What Does Better Look Like? It Depends!
As a supervisor and professor to graduate students, I think this is a really important answer to a really important question. If, as a consumer, a therapist tries to convince you that all therapies are alike, be suspicious. More than likely they either do not have a very good understanding of the various approaches to therapy or they are just trying to keep you as a client. Either way, it brings up read flags in my book.
I make it a very strong point to make sure that students (future therapists!) understand that not all therapies are alike. At the same time, most therapy approaches can be effective at what they are trying to accomplish. The mistake is in thinking that all therapies define a successful outcome the same way! In reality, the different approaches to therapy often represent different value systems and seek different outcomes.
Most therapies do seek to reduce discomfort and improve life satisfaction. The most comprehensive research (in my opinion) comparing therapy outcomes suggest that most therapies are successful in accomplishing this. Additionally, they suggest that building a good relationship with your therapist is the most important variable in the reducing symptoms and viewing therapy as having a successful outcome. Despite this, many therapist remain in a very competitive mode trying to prove that their therapy is best. To be bluntly honest, this debate is more about the therapist's ego than helping the client (again, in my opinion).
Outside of reducing symptoms, there are some important differences in the approaches to therapy that do impact the other outcomes of therapy. The various approaches to brief therapy (cognitive behavioral and rational emotive, for example), focus on the quick reduction of symptoms. Psychoanalytic and psychodynamic approaches (including relational psychotherapy, object relations, and self psychology) place a high emphasis on working through issues from the past and increasing self awareness. Humanistic and existential approaches to therapy (including many of the experiential therapies) also focus heavily on self awareness. In addition, they seek to help people deal with the basic challenges of being human and free up their natural potential. Transpersonal approaches build on the accomplishments of humanistic and existential approaches by more explicitly dealing with the spiritual aspects of the client. These are just a few of the over 150 types of therapy (many of which fall into one of these four categories). I should also point out that any overview as brief as this is necessarily oversimplified.
It can be helpful to do some research into the type of therapy you wish to pursue. As stated elsewhere on this site, unfortunately, there are few resources for helping consumers be informed about such issues (see the Depth Psychotherapy Network for one example of a resource).
The type of therapy and the goals you set make a significant difference in what "better will look like. It is important to discuss what you desire it to look like with your therapist early on. It is generally helpful to revisit this discussion regularly through the process of therapy.
Better generally doesn't mean that you will live "happily ever after." People often enter therapy with unrealistic expectations about the outcome of therapy and how quickly this will occur. Having some periods of being more depressed than usual, some experiences of anger, and other problems is part of being human. Unfortunately, many people, particularly in the United States, have unrealistic expectations about what life should be like. Today, many therapists, myself included, are beginning to wonder if these idealistic pictures of what life should be like aren't overly burdensome and contributing to the suffering of many seeking these ideals.
Better doesn't mean that you will never again struggle with what brought you to therapy. In fact, being better you will likely have some bouts with the same issues again from time to time. In particular, many of us regress to older patterns during times of stress. This doesn't mean that therapy was not successful. It just means that you are human. If the struggles persist long enough, it may be imporant to revisit what originally helped you with the growth and healing.
Good therapists will help client understand and prepare for these inevitable periods where some of the problems return. If therapy was successful, it is likely that you will be more aware of what is happening and the cause the next time around. You will also be more successful at working back through the issue the next time.
Difficulties, sometimes called existence pain (Irvin Yalom's term), are part of being human. Therapy is not intended to take away all the pain of existence. To do so would be to take away ones humanity! Rather, it is helping people live with the reality of existence. As people learn to deal with these realities, there is often a decrease in suffering and greater life satisfaction.
In today's world of watered-down therapy, it can be difficult to know what to expect. The influence of managed care on mental health has promoted a position in which therapy is seen as something only appropriate to help alleviate the more significant forms of suffering. However, many therapists are trained to help people accomplish much more than just alleviating symptoms. Given the current climate of mental health, it is important to know what you want from therapy and how committed you are personally (and sometimes financially) to accomplishing what you want.
Though this is rapidly becoming a minority position in the mental health field today, I still believe that therapy can be one of the best gifts you can give yourself. Therapy is not just for those people whose pain is so intense that they are no longer able to function. Rather, therapy is also appropriate for individuals wanting to increase their understanding of themselves, improve overall life satisfaction, and those seeking personal growth. It is also appropriate for individual seeking to alleviate a variety of types of suffering.
If you are now finishing your reading of this web site, hopefully it has helped you think through ways in which you would like to seek healing and growth. Now you can set the chart toward achieving those goals. Keep in mind, keep them realistic. The happily ever after fantasy often creates more dissatisfaction than hope. No therapist, no matter how talented, can help you get to a place where you will never again hurt. However, a variety of sources may help you improve your life situation and satisfaction while also helping you to better manage and work through the difficult periods.
For many, therapy may be your choice for seeking your goals. For others, you may choose a variety of other resources. Either way, I hope you enjoy the next part of your journey!!