Venting About Your Problems Is Therapy's Failure Mode

At least, it was for me.

The more I learn about how to conduct effective, evidence-based therapy, the more I understand why none of my attempts at getting therapy helped. (It is true that my depression is “in remission” or whatever you want to call it, but I don’t credit the few total months I spent in therapy with that development.)

Many people think that therapy is about paying a person to sit there and nonjudgmentally listen to you vent about your problems. Some of this might come from the prevalence of psychoanalytic thought in our culture, including in stereotypes about therapy and mental illness. Freud and his ideas are still very dominant in the many laypeople’s opinions about psychology. Specifically, I’m thinking of free association, a technique used in traditional psychoanalysis in which the client is asked to just say whatever happens to be on their mind, however silly or irrelevant it may seem. Free association is meant to inspire the client to reveal previously-repressed thoughts or feelings that both client and therapist are then able to learn from and understand.

I suppose that sometimes this can be useful, but other times or for other people, it may not be. The problem is that therapists operating from this perspective will be biased towards finding some sort of hidden meaning in the client’s free association whether it is there or not. If you asked me to free associate, I would probably just rant incoherently about how cool the buildings downtown are or cute things the children in my family say or how frustrated I am that whenever I enter a building I am always very cold because people use excessive air conditioning in this country.

And I’m sure an unscrupulous therapist could just assume that this means that I am obsessed with phallic-shaped objects or I am desperate to have children or I find that this world is too cold and unwelcoming and I long for the safe, warm environment of my mother’s womb. Sure. My own perspective is that the things that I happen to randomly think about when I am not directing myself (or being directed by someone else) to think about something in particular are rarely relevant to the major issues I have in my life. I will survive despite the prevalence of freezing-cold rooms in my day-to-day experience.

So it is with venting about my problems, which is somewhat similar to free-association in that one is asked to simply say whatever they want to talk about or are upset about at the moment. Yes, obviously, it can sometimes be very useful. I do not deny that whatsoever. A therapist may ask, “What’s been troubling you lately?” and a client might say, “My mother is sick.” Or they might say, “My children won’t listen to me and it’s making me mad,” and then the therapist probes a little more and the client reveals that the client and their partner are constantly fighting and contradicting each other and the children don’t know who they’re supposed to be listening to anymore.

The trouble starts when venting about their problems is all the client is ever asked or allowed or encouraged to do. Then you have a therapist who’s doing nothing more than what a trusted, patient, empathic friend could do. And while, to be fair, such friends aren’t as easy to find as we may wish they were, these are not skills that you need at least six years of higher education and at least one (possibly more) professional licenses in order to administer.

And that’s about all I recall doing when I went to therapy. Of course, because I was depressed, the things I vented about frequently had to do with depression in some oblique way. But the key thing on my mind as I headed off to my weekly appointments wasn’t necessarily, “I have depression.” It was, “I just had a fight with my partner and now I’m convinced they’ll dump me and I’ll be alone forever.” Or “I’m terrifying about this exam and if I don’t do well then I am a failure.” Or “I hate myself.” Or whatever.

And my therapists, for the most part, did succeed in creating a space where I felt slightly comfortable with sharing these things, and so I shared them. They would say, “What would you like to talk about?” and I wanted to talk about my conversation with my mother or how much I miss my siblings or my fears about my partner leaving me. The therapists would attempt to understand why I felt the way I did, but they did not seem to do much to change the way I felt, even though I continued seeing the same ones for a few months at least. By then, the real work of therapy should have begun.

Whereas what I’ve now been taught to do as part of my own training in mental healthcare goes more like this: A client comes to you. You ask for some basic information from the client about their life, family, history, cultural/ethnic/religious background, reasons for coming to therapy, and so on. You ask the client what they would like to accomplish in therapy. You tell them a little bit about your own therapy practice and what they can expect from it, and see if there’s anything that makes them uncomfortable or that they feel wouldn’t work for them.

Together, you set some concrete goals for therapy that are as measurable as possible. For instance, “I would like to stop having panic attacks when I leave the house.” Or “I want to find ways to deal with feeling very upset that do not involve self-harm.” Or “I want to learn how to approach people and make friends with them.” Or “My partner and I would like to find ways to manage jealousy.” If the client suggests goals that the therapist thinks are too vague, unrealistic, or dependent on factors beyond the client’s control (“I want to find a partner”), the therapist can discuss this with the client and help them adjust the goal so that it’s more manageable (“I want to get over my anxiety about asking people out on dates” along with “I want to learn ways to deal with feeling lonely”).

Then, the therapy progresses towards these goals. Every few weeks or so, the therapist and client assess how the therapy is going so far, and the client can weigh in on whether or not they think it’s helping, what concrete progress they feel they have made, and so on. The therapist may periodically administer scales or questionnaires that help gauge improvement in a slightly more objective way. The client and the therapist together can decide to adjust or change the goals if they want to, or introduce new ones as older ones are achieved. Being able to assess and adjust therapy as it’s going on, not just when it’s about to end, is very important.

Eventually, depending on the therapist’s style and the needs of the client, they may discuss termination, which is a word I hate that refers to the process of ending one’s work with a particular client. The client may feel that they’ve accomplished the goals they had, or that they’ve gotten as far as they think they can with a therapist and will be okay on their own now, or that they need to find a different therapist who may be able to help them better. Therapy should not continue indefinitely. The therapist and the client may agree to check in again in a certain number of months to see how the client is doing and whether or not they need to return to therapy.

Of course, this is just a template; everyone does it differently and not all clients may want or need all of these steps, but this is consistent with an evidence-based approach. This process holds therapists accountable by encouraging them and their clients to evaluate the therapy.

When I look back on my time in therapy, I wonder if I could’ve done a better job of making it work for me. Maybe I should’ve offered up specific changes that I wanted to see to the therapists, such as “I want to stop crying several times a week” or “I need to learn to be okay with being single.” (Both of these things happened without the help of a therapist, by the way.) But…I didn’t really know that I needed to do that. I saw my therapists as authority figures. I assumed they knew what they were doing, and that they would ask me for specific things if they needed to. I had only the vaguest ideas of how therapy is “supposed” to work, because my psychology classes mainly focused on theories and not on practice.

If you find yourself doing nothing but venting about your problems in therapy–without necessarily then developing any sort of plan to help resolve or cope with the problems–that’s a red flag. Venting can be therapeutic in its own right, but you shouldn’t have to pay for the opportunity to do it. Therapists have a responsibility to provide the best treatment they can; it’s literally in our code of ethics. You deserve that from your therapist.

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Venting About Your Problems Is Therapy's Failure Mode

21 thoughts on “Venting About Your Problems Is Therapy's Failure Mode

  1. 2

    ““I want to stop crying several times a week” or “I need to learn to be okay with being single.” (Both of these things happened without the help of a therapist, by the way.) ”

    How, if I may ask, did you achieve the second? I’ve been single my whole life, and it’s bothered me deeply, but I just can’t goddamn find anyone I connect with and I’d rather just stop trying.

    1. 2.1

      [Preface: I’m answering this because it’s a good question and it’s good of you to ask, but I’d like this particular discussion to end after I post, if possible, because it’s quite off-topic from the original post.]

      Unfortunately, I don’t really know. Maybe if I’d gone about it in a systematic way via therapy, I would know. But I wasn’t paying much attention and it happened over a period of time. One thing that helped was finding a wonderful group of close friends, mostly via the internet. Not only did they help me be absolutely okay with not having A Romantic Partner, but that was also how I eventually did find such a partner and stop being single. My friends provided (and continue to provide) virtually all of the things I would hope to experience with a romantic partner, just not the romance bit. They are there for me for anything I might need. I live with some of them and we cook meals together and share household expenses and hang out on the couch watching our favorite shows. They ask me for support, which I really value and have always wanted to give to a partner. We go out and have fun in the city, or see each other at conferences and other fun things if we live far apart.

      When you say you can’t find anyone you connect with, I don’t know if that includes friends or not. If you don’t have any friends, that’s a simpler problem to address than not having a partner, and there’s some great advice about that on Captain Awkward.

      None of that is probably helpful, but you asked and I wanted to give the honest answer rather than some cheap crappy advice.

    2. 2.2

      Having totally unjustified rock star self esteem and fun hobbies help me, but I have to admit the thing that helped me be chill about a lack of romance thru most of my twenties was when my teenage heat randomly died overnight at 23, around the time I lost my hair. I wish any of this could be given to others – sometimes I feel like a bodhisattva under a curse of silence. I feel really good about myself, but am powerless to help the people who don’t. Which only bothers me so much, because as I said, I feel really good, but it does bother me.

  2. 3

    My first therapist was sorta the unguided type, if I recall. I also had no idea what to expect. Later, I went to the city counseling center, and they did things very much like the better way you describe.

    I’m still uncertain what to say about how helpful it all was, even the better methods (which I also recognized as better). Certainly sometimes it helped me refocus, and work out how to accomplish things.

  3. 4

    I benefited greatly from a fairly undirected style of therapy, but by that point I’d had tons of self-administered CBT, and was actually working as a CBT therapist. I felt like I’d gone as far as I could with that approach, and needed something more open ended. I was really lucky to have a really good therapist, and it never just devolved into endless venting. He kept bringing it back to our (therapeutic) relationship, and how my broader patterns were playing out between us. Powerful stuff, but always very undirected.

  4. 5

    I really dislike therapy, and this may be why; what I dislike about it is talking about the things I try not to think about because they’re upsetting (which isn’t really a good way to deal with them, but it gets me through the day-to-day), and I feel emotionally (and physically) drained after every session. They might suggest various techniques for relaxing, none of which I found very effective, and what I really wanted were more concrete solutions to the specific things I was dealing with at any given time (which they really couldn’t help with). As a result, I would usually give up after a couple appointments because it didn’t seem to help. I’m not getting any better on my own, though, so I’m going to have to suck it up and go back, but I have a better idea what I need from a therapist, so I’m hoping that will help. I think what I need is CBT, not more relaxation techniques, and I’m going to lay out what I want to get out of therapy from the get-go. Maybe I can’t change how tired my depression makes me, but perhaps I can work on how to self-motivate in spite of the fatigue. Likewise, something to help the anxiety that does more than try and relax, because I don’t have any success with that.

    Basically, no venting, because I likewise have friends I can do that with.

  5. 6

    I went the CBT route precisely because I wanted a goal-orientated approach, and was wary of a form of therapy that basically involved me wallowing in misery and talking about my childhood endlessly with no resolution in sight. I know that psychotherapy doesn’t have to be like this, but all the people I knew at the time who had done it were…um… rather self-absorbed types who just liked the opportunity to yak to a non-judgemental stranger about what special snowflakes they were and how unique and important their pain was. That really put me off, although I have met people since who were not like that and were really helped by it.

  6. 7

    I’ve done CBT and also more venting-style therapy. For me, the second was probably more helpful, because I am very analytical and have a lot of self control (way too much at times), so I was already applying a lot of CBT techniques in my life without realizing it. What I needed was to open up more and acknowledge a lot of emotional stuff that I had hidden away. My therapist was very good at sitting quietly for a long time and then ask a single question that forced me to admit stuff I was very ashamed of. It was like taking bitter medicine – awful while I did it, but now I am extremely grateful that I had the opportunity to receive this help.

    In the end, however, I think so much of this boils down to finding a therapist you connect with and trust.

  7. 8

    I’m not sure if this is what anyone else does, but in therapy I usually am supposed to bring a piece of paper about what I am working on, and then the next week we start with questions (checking symptoms I get) and then do a follow up on what I wrote the previous session. I like this since sometimes, I feel good that issues get resolved, or at least there’s a record that we’ve talked enough about a topic and there’s no need to really talk further.

    Of note, my therapist knows my parents split up after my mother (who was severely mentally ill herself) stabbed me (not very effectively) with a kitchen knife. I have not seen her since, and I told my therapist that, aside from letting her know that, I’d rather not think about that and it’s been a long, long time. She seems to accept that and so far, I’m doing relatively well. I’m just happy that I didn’t have to argue about it, also since, because I barely remember my mother, I wouldn’t have much to talk about.

  8. 9

    I’m interested in what you think of Woody Allen, Miri, since his public persona appears to be very invested in venting-type of psychotherapy His archetype, I think, has been very influential in our cultural perception of psychotherapy.

    I have difficulty finding friends on whom to inflict my therapeutic venting because I tend to perceive my problems as less important than those of others and so I do not wish to burden them. Nor do I know what would constitute an exploitation of someone’s patience in this way,and so I tend to just keep my mouth shut and wait for it to pass. I visited the school psychologist a lot when I was little but haven’t seen a shrink for a long time, despite relatives’ urging that I do so. Part of the trouble is that I’m not sure how to articulate my needs. Does figuring out how to articulate my needs qualify as a time-limited specific goal for a therapeutic relationship?

    1. 9.1

      I’m interested in what you think of Woody Allen, Miri, since his public persona appears to be very invested in venting-type of psychotherapy

      I’m afraid I’m the wrong person to ask; I’m not familiar with his work at all and all I really know about him concerns the recent allegations, which are irrelevant here.

      Does figuring out how to articulate my needs qualify as a time-limited specific goal for a therapeutic relationship?

      Absolutely, and that you’ve identified that as an area in which you’d like to improve means that you’ve already done some of the work of therapy (figuring out the problem and setting goals).

  9. 13

    Apparently my therapy is 100% wrong.

    For one, it’s totally open ended. There are a number of specific things I’m working on, but my assumption is that I will always be in therapy, I just may adjust down to less-frequent sessions when I’m doing particularly well. This is basically because I know that it is really, really hard for me to get started again with a therapist once I’m actively depressed or otherwise in crisis-mode (first I have to admit to myself that it is in fact “that bad”, and second I have to actually find the energy to set up an appointment). It’s way easier for me to say at a monthly check-in appointment “hey, can we meet weekly for awhile, this thing is going on and I really need the help” than it is to start fresh.

    Secondly, my therapy sessions don’t typically have a set structure or goal. We do an opening mindfulness exercise, then she asks me what’s on my mind this week. If there is a big thing happening, we talk through that, and we may set some goals/do some exercises to work on that. If there isn’t, we dive in to one of a few topics that are more ongoing/unresolved issues for me (body stuff, family stuff, etc).

    All of the therapy I’ve had has basically been like this. We just talk. They guide the conversation some, so it isn’t just me rambling, and they will ask pointed questions of me or make observations, but that’s about it.

    I get why structure and goals are useful, but personally I have a pretty good toolbox of CBT and mindfulness skills for managing my distressing thoughts and emotions. What I need mostly is a) someone to talk to when I’m doing all that to the best of my ability and I still feel awful b) help processing assorted shit from my past. And for now, a rather open-ended structure is working fine for that.

  10. Ed
    14

    I think a mixture of the venting/non-judgmental listening approach and the structured, goal-oriented approach is best for me. My therapist suggests a lot of coping and mindfulness techniques which are great, but she also listens and it is so wonderful to be genuinely listened to.

    It actually hasn’t been my experience that the world is full of sympathetic listeners. And I do have a fair number of friends. With a couple of exceptions, sharing how I feel with friends or relative gets me:

    1. A sense of their deep discomfort.
    2. “Everything is OK.” , “You’re life is great”, etc.
    3. All I have to do is try harder/will myself to feel good. Happy thoughts. Positive thinking.
    4. All I need to do to get better is to do the things I can’t do when I’m depressed or obsessive (vicious circle).
    5. And of course, religion.

    I’ve never had a therapist with a pure CBT approach, and from the sound of it I would find it demeaning, cold and cruel. There is also a balance needed between discussing the past and present. Understanding how I was programmed helps me alter that programming. Understanding patterns in my life over time helps me realize that many things I took for granted as just the way I am can be rebelled against by moving in another direction.

  11. 15

    I think this is a great post, but I will note that for my own idiosyncratic self, venting was helpful not (or at least not primarily) as catharsis or as an associational exercise, but actually as part of a process. I started seeing a therapist at about the same time I was prescribed phenelzine, so about 6 months ago now. Much of the general improvement that I have experienced in that time has been due to the medication, but therapy has also been very helpful (it’s something I really should have done much sooner), and specifically, the venting that I did in the early sessions was foundational in that without it, some of the later stuff would have been difficult.

    The reason is pretty simple. I’ve spent so much of my life cringing and apologizing for existing that it was an enormous personal step for me to talk forcefully about my issues, ie to make myself the center of attention, even in a situation in which the listener was literally being paid. (I couldn’t do it the first few sessions; the therapist would spend as much time prodding and asking leading questions as I would spend talking. She wasn’t just playing the part of a passive friend here; she earned her paycheck.) Now, that’s obviously not all we’ve done, and I do agree that if you’re doing nothing else you should probably find a new therapist, but I feel like I can trace elements of what I see as my improved mental health directly to those venting sessions.

    A few weeks ago, for example, I started a little online writing project. Before therapy, I would never have done that, because I saw myself as stupid and unimportant and untalented, and anything that I could possibly say or write or think could be done better by a whole hell of a lot of people. But now, do you know what? Even if that’s true, I like doing it, and since I matter, through the commutative property this means the pleasure I take in writing matters, thereby justifying my project. You might roll your eyes, but I really genuinely do think there is a direct connection between that attitude and the therapy sessions I’ve spent venting and having someone actually listen to and validate me.

    So I’m not disagreeing, but I’m also raising the possibility that some minority of people in therapy might be like me, and thus for whom the act of venting to a real actual person is in itself part of a process of self-improvement, or healing, or whatever you guys call it.

  12. 16

    I have a quick question that I am having difficulty finding the answer to. What do you call it when a client excessively dumps/vents in therapy? I’m looking for the beneficial term when the venting has helped them to see the solution.

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