I have been through lots of therapy and lots of therapists in my life and my contention is that therapy can’t be used to actually treat uncontrolled, serious mental illnesses. Now, don’t get me wrong, therapy can be supportive to a person with an uncontrolled, serious mental illness and therapy can be useful to a person with an uncontrolled, serious mental illness (such as in the case where the therapist tracks your bipolar symptoms and report changes to your doctor) but therapy cannot be used to actually treat a serious and uncontrolled mental illness.

Everyone with a Serious Mental Illness Should Be in Therapy

I regularly recommend therapy to people for a variety of reasons. Therapy can help with relationships, coping skills, dealing with issues and traumas and more, but there are only some people that can truly treat their mental illnesses with therapy and only at the right time. This notion that psychotherapy would cure mental illness if everyone was just in it and just tried, is pure nonsense. Yes, in therapy you have to try and you have to do the work but even if you do that, it might not make your mental illness any better.

Uncontrolled, Serious Mental Illness and Therapy

Therapy can be beneficial for people with serious mental illnesses but therapy can't be expected to treat serious, uncontrolled mental illnesses.And if you have a serious, uncontrolled mental illness, therapy is not going to fix it. You want to talk to someone you trust? Go ahead. You want to be supported by someone? Great. But if you want to treat your mental illness, you better be seeing a doctor, too. Therapy is simply not the cure-all that some people (usually therapists) claim it to be.

This is because therapy cannot possibly work if you have seriously uncontrolled symptoms. If, say, you’re in the trough of a severe depression and suicidal, therapy just doesn’t cut it (trust me, I’ve been there). If you’re floridly psychotic, therapy won’t help. If you really are severely ill, therapy can still be useful but it won’t actually make the mental illness better. It won’t make you stop seeing little, green men.

Why Won’t Therapy Help Serious, Uncontrolled Mental Illness?

It’s like this. If you’re at the bottom of a 20 foot pit, therapy can offer you a coping skill of a five foot ladder; too bad that’s 15 feet short. If, on the other hand, you were only in a five foot pit, that coping skill would be great. So, if, for example, your depression were not as severe, you could expect therapy to be more effective. You just can’t make that kind of progress when your brain is severely dysfunctional.

It’s like all those people who say that everyone with a serious mental illness should exercise to get better. Well, if getting out of bed and making yourself a ham sandwich is too much for a person then the idea of the person getting up, putting on clothes and leaving the apartment to do something that requires energy and that he or she doesn’t want to do is just, plain ludicrous.

People with Serious, Uncontrolled Mental Illness

I’m not saying you shouldn’t start therapy if you have a serious, uncontrolled mental illness. As I said before, you may find other benefits from therapy. What I’m saying is that you need to be seeing a doctor as well and that medical relationship is the one that’s going to lift you up enough for the therapy to start taking effect. Because I have learned a lot in years and years of therapy but none of it has been able to get me out of a 20 foot pit. Once that pit started to dissipate, however, therapy made a lot more sense.

Image by Fox Valley Institute.