Some degree of distress just proves the process is working
‘Get help and get happy!” runs a tagline for one of the new generation of e-counselling services, offering psychotherapy by text, phone and video chat. Except it turns out that getting happy is by no means guaranteed to be therapy’s only outcome. One recent paper (which I found via the excellent Research Digest blog) estimates that, when it comes to cognitive behavioural therapy, 43% of clients will experience unwanted side-effects like distress, a deterioration in their symptoms, or strained family relations. “Psychotherapy is not harmless,” the paper’s authors conclude. It’s useful research. But that conclusion highlights a widespread belief about therapy that gets stranger the longer you dwell on it: why on earth would anyone assume it was harmless in the first place?
There are echoes, here, of the surprise that greets media revelations that mindfulness meditation – another seemingly guaranteed path to happiness – has its perils. Beginners, especially if they’ve experienced trauma, sometimes report emotional “flooding”: once they turn their attention inwards, and follow the instructions to notice their emotions without judgment, they’re engulfed by thoughts and feelings they’d previously been keeping in check. (Repression may not be the healthiest technique for dealing with trauma, but it can be a practical way to get through the day.) Advanced meditators, meanwhile, occasionally report distressing experiences of panic or meaninglessness known as the “dark night”, a result of fundamentally rewiring their perception of reality.
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