"What would Cecelia think? I have my therapist’s voice in my head a lot when I’m considering doing something 'bad'," says 27-year-old TV producer Emily*. "I’ve definitely refrained from certain acts because I know I have to tell her about it afterwards." Emily started therapy two years ago to deal with a sexual assault but now her sessions focus mainly on whether or not she should keep certain relationships in her life.
"I’ve made some huge life decisions that I don’t think I would’ve done without her, like breaking up with my boyfriend of seven years," she continues. "I’ve always found decision-making difficult; she’s my anchor."
Sarah* began therapy in addiction rehab six years ago and continued after more or less resolving (or processing) the major issues she went in with. "I'm not in a state of real crisis right now, I don't need a lot of support," says the 28-year-old executive assistant. "It's just a really helpful tool to keep me clear-minded and calm. I like having her unbiased opinion on situations, whether I’m considering getting a new job or musing over an argument with a friend."
It could be argued that Emily and Sarah are overly reliant on their therapists. But where is the line? Therapy is undoubtedly brilliant; it can be life-changing and soul-saving. But is it possible to have too much?
The Australian Institute of Health and Welfare reports that 462,000 people received state/territory community mental health care in 2019–2020. Even if we don’t go to therapy ourselves, we love to therapise the hell out of absolutely anything, from diagnosing a friend’s new lover as a 'narcissistic gaslighter' to prescribing life advice based around an Instagram quote we saw one time. Therapy is everywhere and that can be dangerous.
Dr Alan Redman, a psychologist with over 20 years’ experience, explains that overreliance on therapy can come "when a therapist provides something that’s missing from the client’s life in terms of support". This could be simply a willing pair of ears, although Dr Redman stresses that the whole point of therapy is to work towards goals, not just pay someone to listen.
Emily feels that she doesn’t have the safe space to be honest anywhere else in her life. But surely that’s pretty normal? Most people don’t have someone who hangs on their every word without superimposing their own experience at the first opportunity.
"I feel scared at the thought of my therapist leaving me suddenly. I’d feel untethered, a bit like I was floating in space," says Emily. "It would have to be quite a slow, weaning-off process I think. I couldn’t go cold turkey."
Emily’s language raises a more complicated question: is it possible to be addicted to therapy?
"Attaching the words 'therapy' and 'addiction' is problematic as that’s something therapy is there to address," says Dr Redman. "But it makes sense for the positive feelings you get from therapy (from a trusted, unjudging relationship that helps you unlock realisations) to be somewhat addictive or at least leave someone craving that positive reward regularly."
A therapist will never give their client answers. But they do provide the tools and techniques for dealing with decision-making.
Dr Alan Redman
An attachment of some sort is totally normal. Who wouldn’t get used to the experience of being in the same place, at the same time, with the same person and the same purpose: to talk about yourself?
So what are the signs of a genuine overreliance?
For starters, not being able to make a decision without consulting your therapist is a sign you don’t trust yourself. "A therapist will never give their client answers," says Dr Redman. "But they do provide the tools and techniques for dealing with decision-making." The decision-making reliance comes from the space that therapy provides to think about and talk yourself through your problems.
"I absolutely think there is such a thing as too much therapy," says Hattie MacAndrews, a confidence coach who has had therapy on and off three times during her adult life. "While therapy served a purpose for me, I found it unhelpful at times, going back every week and rehashing old traumas." MacAndrews believes that once you’ve covered past events that are holding you back, you need to go off into the world and practise what you've learned. "If new problems come up in three months or a year, or you aren’t coping, you can always go back," she continues. "But it's a dangerous trap to stay in therapy week after week, year after year."
"If the client enjoys the ongoing process of the therapy but isn’t particularly change- or goal-focused, the dynamic can turn into an open-ended coping mechanism," warns Dr Redman. Longer term therapy is an approved method; the more conventional brief therapy is restricted to a specific number of sessions. "The key aim of therapy is to help people reach their goals and these should be set from the very beginning."
Emily and Sarah aren’t addicted to therapy just because they extended their therapy beyond their initial goals but the way they’re using sessions as a crutch for everyday problems is something to consider.
"It becomes a problem when you keep going round in circles with the same problems and there seems to be no improvement," continues Dr Redman, stressing that it is the therapist’s job to notice if this happens. "The therapist should suggest a change in the style of therapy or a new therapist altogether." The technical term for ending therapy is 'termination' and it’s a crucial phase of the process. If the therapist allows the client to avoid or drag out termination, it is a failure on their part.
Sarah Elliott, a psychotherapist in training and certified life coach, believes that a client’s reaction to her taking annual leave is a good indication of how reliant they are. "When I told my clients I was going on holiday recently, some reacted stiffly, telling me I hadn’t given them enough notice," she says. "They acted as if they were in crisis and asked to still have their session – this is when we needed to discuss their attachment style."
Coaching is not the same as therapy and is entirely unregulated but Elliott often has clients who do both. "I've had people who work with a therapist, a couples therapist and me as a life coach," she continues. "They tell me about therapy courses they’ve been taking and when they follow me on Instagram I see they’re following lots of therapy accounts. This raises concerns."
It becomes a problem when you keep going round in circles with the same problems and there seems to be no improvement.
DR ALAN REDMAN
The rise of Instagram therapy accounts worries Dr Redman, too. "There is huge benefit in the talking nature of therapy so to reduce the process to a generic, one-size-fits-all approach won’t be as powerful as the real thing," he says. That's not to say they are entirely without value. Accounts like @hazel.gale.therapy, run by a qualified therapist, make techniques for tackling issues like anxiety accessible to those who can’t afford the real thing. This can be vital short-term help for the many people on waiting lists for NHS treatment.
However, there are many less reputable accounts run by influencers who aren’t real therapists. "You need to make sure of the credentials, expertise and experience of the account owner, otherwise it could do more harm than good," warns Dr Redman.
Then there are the accounts that don’t claim to provide therapy yet rattle out therapy-sounding advice in bite-size infographics. Viral relationship account We’re Not Really Strangers presents statements like 'if they liked you it would be obvious' as fact. This is simply not true but the message gets devoured as Instagram share-bait by the account's 4.9 million followers.
MacAndrews' clients often bring Instagram quotes like these to her in relationship-focused coaching sessions. "It’s easy to interpret these messages as truth and start acting on them, especially if you’re in a vulnerable headspace," she says.
Sarah knows many people who seem like they’ve had too much therapy despite never having been to an actual therapist. "They are living this Instagram quote life," she says, "and those messages out of context can be really limiting and leave you even more confused."
So can you have too much therapy? Arguably yes, if you aren’t actively working towards an end goal or if you are looking to endless different therapised avenues for help. At some point you need to learn to trust your intuition and make decisions on your own terms.
If you’re trying to figure out if that time is now, bring up the idea of ending your sessions with your therapist and see what they say. Perhaps, if you’re finding that talking therapy isn’t improving your mental state enough, you might want to consider medication. For some people (like me), therapy alone isn’t enough to address the chemical imbalance in our brains and that is perfectly okay.
"When I make decisions based on how I am going to feel when I go into the room and tell my therapist, it’s not because she will judge me," says Emily. "It’s because I’m judging myself." In the short term, this is how we begin to hold ourselves accountable and make the changes we want to see in ourselves. Just don’t let it get too Jiminy Cricket on your shoulder, okay?
*Some names have been changed to protect identities