My training in psychology is in research at the sub-clinical level, specifically sports psychology and personality theory. However, because I deal with human subjects (as opposed to animals), I have to be aware of vulnerable populations in my research. This means I’ve taken a few psychopathology courses, some neuropsychology courses, and had a few units of psychopharmacology sprinkled across diverse classes. I’ve got a better-than-average grasp of therapeutic interventions, mental illness, and addiction. And if there’s one addiction that troubles me the most, it’s addiction to therapy itself.
It doesn’t seem like it should be possible, yet it is: For some people, therapy itself is addictive. I’ve seen this play out with people in my own life time and again (repetition compulsion on my part, but that’s another blog post to make). The individual goes to therapy, enjoys the initial rapport and the interest the therapist shows in them, and then loses interest in the therapist when the time for the real work begins. At this point, the therapy addict either becomes combative with their therapist or they simply change clinicians.
Therapy reinforces talking about the self. The therapy addict enjoys the attention and craves discussing the same points of their life repeatedly because their life is largely stagnant. They go over the same ground with each new therapist and get different feedback until a diagnosis emerges and they have to begin working on themselves. But this work means examining their life, behaviors, beliefs, moods, and thinking processes; work means the stagnant life must be seen for what it is and they must change it by changing themselves. The familiar pain that brought them to the therapist in the first place must be replaced by the pain of ripping off the proverbial Band-Aid and examining where they were hurt, by whom, and how. As Rollo May put it, “Either way, it’s going to hurt.” And, unfortunately, therapy hurts worse because the healing process is unfamiliar and largely self-inflicted.
The common mantra of the therapy-addict is, “I can’t do that.” When asked to meditate daily, they claim they experience anxiety. So when an anxiety controlling exercise like a specific visualization is suggested, they can’t do that, either. When told to keep a journal, they fail to do that or keep one that is superficial and fails to record genuine reflections. If asked to undertake a physical task such as low-impact exercise, they find some reason not to or, worse yet, develop a psychosomatic illness that prevents them from walking around the block (or they insist they don’t need to do this because they get enough exercise already). Healthy thoughts are problematic, too, and efforts to employ cognitive behavioral therapy fall short and negative ideation increases as a result of their apparent failure.
Of course, the therapy addict wants to fail. Failure means finding another therapist or, at the very least, revisiting their past in an effort to root out more repressed trauma. It’s important for the therapy addict to fail because that reinforces their need to be in therapy.
Most if not all therapists (or at least the legitimate ones) don’t want a perpetual client. One of the main goals of any good therapist is to get the client off the couch; if therapy works, then there should be an end to therapy at some point.
The problem with therapy addicts is that they can’t be helped. Efforts to help a therapy addict only feed the addiction. Moreover, it seems as if therapy addiction is comorbid with codependency and heightened levels of trait narcissism, neither of which are good.
I speculate that in the near future, therapy addiction will be added to the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. First, it will appear as an emerging disorder and then be added to the factitious disorder category. Unfortunately, due to the nature of the illness, how it’s going to be treated will probably be pretty rough. But it’s real and it’s definitely problematic.