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Kousha Navidar: This is All Of It on WNYC. Hey, I'm Kousha Navidar in for Alison Stewart. It's another beautiful day. I'm so grateful that you're spending some of your day with us. Thanks for being here. We got a cool show today. We're talking to author Claire Messud about her new novel. We're talking to the creator of the very funny show, Girls5eva, Meredith Scardino. We're talking to the chef and author of a new cookbook. The chef is Edy Massih and the book is called Keep It Zesty. That's in the future. Let's kick it off talking about if and when we should quit therapy.

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Kousha Navidar: Going to therapy was once something that happened in the shadows. It wasn't something you talked about in public or even to your friends and family. There was this stigma that gave rise to the dramatic inner turmoil we got to see play out with characters on TV like Mad Men's Don Draper or Tony Soprano. By this point though, today, the idea of therapy has run the bell curve from stigma to something everyone should be doing, and now, maybe according to my next guest, something people might consider walking away from.

Therapy-speak is now ubiquitous and often misused. "I'm in therapy" is something you'll see on dating profiles where once it was considered skeletons in the closet. In many circles, therapy is as much a part of being healthy as exercise, a balanced diet, brushing your teeth, and, for sure, absolutely, therapy has helped countless numbers of people make sense of themselves and the world around them, but here's the question. Should we be thinking about our mental hygiene with the same stick-to-itiveness that we think about dental hygiene?

What if you're not getting anything out of therapy? What if you're retreading the same terrain over and over or maybe it's even making you feel worse? A recent article in The Cut asks the question, "Is it time to quit therapy?" It was written by Melissa Dahl, who is a health journalist and the author of Cringeworthy: A Theory of Awkwardness. In the piece, she speaks with patients as well as psychologists who have given up therapy or advocate for doing so. Melissa, welcome to the show.

Melissa Dahl: Hi. Thanks so much.

Kousha Navidar: Absolutely. Listeners, have you recently given up therapy or have you been thinking about it? Share what's on your mind as part of that decision. We're at 212-433-WNYC. That's 212-433-9692 or you can text us at that same number or hit us up on social. We're @AllOfItWNYC. Melissa, how would you characterize the trajectory of our cultural attitudes about therapy that I touched on in the intro? Anything you'd want to add or amend about the way things have changed?

Melissa Dahl: No, I think you really nailed it. It's been so interesting just in my lifetime, even just in my adulthood really. I'm not that old. [chuckles] Therapy really went from something like you said, that was something that wasn't talked about. Maybe you were a little bit embarrassed about it. It had negative connotations to this thing that people post on their dating apps.

People post on their dating apps that they only want to date someone who is in therapy. The singer, Ariana Grande, on her latest album, she name-checks three different therapy concepts like codependency, therapy, and self-soothe in one single verse in her latest album. It's just become something that was in the shadows to being pretty ubiquitous in certain circles, I should say.

Kousha Navidar: I love that you bring up the Ariana Grande example because I would love to talk about the different kinds of therapy actually because some come with built-in goals. With built-in milestones, that might suggest an endgame. Others are more open-ended. Can you take us through maybe a 30,000-foot view of these different modalities?

Melissa Dahl: Yes. Well, I will say for this piece, I really concentrated on just the broadest term of the definition when you hear the word "therapy," which is just basic talk therapy. That's, I think, what people refer to when they just talk generally about therapy. There's maybe somatic therapy that's more focused on the body or there's things like EMDR that use these pulses that are supposed to really help with trauma, but my piece really focused on talk therapy. That's what I'm talking about.

Kousha Navidar: In terms of therapy goals or milestones, what do those normally look like for patients that would be conducive to short-term rather than indefinite therapy?

Melissa Dahl: Well, the people that I talked to for the story and I talked to something like 15 to 20 people who had recently quit therapy, it was actually wild how easy it was to find subjects for the story. They really almost all said to me, they had entered therapy to talk about something specific. They were going through a breakup or a family crisis or something like that and then they just stayed. They stayed. They just kept going for years and years and years.

It was helpful until it wasn't, until, like you said, they found themselves retreading the same old subjects or maybe getting worked up about things they weren't really worked up about. I came in the end from talking to all these people. Most of them also said to me, those who had quit therapy, they said they would go again. It's not like they were anti-therapy. It's not like they thought it wasn't helpful, but they would go again with a different mindset. They would go in with a discreet problem they wanted to talk about. They would talk about it and then they would go back into their lives without the therapy.

Kousha Navidar: Listeners, if you're just joining us, we're talking to Melissa Dahl, a healthcare reporter at The Cut. We're talking about whether and when you should potentially quit therapy when it stops working in your life or if it's something indefinite that is like going to the gym or brushing your teeth every day. If you are listening right now and you've recently given up therapy or if you've been thinking about it, we want to hear what's on your mind, or if you believe the other side that it is something that's indefinite, we want to hear that too. Share what's on your mind as part of that decision. We're at 212-433-WNYC, 212-433-9692. Melissa, we've got a caller. Let's go to them. Lee in Manhattan. Hi, Lee, welcome to the show.

Lee: Hi, my name's Lee and, yes, I have gone to therapy. I think everybody should try therapy at least once, especially if you need it. I think it's really good. A therapist I was with for seven years, it was really great, very helpful. I started thinking, "Well, when does this end? How do I know it's over?" I was brave enough to ask that question. I said, "How do I know when we're done, when it's finished, and when I don't need therapy anymore?" She said, "Oh, you're just at the very beginning." That was the day I quit and have done great ever since.

Kousha Navidar: Lee, thank you so much for that call. I'm sure that you have heard a lot of stories like this, Melissa. It's an interesting dynamic, right? In some ways, those that are delivering the service of therapy, is it the case that they have some kind of incentive to keep it going or even is that something that shouldn't cross your mind when you're sitting in the room with them? Unpackage that a little bit.

Melissa Dahl: Well, from the clinician's point of view, I suppose there is the incentive of a client that brings in reliable money every week, but the psychologist I talk to and most therapists you talk to will say that the goal isn't indefinite therapy. The goal is to give you some tools to apply to your own life and then go out there and use those tools. Something that people said to me a lot actually is that they would be in therapy. They would talk about these tools with their therapist, but then they wouldn't apply them. They wouldn't use them, but there was something about ending the therapy that took away that safety net and made them feel like, "Okay, I got to figure this out on my own," and "Hey, I know how to because I've been in therapy. I've learned all these things."

Kousha Navidar: Do you have any insight from talking to all of these clinicians about the ways to navigate that conversation about an end date or whether that is applicable to your situation when you are in therapy?

Melissa Dahl: Sure. I think it's just something you can bring up. A lot of times, you're in therapy maybe to work on communication. I think it's actually pretty important not to just ghost your therapist and just stop going. I think that part of the point in therapy is to model the relationships and the communication skills you want to use outside of therapy. You can do that even when you're bringing up this question of stopping.

I will say, I tried not to ghost my therapist earlier this year, but I was like, "Okay. I'm done." She really insisted that we come back for just one more session and talk things through. I think from the therapist I talked to, I think most of them will have a similar approach. They'll help you ramp it down or a lot of them are really excited that you feel ready to graduate. I would think it's just something to bring up pretty straightforwardly.

Kousha Navidar: We have a therapist actually that's on the line right now. Gio from Queens. Hi, Gio. Welcome to the show.

Gio: Hi. I just want to say real quickly. Freud said about therapy, he said that therapy is over when you are able to love, be loved, and to work. That's it. It's over and done with. No therapist should keep you on longer than is necessary. They should check in with you once in a while. When the relationship becomes equalized, when you and the therapist begin to feel more on an even keel, then that's a sign that it's beginning to come to the end. Then when you say it's over and done with, that's it. It's over and done with. They can ask if you'd like to come back and have another session, but that's it. As soon as the patient says it's over, that's the end of that.

Kousha Navidar: Gio--

Gio: And--

Kousha Navidar: Sorry. Keep going.

Gio: No, that's it. I'm just rushing because I'm at lunch.

Kousha Navidar: Oh, I got it. No, I hear you. Gio, thank you so much for that call. That is from a clinician right there, Melissa, talking about one perspective. We are talking to Melissa Dahl, the healthcare reporter at The Cut. We are talking about therapy and specifically when and if to know that it's time to "quit" your therapist. Listeners, if you have a story about recently giving up therapy or it's something that you've been thinking about or maybe you never planned to quit, we want to know how you're thinking about how therapy should fit into your life. Give us a call. We're at 212-433-WNYC. That's 212-433-9692.

Melissa, you write about how ubiquitous the idea of therapy has become after being so intensely stigmatized, which we had mentioned at the beginning of the interview. Does that cultural context for you change this conversation about the role of therapy and how long folks should pursue it? Is there more pressure you feel now from all these different cultural conversations?

Melissa Dahl: There might be more pressure, yes. It is funny how it's just worked itself into-- I think that there's been a lot of chatter about how, frankly, annoying so-called therapy-speak is, especially when it's misused. I want to be clear though. I think it's like a net positive that we as a culture are more comfortable talking about mental health and talking about our own desires to improve ourselves and figure out the way we work. It's just like it reaches a certain point where it maybe becomes just the kind of a self-examination. It's no longer as helpful as it was in the beginning. There's actually a lot of research that ties excessive self-focus to depression and anxiety, so that's not exactly the goal there.

Kousha Navidar: Can you unpackage that idea of it being a net positive? Because I think that's very interesting, especially with social media being such a prevalent part of our lives now and therapy-speak being such a core part for some people of their experience online. It can often feel like there is this counterintuitive effect like you're talking about, but you still say, "Hey, this heightened discussion and that presence on our different outlets is still a net positive," right?

Melissa Dahl: I really do think so. I think that's a pendulum swing that's gone way in the direction of people self-diagnosing, all kinds of mental health ailments. Maybe people misusing therapy-speak in a way that takes a toll on relationships. All of that is that extreme in the negative direction, but I do think maybe just talking about myself and talking about the people I talked to for the story.

All of them were like, "I'm so glad that it's easier to access to this than it ever has been before. I'm so glad I had this opportunity to talk to someone about my feelings and my mental state." Maybe we're just coming back from that pendulum swing of-- it went from something that was shameful to something that everyone is supposed to do. Maybe, hopefully, we'll reach some kind of middle ground here.

Kousha Navidar: Right, it sounds like a question of calibration, really, which isn't totally rocket science, but it's the idea of how to fit it into your life instead of it being a catchall for everyone like a one-size-fits-all situation, which I think with any good therapist, it is not that case. It is, by definition, something that's tailored to you. We've got some more callers. I'd love to go to Kathy in Manhattan. Hi, Kathy, welcome to the show.

Kathy: Hi, thanks. Here's my story. I had a really good therapist for several years who helped me with family issues, with illness in my father, with work-related issues, giving me the courage to quit a job that I wasn't happy in anymore, but then I felt like I reached a plateau and that I was in good shape and that I could take a break. I'm someone who's been in therapy on and off over the years because I think it is useful, but it was time for me to take a break.

She acted like I was breaking up with her, that I was being irresponsible, and I was like, "Well, I'm done. I think that's so unprofessional." Then fast forward some years later when my husband was diagnosed with Stage 4 pancreatic cancer and was going to die and I thought, "Oh, I could use a therapist again," and I would've liked to have gone back to this woman because she knew me and we had a relationship already, but I just felt like I couldn't go back to her because I thought that was so unprofessional.

Kousha Navidar: What did you do, Kathy?

Kathy: I found someone else. [chuckles]

Kousha Navidar: That relationship worked out for you with that therapist that you found that was new?

Kathy: Yes, very much so.

Kousha Navidar: Wonderful. Well, Kathy, thank you so much for that call. I'm sure it's a story that many people can share. Let's go to Doris in Trenton, New Jersey. Hi, Doris, welcome to the show.

Doris: Hi. My question in listening to Ms. Dahl is that in order for you to make up your mind whether or not you should let therapy go or you should continue it, I think, has a lot to do with the specific goals that the therapist has for you. That seems to be really unclear in a lot of instances where I have seen a therapist. I just want your feelings about that.

Kousha Navidar: Doris, thanks so much. Melissa, what do you think?

Melissa Dahl: I think, again, it's ideally something that if you have a good relationship with your therapist, if your therapist is a well-intentioned clinician who wants what's best for you that it could be something you work on together that you off-ramp the relationship together. I think it really just depends on the person that you have and the relationship you have with them. It reminds me when the last person was speaking about their disappointing experience trying to end that therapeutic relationship.

That's so disappointing and that's just terrible, but that reminds me a little bit of something I talked to with one of the therapists I spoke to for the story, which she was like, "We've put therapists up on this pedestal." She was like, "I'm just a person. I don't know everything." I think there's maybe some room for just remembering this is a person you have a relationship just like any other person you have a relationship with.

Kousha Navidar: Let's go to Barbara in Mineola. Hi, Barbara, welcome to the show.

Barbara: Hi. I just want to share my experience. I'm on antidepressants and sleeping pills for chronic insomnia and anxiety. My MD, I'm required to go to psychotherapy twice a month, and I see my MD once a month. If I don't go to the psychotherapy, my MD will not dispense my medications for the next month. I'm trapped in a way because I'm feeling much better. The medications have been switched around and the cocktails has been switched and I'm on the per cocktail. I'm feeling much better.

I'm functioning beautifully. I'm emotionally stable. I'm sleeping, but yet I have to go to see him twice a month. Sometimes I go and it's awkward because I'm feeling really good. I really don't have anything to discuss that I'm in dire straits of. I just find it frustrating because I feel like I'm wasting everybody's time and my money. If I don't go, then my shrink will not give me my medication. I don't know if anybody else has been in that situation. If they have, I would appreciate knowing how I can get out of this. Thank you.

Kousha Navidar: Barbara, have you been able to engage in discussions like that with your providers about what the off-ramp looks like?

Barbara: Well, they say that in order to get the meds, I have to be in therapy. I've been in therapy with this doctor for four years. The first year, yes, I absolutely needed to see him sometimes more than twice a month. Now that I'm stable and my medications are no longer being changed and everything's fine, I still am required to go to see him, which I don't mind. He's a great guy, but there are some times, like I said, that I feel like I don't have anything to work on.

Kousha Navidar: Barbara, thank you so much for that. We'll have to pause there for a time. If anyone listening has been in a similar situation, you can feel free to text us. We're at 212-433-9692 or hit us up on our social channel @AllOfItWNYC. We got time for just one more caller. Let's hear from Liz in Westchester. Hi, Liz, welcome to the show.

Liz: Hi. Thank you. I had a quite different experience than a number of the people are talking about. It took me a long time to find a therapist that really worked for me. I went to him for about three years and I stopped and I went back. Then at a certain point, he said to me, "I think you should start to think about leaving therapy." At that time, I went, "Ah." I found a year later, I was ready. I was ready because I realized that I knew what he was going to say when I asked a question or presented a problem.

I thought it was terrific of him to take that stance as a professional. Have I not wanted to quit, he would have gone on. For him, it was a very definite experience of working with me until I was well. I also found, I'll just say, that the first year of therapy, I think someone spends a lot of time on the problem that they went for. Sometimes it takes another year or two to get to both deeper and more extensive problems, so I would encourage people to stay for at least two years if they like their therapist.

Kousha Navidar: Liz, thank you so much. We'll have to pause you there, but it's great to hear that you had that other side of the experience and one that I think many people hope to have. We're out of time. We'll have to pause there, but there was one caller who had to leave whose comment I wanted to read. This was Alan.

Alan said, "When I was a teen, I was incarcerated as a juvenile. I had court-mandated therapy and he was a strict Rogerian who didn't believe he should have any input. Didn't say anything, but what do you think or say more about that? Sometimes we sat in total silence while I watched his beard grow. After two years, I learned introspection. It was a wonderful experience." We've been talking to Melissa Dahl, the healthcare reporter at The Cut, whose story investigates when and if therapy should be something that you quit or if it should be indefinite. Melissa, thank you so much for joining.

Melissa Dahl: Thanks for having me.

 

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