What Psychotherapy Won’t Fix

As one year ends and a new one begins, some people think about ways to start over. Be happier. Renew energy. Often, they turn to psychotherapy, and in many cases, it works, or at least provides a roadmap to a more satisfying life.

But mental health is like physical health-some things just don’t change. In an effort to help prospective patients understand what psychotherapy can and cannot do, a recent post on the Psychcentral.com website enumerates five things therapy won’t cure.

The advice isn’t just a reality-check; it’s an effort to help people save time, money and frustration. “Therapists, by their nature, tend to want to help every person who comes through their door,” writes John M. Grohol. “Even well-meaning therapists may not fully appreciate when they are largely going to be ineffectual in treatment because of the type of problem presented. After all, psychotherapy isn’t some magical elixir. Talking about some topics simply won’t do much to help the situation.”

Five Things Psychotherapy Won’t Change

1. Personality

Personality disorders are recognized as mental disorders. Typically, they’re more ingrained and more difficult to change than most other mental disorders. They begin in childhood and are shaped by experiences. “You can’t expect to undo decades of personality development in a few months’ worth of psychotherapy. (Years, maybe.)”

But psychotherapy can help mitigate some of the worst features of the problem. For instance, someone with narcissistic personality disorder may continue thinking he or she is better than everyone else, but awareness can help him or her tone it down in interpersonal relationships to become less of a social and work impediment. Another example: Introverted people will still be introverted, but can learn how to relax in social situations.

2. Childhood

No one can go back and fix a lousy childhood. It’s a piece of personal history.

But through therapy, someone can see how he or she interprets what happened in childhood affects behavior now. Then a choice can be made whether to indulge those issues, or grow through them by understanding their significance. A patient will still have had bad parents, rotten siblings, an unsafe childhood home or neighborhood. But those things are afforded a perspective that renders them less hurtful in the present.

3. Half a Relationship

A healthy relationship is a joint effort. Psychotherapy can help couples through rocky times, but only if both parties approach counseling with an open mind and a willingness to work on the relationship. Attendance counts, but work product is key.

That doesn’t mean it isn’t worthwhile if only one-half of a couple goes for therapy; often that helps the patient cope better with the situation or decide to end it. But if the goal is to maintain and sustain a relationship, it takes two to tango.

4. Broken Heart

The side effects of lost love can be long term. Professional counseling isn’t likely to help much, but talk therapy can if the listener is a close friend. Common activities and shared experiences make the painful time seem shorter.

Psychotherapy might help, however, in situations where someone is “stuck” ruminating over details of an old relationship, even years later. If someone can’t move on, talking to a professional might help bring perspective in the same way it does to childhood issues.

5. Bereavement

Typically, grief isn’t considered a mental illness in need of treatment, but its hallmark is depression. Despite popular common wisdom about the stages of grief, the reality is that everyone’s grief is unique.

Psychotherapy won’t help speed the natural processes of time and perspective. Like lost love, grief needs space for remembrance and reflection. It’s done best mindfully and with patience. And like love, it can help someone who cannot get over the loss, even years later. But for most people, “psychotherapy is both unnecessary and overkill for what is a normal process of life and living.”

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