By Mark Ryan, BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist
Therapy is more visible and more accepted than it used to be, and yet many people still decide it is not for them. Perhaps they have heard stories that did not resonate, worry about what others would think, or simply do not feel unwell enough to justify it. These beliefs are personal and often rooted in upbringing, culture or past experience, and they deserve respect. They are also, in many cases, based on myths or on ideas that no longer match what therapy offers. This article looks at eight of the most common reasons people give for thinking therapy is not for them, and why for most people it can be more welcoming, more useful and more relevant than they expect.
The reassuring news first. Decades of research, including hundreds of randomised trials, show that effective psychotherapies are available for most mental health difficulties, and that therapy can improve quality of life as well as reduce symptoms (Cuijpers, 2019). Therapy works, and it works for far more than crisis.
1. “I’m not struggling enough to need therapy”
This is one of the most common beliefs I hear. Many people assume therapy is only for breaking point, when life feels unbearable or has fallen apart. In practice, a lot of good therapy happens with people who are coping well on the surface but want to understand themselves better, make sense of a life event, change a pattern or improve their relationships.
There is evidence that you do not need to wait. A meta analysis of 18 studies of people with clinically relevant depressive symptoms who did not meet the threshold for a diagnosis found that psychotherapy reduced symptoms compared with usual care, and that fewer people went on to develop a major depressive episode over the following six months (Cuijpers et al., 2014). Starting sooner is a sensible choice and not an overreaction.
Therapy is also for the person who feels stuck in a loop, is working through change, or simply wants to know themselves better. You do not have to be drowning to benefit from learning to swim.
2. “Talking won’t change anything”
For some people, talking about problems sounds pointless or even self indulgent. If you have coped by pushing feelings down or by getting on with things, sitting with emotions can feel strange and unfamiliar.
The research on talking therapies tells a different story. The hundreds of trials behind the overview mentioned above are trials of talking therapy, and they show real improvement for most mental health difficulties (Cuijpers, 2019). In my experience, putting what has been tangled up inside you into words, in front of someone who listens carefully, often brings a clarity that thinking alone does not.
It is also true that talking can feel awkward at first. Most people find that the awkwardness passes within a few sessions as the room begins to feel familiar. A good therapist will not leave you to fill the silence on your own. They will help you find your way into it.
3. “I should be able to handle this on my own”
This belief often comes from messages about strength, independence and self reliance. Many of us were taught, openly or in passing, that asking for help is weak and that emotions are something to manage in private. Men in particular tell me they feel they ought to be able to fix things themselves, and the article on men's mental health and masculinity looks at where those messages come from.
The research shows that these beliefs have real consequences. A systematic review of 144 studies with more than 90,000 participants found that stigma has a small to moderate negative effect on seeking help, with men, young people and people from ethnic minorities among those most deterred (Clement et al., 2015). In other words, many of the people who most need support are the ones least likely to ask for it, and the reason is a social message and not a personal weakness.
Humans are built for connection. Managing alone is a skill, and so is knowing when to share the load. Choosing therapy is an act of self respect, and in my experience it is one of the more courageous things people do. You can be capable and independent and still benefit from having someone in your corner.
4. “Therapy is too expensive”
Cost is a real barrier and deserves to be taken seriously. Private therapy is an investment and not everyone can make it. It helps to look at the whole picture, because there are more routes than many people realise.
In England, NHS Talking Therapies accept self referrals for common difficulties such as anxiety and low mood, so you can often make contact without seeing your GP first.
Many private therapists keep a small number of reduced fee places, and it is perfectly acceptable to ask.
Charities, community counselling services and training clinics, where trainees work under supervision, can offer low cost sessions.
Online therapy can reduce travel time and sometimes cost.
Some workplaces offer employee assistance programmes with a set number of free sessions.
It can also help to think about what you are already spending on coping, whether that is evenings out, shopping, subscriptions or endless scrolling. Many of these bring short term relief, and therapy aims at longer term change. If you want a sense of what to expect from fees in London, the article on couples therapy costs sets out the range and what you are paying for.
5. “Therapists will judge me or won’t understand me”
This fear is common, particularly if you have felt dismissed, misunderstood or judged before. Trust matters in therapy and it makes sense to be careful about who you let in.
Therapists are trained to work with people from every background, and acceptance without judgment is at the heart of good practice. Many people find it a relief to say aloud the things they have never said, and to be met with interest and not criticism. This matters even more if you have worried about being judged for who you are. I work with LGBTQ+ clients and with people in consensual non monogamous and other non traditional relationships, and I would encourage anyone to look for a therapist who is openly affirming and who does not treat your life as something to be explained.
If the first therapist does not feel right, that is useful information and not a failure. A large meta analysis of 295 studies and more than 30,000 clients found that the quality of the working relationship between client and therapist is consistently linked with how well therapy goes, across different treatment approaches (Flückiger et al., 2018). Finding someone you feel safe with is part of the work, and the article on choosing a therapist in London offers practical guidance on how to do it.
6. “It didn’t work for me before”
Perhaps you tried therapy and it did not help, or left you feeling more confused. That can leave a lasting impression, and I am sorry if it did.
Therapy is not one thing. There are many approaches, from cognitive behavioural to psychodynamic, person centred and integrative, and therapists vary widely in style, experience and personality. What did not work once may work with a different person, a different approach, or at a different point in your life.
The same meta analysis found that the alliance, meaning the sense of working together on shared goals with someone you trust, was linked with better outcomes whatever approach was used (Flückiger et al., 2018). So if the connection was not there, that tells you about the fit and not about you. The article on when therapy doesn't work yet explores setbacks and what can help, and it is worth a read if you are weighing up a second attempt.
7. “I don’t want to talk about the past”
Some people worry that therapy will drag up painful memories they would rather leave alone. This is especially understandable for people who have survived difficult experiences and built strong ways of coping.
The good news is that therapy does not have to begin with the past. Many approaches focus on the present, including how you think, feel and behave now, and how your relationships are going. You are always in charge of what you share, and a good therapist works at your pace and will not push you into territory you are not ready for.
In my experience many people find that once they feel safe, they choose to explore earlier experiences for themselves. That is not about dwelling on the past. It is about understanding how it shapes the present, so that it can loosen its hold. The decision is yours, and you can take it slowly.
8. “I don’t have time for therapy”
A busy life can make weekly sessions feel like one more thing on the list. It can help to ask whether therapy takes time or makes time. When we are stretched thin, we tend to be more reactive, more tired and less clear, and a lot of energy goes into managing feelings we have not had room to look at.
One hour a week can create space to think, and many people find the benefits spill into the rest of their week through calmer conversations, better sleep or clearer decisions. Online sessions can cut out the commute. Some people prefer fortnightly sessions at first, and that is something you can discuss with your therapist.
Therapy could actually be more accessible, meaningful, and relevant than you might realise
Small Worries That Stop People Starting
Alongside the big beliefs there are usually a few smaller worries, and they deserve a straight answer.
What if I cry? Many people do, and therapists are used to it. Tissues are in the room for a reason, and there is no need to apologise. The article on tears explains why that can be a helpful part of the process.
What if I have nothing to say? You do not need a prepared speech. Starting with "I'm not sure why I'm here" is a perfectly good opening, and a therapist will help you find your way from there.
What if I am not the right sort of person for therapy? There is no right sort. People come at every age and from every background, and with every kind of question.
What if it makes things worse before they get better? Some sessions are tender, and you may feel tired afterwards. You can always say that something is too much and ask to slow down.
Is it private? Therapy is confidential, with a few well understood limits around safety that your therapist will explain at the start.
Things to Try Before You Book
If you are still unsure, you can take a small step without committing to anything.
Write down in a sentence or two what you would like to be different. It does not need to be clear or neat.
Notice which of the eight beliefs above sounds most like you, and ask where you learned it.
Speak to a trusted friend about the idea of therapy and see how it feels to say it aloud.
Book a short introductory call or consultation and treat it as a chance to see whether the person feels right, with no obligation to go further. I’ve prepared a guide on how to prepare for your consultation which you can access here.
What Therapy Feels Like
If you have never been, it may help to know what to expect. The first session is usually a conversation, with no tests and nothing you need to prepare. You will be asked what brings you, what you would like to be different and a little about your life. You can say as much or as little as you like, and you can ask me anything about how I work. The article on the first session describes this in more detail, and the guide to what to expect from relationship therapy covers what follows.
Many people notice small changes early, such as feeling less alone with a problem, or understanding a reaction they had always been ashamed of. Bigger changes usually build over weeks and months. You can also go on your own, with a partner, or both, whether you are in a monogamous relationship, an open one, or single.
Final Thoughts on Therapy and You
If you have ever thought that therapy is not for you, you are not alone. Those thoughts usually come from somewhere real. They may also rest on misunderstandings or on experiences that no longer fit your life.
Therapy does not ask you to be broken. It does not demand that you open up before you are ready. It invites you to explore, with curiosity and compassion, what it means to be human, to struggle and to grow. If you are not sure whether it is right for you, the self assessment guide is a gentle place to start.
If you feel like now might be the right time to talk it through, I offer a free 30 minute consultation in person in London or online. There is no pressure and no commitment, and you are welcome to reach out whatever your background, relationship structure or reason for wondering.
About the Author
Mark Ryan is a BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist, and the founder of Rise and Grow Therapy, a private practice offering couples and relationship therapy across Kensington, Pimlico, and Angel, Islington in London, as well as online consultations. His approach draws first on Imago Relationship Therapy, alongside integrative relational, attachment based, Gottman, and systemic approaches. Mark works with couples of all kinds, including LGBTQ+ couples and those in non traditional relationship structures such as consensual non monogamy, as well as with individuals working through relational issues.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health related stigma on help seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11 to 27. https://doi.org/10.1017/s0033291714000129
Cuijpers, P. (2019). Targets and outcomes of psychotherapies for mental disorders: An overview. World Psychiatry, 18(3), 276 to 285. https://doi.org/10.1002/wps.20661
Cuijpers, P., Koole, S. L., van Dijke, A., Roca, M., Li, J., & Reynolds, C. F. (2014). Psychotherapy for subclinical depression: Meta analysis. British Journal of Psychiatry, 205(4), 268 to 274. https://doi.org/10.1192/bjp.bp.113.138784
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta analytic synthesis. Psychotherapy, 55(4), 316 to 340. https://doi.org/10.1037/pst0000172
