Disclaimer: This text is for reflection and information only. It is not medical or psychological advice and cannot replace personal work with a therapist, psychiatrist, or crisis service. 

Why talk about therapy at all?

 If you try to make sense of the field of psychotherapy from the outside, it is easy to get lost. 

Do I really need therapy? Does it even work? When is the “right moment” to go? How do I choose a therapist? How do I know if it is helping, or if I am “just talking”?

You might have asked yourself some of these questions. Maybe you are therapy‑curious and still hesitating. Maybe you have already tried therapy and left with the feeling, “It didn’t really work for me.” If so, this article is for you.

My goal is not to convince everyone to go to therapy. It is to map the main questions and conflicts around therapy, show what research actually says, and offer one way to look at how therapy works: from short‑term symptom relief to deeper changes in who we become.

Before we start, one more thing.

  • This is not medical advice.
  • It cannot diagnose, treat, or replace urgent professional help.
  • It is a structured reflection based on research and on experience in the field.

A few words about where I speak from. My background is in process‑oriented psychology (Processwork), and I have been on both sides of the chair – as a client and as someone who accompanies people in inner work. I also build tools for inner work with night dreams and, in my day job, I build digital marketplaces.

Here I am not defending any particular method. I am trying to look at the field as it is: what seems to help, what confuses people, and how culture shapes our choices.

We start with the simplest and hardest question: Is therapy even helpful at all?

 The general state of therapy – is it helpful at all?

What do we mean by “therapy”?

In this text, “therapy” means a structured, regular conversation with a trained professional (psychotherapist, psychologist, counsellor). I am not talking about:

  • talking with friends (important but different);
  • consulting or spiritual guidance (overlapping but not the same); 
  • medication prescribed by a psychiatrist (another important piece of the puzzle, but with its own rules).

Within psychotherapy there are many schools – cognitive‑behavioural, psychodynamic, humanistic, systemic, process‑oriented, and others. They differ, but the main question still stays the same: do these conversations help people or not?

How many people use therapy, and when do they seek it? 

Across European countries, a growing minority of people have tried psychotherapy at least once in their life. In some countries, this is already a normal part of life. In others, it is still rare and often hidden. People usually start therapy not because they are “curious”, but because something has become too much.

Typical reasons include:

  • persistent anxiety, panic, or depressive episodes;
  • burnout and work‑related stress;
  • relationship or family crises;
  • traumatic events and losses;
  • a general feeling that life has lost meaning or direction.

When asked in surveys, many people say they would only consider professional help when their symptoms are severe or clearly interfere with daily life. Earlier stages – chronic dissatisfaction, borderline burnout, repetitive conflicts – often do not “feel serious enough” to justify therapy.

This threshold is interesting. It says more about culture than about what therapy can and cannot do.

When do people think they “need” therapy?

The idea that “therapy is for people who are really ill” is very strong.

In several surveys, people describe psychotherapy as something you turn to when you are at the limit: cannot work, cannot get out of bed, cannot control your behavior. Feeling bad, confused, or stuck is often seen as too weak a reason.

As a result, people with serious problems delay help because they still do not feel “ill enough”,  and people with “okay” external lives but high inner suffering feel almost guilty for even thinking about therapy.

You might recognize phrases like:

  •  “Others have it worse.”
  • “I am not crazy, so I don’t need a psychologist.”
  • “My parents never went to therapy and they survived.”

These sentences sound personal, but they are learned. They belong to the culture as much as to you.

So, is therapy helpful at all?

When researchers look at thousands of people before and after psychotherapy, they notice three main patterns:

  • many people do get better: symptoms reduce, functioning and quality of life improve; 
  • a smaller group shows little or no change; 
  • a minority report that they feel worse or had clearly negative experiences. 

If you put all this together, one practical (and pretty obvious) conclusion appears:

In general, psychotherapy helps a large share of people who try it. It does not help everyone in the same way, and in a small number of cases it can be unhelpful.

This is still not a miracle, but it is much closer to “something that often works” than to “nothing helps”.

And, actually, that is the point of this article – to help you make therapy more effective for yourself, if you decide to try it. Or maybe you now can take a more grounded decision that you do not need therapy – that is also a good outcome.

Main questions and conflicts around therapy

If therapy is generally helpful, a logical question arises: why, then, does not everyone use it? There are many controversies around therapy, of course, but these are probably the top five “elephants in the room” that often appear when people think about starting, continuing, or returning to therapy:

  1. “Is therapy really for people like me, or only for the ‘really ill’?”
  2. “Shouldn’t I be able to handle this on my own?”
  3. “Will therapy be a quick fix or an endless tunnel?”
  4. “Does therapy actually work – and what if it did nothing for me last time?”
  5. “Is therapy about removing symptoms or about personal growth?”

Have you ever had any of these doubts, questions, or inner conflicts? If yes, studies suggest that you are far from the only one, and that the state of the “therapy field” – as you will see below – depends to a great extent on the culture in which you and I grew up.

Each of these points would deserve a separate article (and maybe we will write them if there is enough interest in the topic). For now, I will focus mainly on point 5 – “Is therapy about removing symptoms or about personal growth?”

Fast results or personal growth?

Sidenote: what I describe next is more my own take from Processwork and practice than something I can directly prove with data.

Very often, when people come to therapy (or, at least, at some point in the process), their question is: “What do I do to solve this? How do I get rid of the symptom?”

Let’s pause here. This is a valid question by all means! It is totally fine to view therapy as a tool to take the pain away as quickly and cleanly as possible. And here I want to make a slightly provocative suggestion:  therapy is not always very good at exactly that – if we understand “good” as simply removing uncomfortable experiences without touching anything else in life.

Here is why.

In a number of psychological approaches, and Processwork is one of them, symptoms and problems are not only obstacles to be removed. They are also seen as pointers to a part of our identity that we do not yet know well, or do not fully accept. This “new” part of us wants to enter our life, to be recognised, embodied, and lived. The anxiety, the conflict, the burnout, the disturbing dream – all of that can be one of the ways this part knocks on the door.

From this perspective, the paradox is that the most stable way to “get rid of the symptom” is sometimes to turn towards this unknown part of yourself and give it a place, instead of fighting it as an enemy.

So does it mean that we should use therapy only as a tool for personal growth and not think of it as an ambulance for our hurting needs? In my experience, hurting needs are more often a driver for therapy than personal growth. But we can argue that if, alongside wanting to get rid of the problem very fast, we can also *hold a little awareness* and interest in “what new ‘me’ is trying to emerge through this”, we can get more benefit from therapy. And, in a slightly paradoxical way, that may help the aching problem resolve faster.

How culture shapes our attitude towards therapy

Cultural messages you may recognize

Let’s now dive into how some of your inner doubts or attitudes around therapy may, in fact, not be fully “yours”, but echoes of the community and culture you live in. Very often they do not appear as official rules. They sound more like background sentences we grow up with – sentences that quietly define what is “normal”, “strong”, or “shameful”.

Here are a few examples that appear again and again in different forms:

  • “Real men don’t talk about feelings.”
  • “Family problems stay in the family.”
  • “If you see a psychologist, you must be crazy.”
  • “Adults solve their own problems.”
  • “You don’t wash dirty laundry in public.”

You might never have heard them said out loud. But you can feel them in how people react when someone mentions therapy.

How attitude to therapy is culturally dependent

See sources for the references

  1. Northern/Western Europe vs Southern/Eastern Europe. 
    In Scandinavia and parts of Western Europe, therapy is almost part of normal hygiene: surveys in Sweden and Finland show relatively high lifetime use and low public stigma; mental health is talked about more like physical health, and the main problem is capacity and waiting lists, not shame. In contrast, in parts of Southern and Eastern Europe, lifetime therapy use can be below 10% (in some Eastern countries under 5%), and stigma is much stronger: in Greece, for example, around 86% of people feel that society judges those with mental health problems, and in countries like Poland or Romania many still see therapy as “exotic” or only for severe cases.
  2. Netherlands/Belgium vs Italy/Latvia
     An EU survey that asked “Would you see a psychologist for a personal problem?” found big gaps inside the same union: people in the Netherlands and Belgium were among the most likely to say “yes”, while in countries like Italy or Latvia willingness was much lower. In practice this means that, with the same level of suffering, a Dutch person is statistically more likely to think “maybe I should see a therapist”, whereas an Italian or Latvian counterpart is more likely to stay inside family circles, go to a GP, or try to endure alone.
  3. UK/Germany vs Southern Europe
     In the UK, about one in three adults have tried therapy at least once, and roughly three‑quarters of those who did would recommend it to others; therapy is increasingly framed as a proactive step for well‑being, not just a last resort. In Germany, roughly 18–20% of adults receive some form of mental‑health treatment in a given year, and a majority say they would advise a friend with depression to seek counselling rather than hide it. Meanwhile, in Southern Europe, lifetime therapy use is much lower (Italy is around 10%), with a stronger tradition of “family first” and a tendency to rely more on medication or informal support than on talk therapy, although young people in cities (for example in Spain, post‑COVID) are pushing that trend in a more therapy‑friendly direction.

Disowning a little may help 

Thinking that it is not only you, but also your culture speaking, can already make life a bit easier. Not only general acceptance of therapy is country‑dependent; even the inner threshold of “is my issue important enough for therapy?” is something we largely learn from the environment in which we grew up.

You do not need to wage war on your culture. But you can say to yourself, for example: “I am allowed to ask what I need, not only what my culture expects.” 

You may still decide not to go to therapy, or to stop if it is not what you need right now. But it will be more of a choice, and less of an automatic reflex.

Some takeaways

If you are still reading, you are probably somewhere near the threshold: thinking about therapy, reconsidering it, or trying to understand your past experiences. Here are a few things you might take from this article.

Your confusion is normal

The conflicts we talked about are not signs that you are indecisive or weak. They are common patterns that appear in many people’s minds when they think about therapy.

Separate “me” from “my culture”

Easier said than done. It is like telling a fish to separate itself from the ocean. But just being aware that some of your inner sentences come from the culture can already make things lighter.

Fast results and personal growth

Try to keep some awareness that identity change is what plays out in the long run, and that symptoms are – from one perspective – just “doors” into a new you. Or forget all of this if you are in the middle of a conflict – then it is perfectly fine to say “to hell with personal growth”.

Is therapy “worth trying” in general?

Based on the data we have, one grounded conclusion is:

  • for most people, psychotherapy is helpful;
  • for some, it helps only partially or not in the way they hoped; 
  • for a minority, it can be unhelpful or even negative.

In other words, therapy generally works more often than it fails. And now, since you have come this far and read the whole article (congratulations), you already know some typical pitfalls and some helpful attitudes. This means that, if you decide to try it, we can genuinely hope that therapy will bring more clarity and relief into your life – and maybe help you move a little further from “Do I really need therapy?” toward “Who am I becoming?”

Sources

1) Scandinavia / Western Europe vs Southern / Eastern Europe

These conclusions are drawn from several sources:

The approximate 30–40% lifetime use figures in Scandinavia I cannot back with a precise link here; this comes from earlier reading, so you may treat it with a bit of healthy scepticism.

Additional sources cited in the article:

  1. UK public attitudes and usage (who goes to therapy, why, and would they recommend it?): BACP Public Perceptions Survey 2025 
  2. EU stigma and help‑seeking (core background for “stigma vs willingness to seek help”): Mojtabai, R. (2010). Mental illness stigma and willingness to seek mental health care in the European Union.  Social Psychiatry and Psychiatric Epidemiology, 45(7), 705–712. 
  3.  Germany: rise in acceptance of mental health professionals over 30 years:  Angermeyer, M.C. et al. (2023). The rise in acceptance of mental health professionals: help-seeking recommendations of the German public 1990–2020. Epidemiology and Psychiatric Sciences.
  4. Germany: attitudes toward psychotherapy and health literacy (good for “handle it alone” / literacy themes): Schröder, R. et al. (2025). Attitudes Toward Psychotherapeutic Treatment and Health Literacy in the General Population in Germany: Cross-Sectional Study.* JMIR Public Health.  
  5. Romania: stigma as barrier (useful for Eastern Europe contrasts): Manescu, E.A. et al. (2023). *Mental health related stigma in Romania: systematic review and narrative synthesis. BMC Psychiatry, 23:560. 
  6. Negative effects of psychotherapy (for the “it sometimes harms” nuance): Crawford, M.J. et al. (2016). Negative effects of psychotherapy: estimating the prevalence in a random national sample. 
  7. Expectations and attitudes about psychotherapy (good for the “what people expect before starting” part): O’Callaghan, E. et al. (preprint). Consumer Expectations and Attitudes about Psychotherapy: A Survey.