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"What if the Therapist Tells Me I'm Crazy?"

Discovering that your struggles make perfect sense.

Key points

  • Starting psychotherapy is a vulnerable time and can trigger insecurities about what the therapist might see in you.
  • Therapy will likely reveal more about what is right with a person than what is wrong.
  • Choosing to seek therapy when it's needed is an expression of sanity and wholeness.
Motortion/Adobe Stock
Source: Motortion/Adobe Stock

“So… what do you think?” Meghan asked toward the end of her first appointment with me. I gave her a brief summary of my assessment and told her she met criteria for a diagnosis of major depressive disorder. I also said she would probably get a lot out of treatment, and mentioned some things we might work on together.

She still seemed to be holding her breath, as if waiting for the punchline. “I guess…,” she began, then stopped. “Well, I guess what I really want to know is—do you think I’m crazy?” she asked. Deep down, Meghan feared that she was broken in a fundamental way.

Many people who start therapy (and many who are afraid to) share this apprehension—that when a trained professional looks deep into their psyche, they’ll discover an essential deficit. For Meghan, it was the fear of being told that she really was less than, an imposter, and that even psychotherapy couldn’t fix her.

What Coming to Therapy Means

Most people start therapy when they’re really struggling, often through the hardest time of their life. For this reason, it can feel like a defeat—especially in a society that continues to “other” those with mental health challenges. This enduring stigma stops many from seeking treatment.

But the decision to start therapy is a sign of your wholeness. No matter how hard a time you’re having, or how hopeless you may feel, a part of you is determined to find the support you need.

I reassured Meghan that I didn’t think in terms of “crazy” or not, and that in fact, I had the opposite impression of what she was afraid of. “Coming for therapy is a sign of what is right with you, not what’s wrong,” I told her. A part of Meghan recognized that she needed help, and was willing to move through her hesitation and societal stigma to get it.

What You Discover in Therapy

Here’s what you’re likely to find out for real when you start going to therapy. First, you’ll find validation for thoughts and feelings you struggled to understand.

Your therapist may help you see that of course you think and feel those things, based on what you’ve experienced. Of course you sometimes assume people are talking about you behind your back, since your mom constantly criticized you. Of course you have a hard time feeling secure in your relationships when your childhood was marked by loss and instability.

You’ll probably discover that your fears and struggles make sense, on account of what you’ve lived through. Maybe you've survived major trauma, and have a hard time feeling safe. Perhaps you've lived through a loved one's betrayal, and now you often feel like you're waiting for the other shoe to drop. Instead of beating yourself up for reacting in ways you don't understand, you can start to develop compassion for who you are and what you've been through.

You may also find out that you have more strength than you knew, the same strength that has sustained you this far and that drew you to the work of therapy. Along the way, you’ll understand more clearly the ongoing legacy of the traumas and hurts you’ve lived through.

While it may feel paradoxical, you’ll come to see how fundamentally sane you are. Many of the people I work with even start to see that what they called “crazy” was the radically sane part of themselves that refused to go along with the insanity around them. For example, you might have been labeled the "problem child" in your family because you were the only one who refused to sweep longstanding problems under the rug, and you couldn't help but shine a light on the things that everyone else chose to ignore.

And finally, you may very well begin to accept that the patterns giving you trouble now—ways of relating to others, thought processes, emotional responses—developed when you desperately needed a way to survive. Maybe you learned to never get your hopes up, for example, because they were so often dashed when you were a kid; now that you're all grown up, it's still hard to trust that things will work out.

Although these ways of coping might not work so well anymore, they got you through a perilous past. They were the very best that anyone in your position could have done.

The same wise part of you that formed these defenses may begin to let you know that it’s time to try something new, as I describe in Mindful Cognitive Behavioral Therapy. Even if you feel broken, starting therapy shows that the seeds of new life are already within you.

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Gillihan, S. J. (2022). Mindful cognitive behavioral therapy: A simple path to healing, hope, and peace. HarperOne.