? because to me it feels like pushing…like she’s telling me i *have* to relive those memories and deal with the fallout, even though i don’t feel ready.
    i suppose in this case it falls to me to be able to say “i’m not ready for that, let’s not.” but for so long i was weak and depressed and vulnerable and so couldn’t speak up. gosh this isn’t an easy thing to draw a line between, you’re right, it is a very fine line between struggling with pain of trauma but being okay, and getting re-traumatized.
    i have learned that some of my most amazing, effective healing has happened by myself, when i couldn’t afford to see my therapist for months. maybe that was just about timing, and how i was already doing better, who knows. but it has opened my eyes a bit about how healing does not have to be a painful road. it is also very very clear to me now why there are different stages of therapy, and why the first is stabilization. dealing with the fear of monsters beneath the surface is only going to be helpful when you’re out of the water. otherwise they can still pull you down below so easily.

    i sort of babbled too, haha, but no, you made a lot of sense. 🙂

    I think this thing you said hits the nail on the head for me:
    “I wish people would realize that in order to recover and heal, my wanting it and my feeling safe and strong enough and ready to face is key. I don’t want anything if I feel pushed or manipulated.”

    • Lola
      Jan 15, 2013 @ 08:03:22

      Ugh, quite honestly, Hats, I’d freak at the announcement that ‘the big issues are gonna come up soon’. (But then, I already freak when mom says ‘Lola, we got to talk’ in that no-nonsense voice of hers, so much that mom makes sure she only says that when she knows that I’m feeling particularly safe at that moment.)

      And yeah, it’s probably helpful to tell her that you don’t feel ready for the ‘big issues’ when that’s how you feel. If she handles that responsibly and respectfully, then all is probably well, but if she kept on pushing… I don’t know. Or maybe you could let her know in general, like in a calm moment when you feel in a good place yourself, how those ominous announcements of ‘big stuff’ that’s will have to come up in her opinion makes you feel really uncomfortable and why, and see if she understands that? Gee, yeah, it really sucks that sometimes the line between ‘hurts but is okay’ and ‘hurts and is not okay, but actually re-traumatizing’ is so very fine.

      But in general I don’t believe that healing is a painful road in itself, but more a road of determined work with painful puddles that sometimes have to be looked or stepped into, but if you don’t feel ready at that time, there’s always other stuff to work on, so that in the meantime you can go back and get your gum boots, so that you feel better equipped to deal with the puddle when it comes up the next time around. 🙂

  6. Diversity is Art
    Jan 14, 2013 @ 22:52:45

    That’s absolutely true, therapy is supposed to be a safe place, it can hurt sometimes but saying it has to hurt is dangerous. Life hurts too but if someone keeps causing pain there is something wrong. How can someone start healing if they keep getting hurt?
    I wish all therapists knew this. Consent and being considered an equal partner really is two of the most important aspects of therapy for me.
    I was told therapy needs to be painful too many times and always ended being dangerous, it’s sad that this occupation gets so many people with some kind of savior complex that see no harm in manipulating others to “help” them, you can’t even argue with them. 😦 Do-gooders always cause more harm than actually help anyone and not only as therapists and other helping professions, they just cause more harm when they work like that.
    Great post. 🙂

    • Lola
      Jan 15, 2013 @ 08:11:12

      Thank you! 🙂

      I totally agree that especially in this profession there seem to be so many self-appointed “saviors” around who, in the name of doing good, end up wreaking havoc because they actually don’t know what the fuck they are doing with their “good advice”. (I also suspect that a fair share of them quite enjoy the power that comes with telling emotionally vulnerable people what’s “right” and what to do, even if they’d never admit to the enjoying-the-power part. But hey, I might be wrong. It’s just the impression that I got.) I really wish all therapists were aware that more hurt itself is hardly gonna make something that hurts in the first place better. Sure, healing has painful moments, and getting through them safely helps, but the ‘safely’ part is key here. And hurt itself is hardly what causes safety – else I’d be a really safe person already! 😉

  7. lostservice22
    Jan 15, 2013 @ 03:23:28

    Well said. unfortunately it does take a lot of time to find a good fit in therapy. I have had far to many times in the past when they didn’t push hard enough because I was so young at the time. 12 or 13 and I didn’t get anything out of it. I spent years feeling that therapy was pointless. still have not been to see one. have been considering looking into it even tough I have come so far. I am sure I still have lots of things I could use some help with.

    • Lola
      Jan 15, 2013 @ 08:17:14

      Thank you! 🙂 I can totally relate to how long it takes to find a good fit in therapy. It took me almost 10 years of well-meaning, but incompatible-with-me therapists until I finally found one I can work with in a good and healthy and helpful way. Before that therapy always ended up feeling pointless to me, too. But a good therapist makes a really meaningful difference, so yeah, if you want to look into it and find one who you feel safe and comfortable with, it can probably make a positive difference for you, too. 🙂

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