“She’s been in therapy for 10 years?! But she’s always had it so good! Friends, a good marriage and great career! WTF’s the therapy for?!”
Mental health therapy can help people work through trauma, depression, anxiety, grief and other genuine struggles.
But an uncomfortable question deserves consideration: Can therapy sometimes become a long-term response to ordinary life difficulties or even common bumps and dips in the road?
Consider someone who grows up with extraordinary advantages. Let’s call her Sharlene.
Shar’s parents have a loving marriage, free of any type of abuse.
Her parents are clean: no substance addiction, no criminal activity. Her siblings aren’t abusive to anyone.
There is no devastating family tragedy that could psychologically scar a young mind long-term such as death of a family member.
There’s no chronic major stressor such as ongoing serious disease or being subjected to abusive teachers or coaches.
As a child and teen Shar attends excellent schools, enjoys good health, has supportive friends, frequently goes on family vacations, and her father makes enough money so her mother doesn’t have to work.
In college Shar finds a loving partner, has athletic success, builds a lucrative career after graduation, marries her sweetheart and maintains a close relationship with her parents.
By most conventional measures, she has an enviable life. And she’d like to be a mom one day.
Yet Shar has been getting ongoing mental therapy for the past, let’s say, 10 years, beginning at around age 20.
What on earth explains that?
A person can experience anxiety, depression, perfectionism or deeply rooted insecurities without having endured a recognizable trauma.
As a provider for special needs adults, I’ve had access to documentation of their family histories.
The trauma that some of these individuals have been put through is unspeakable.
One woman was repeatedly sexually assaulted in childhood; her mother was a serial arsonist; and one day the mother literally burned down their house, then abandoned her daughter (which probably was for the best, but still, being abandoned by your own mother — even a neglectful one — can hit like a wrecking ball).
Another individual, with autism, had an alcoholic mother, and as a teen was homeless by herself on the streets, then somehow ended up with her father and at 19, despite having normal intelligence, was working on her GED and had never learned to drive.
What they would’ve given to have Shar’s childhood.
Nevertheless, emotional pain doesn’t always require overt trauma such as getting repeatedly beaten by a parent, raped by an older brother or growing up in a cramped rundown apartment in a crime infested neighborhood.
With all that said, the question of what therapy is accomplishing after 10 years, in an individual such as Shar, is reasonable.
Shar might answer, “It keeps me afloat; it keeps me grounded; it helps me manage my anxiety from viewing Instagrams of women with better skin, prettier faces, thinner waists.”
When Therapy Helps and When It Becomes a Crutch
There’s no universal timeline that determines when therapy is appropriate or when someone should stop.
But therapy should ideally help people develop tools they can use outside the therapist’s office.
Progress might include handling disappointment, tolerating uncertainty, challenging distorted thinking and learning to function without needing constant reassurance or validation from online strangers.
If therapy continues for years with someone such as Shar, rather than the woman whose mother went around setting fires, it makes sense to wonder whether the person is making meaningful progress, whether the treatment approach remains effective and whether the original concerns have changed.
The Role of Perfectionism and Parental Expectations
A parent who places excessive emphasis on athletic performance, academic achievement or appearance may unintentionally teach a child that approval depends on meeting demanding standards.
A young woman raised with very high expectations might become intensely self-critical, even when her parents stay together and provide abundant love and material security.
She may have learned to fear failure rather than how to recover from it.
At the same time, not every demanding parent causes lasting psychological harm, and not every person who struggles with expectations needs a decade of treatment.
There’s a difference between acknowledging emotional suffering and assuming that every painful feeling requires prolonged professional intervention.
Those facing financial insecurity, caregiving burdens, illness, unsafe relationships or childhood abuse may have challenges that require substantial support.
Their circumstances deserve recognition, but their suffering doesn’t make someone else’s distress invalid.
A useful question is whether people are learning to manage their difficulties, develop confidence and participate fully in their lives.
Resilience doesn’t mean never feeling anxious, insecure or overwhelmed.
People should be able to seek mental health treatment without judgment.
But we should also be comfortable discussing personal responsibility, being accountable, coping skills and the ability to effectively navigate ordinary adversity.
