Dear Therapist:

I’m wondering if therapy can help a person who is in a difficult situation that can’t be changed. I understand if someone is depressed with life therapy can help them feel better but if someone is dealing with a reality that is bad is there a point of going to therapy? I understand the question is broad but I would prefer not to go into my own personal details. Either way there are many such examples, financial, familial, medical, etc. where there is nothing really to change. What does therapy have to offer, if anything, in that type of situation?



Without details, I can only speak broadly. Generally speaking, our minds are comprised of both the conscious and the unconscious. This means that we react to pretty much everything from a conscious (logical) perspective as well as from an unconscious (emotional) perspective. These two are inextricably linked.

Even in situations that appear to call for only a logical, analytical approach, there is some level of emotion involved. In most cases, our emotional “thought” is more prominent than we recognize. For example, when shopping for a new suit we would assume that the unconscious mind should have no say; we should simply choose a suit based on the fabric, construction, and price. However, for most people there are “thoughts” that are contributed by our unconscious impulses. Is this suit expensive-looking enough? What will others think of me? Does it match my sense of status? Will it make me feel good about myself?

So our unconscious mind is always at work giving us prompts, thoughts, and beliefs that don’t necessarily conform to the logical reality of the situation. Perhaps more importantly, our unconscious mind is insidious in the sense that we are by definition unaware of these impulses. These unconscious feelings are often based on insecurities that we are not at the time acknowledging.

Most often, we have no great need to identify our unconscious impulses in order to separate them from our conscious thoughts. If I wind up buying a slightly more expensive suit, it may be of no real consequence. Additionally, each time I wear it, I do feel a little better about myself. (I’m not going to focus on my conscious, logical thoughts every time I contemplate wearing my new suit, thereby becoming okay with wearing a less expensive one.)

When we are faced with situations in which our unconscious motivations are strongly triggered, our thoughts are typically more highly affected by emotional triggers. This can lead to a higher level of emotion than is healthy. In the suit scenario, the conscious/unconscious mix may be ninety-percent logic and ten-percent emotion. In a highly charged emotional scenario, however, it can be closer to fifty-fifty. At times, it can be largely emotional.

When this occurs, it becomes more important to identify our emotions and the insecurities that are triggering them. Doing so can help with two things. It helps us to focus on our logical, intellectual thoughts, thereby allowing us to work through the situation in a calmer fashion. This often leads to better and more rational decisions, and allows us to take our minds off of an ongoing concern. It also gives us the chance to identify some of our insecurities and the ways in which they affect our moods. This can help us to resolve some of these insecurities and reduce the likelihood and severity of their triggers.

Therapy can help us to recognize many of these issues and to work on them. There are other, more concrete, ways in which a therapist can help us to deal with specific emotional reactions. However, working on the underlying factors can help us to change how we more generally deal with our thoughts and emotions.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer / 718-258-5317