13 Controversial Truths About Therapy That Few Talk About
- Dr. Scott Eilers, PsyD, LP
- Oct 11
- 3 min read
I became a therapist because I believed therapy could change lives. Then I saw what happens behind the curtain and understood why so many clients stay stuck.
I had imagined therapy as a deeply human space where pain met understanding and science turned that understanding into healing. But inside hospitals, clinics, and private practices, I saw clients repeating the same stories week after week, therapists taking notes but rarely guiding, and a system that confused stillness for progress.
That realization changed everything for me. Because if therapy effectiveness depends on anything, it’s movement whether the process actually helps people change. Real healing takes more than empathy. It takes direction, courage, and honesty about what works and what doesn’t.
Here are 13 hard-earned truths that reshaped how I practice and how I see therapy today.
1. Listening Isn’t Enough
Listening is the foundation, not the finish line. Real therapy begins when reflection turns into guidance, when the session moves from talk to action.
2. Sometimes Advice Is Compassion
Therapists fear being “too directive,” but silence can be avoidance. When better sleep, movement, or structure would help, say it. Clarity is kindness.
3. Humanity Builds Connection
Sharing small, real experiences within boundaries, bridges the gap no degree can. Clients heal faster when the relationship feels human, not clinical.
4. “How Did That Make You Feel?” Isn’t Always Helpful
Most people already know how they feel. They need to learn what to do with those feelings.
5. Therapists Need Their Own Stability
Clients can sense authenticity. Therapy works best when the therapist models regulation, not perfection.
6. Practical Help Counts as Therapy
Helping someone open mail, make a call, or face an avoided task isn’t “less professional.” It’s meeting anxiety and dysfunction where they live.
7. Insight Without Action Changes Nothing
Understanding the “why” doesn’t automatically change the “what.” Progress happens when insight meets consistent practice.
8. The Past Isn’t Always the Answer
Knowing where pain began matters but building skills for the present matters more. You can’t rewrite history, only reshape today.
9. Not Everything Is Imposter Syndrome
Sometimes discomfort just means growth. Not every insecurity needs a diagnosis; some need time and repetition.
10. Therapy Needs a Plan
“Holding space” is valuable, but direction is essential. Clients deserve to know what progress looks like and how to measure it.
11. Sometimes the Therapist Must Lead
When depression or fear leaves clients immobile, therapists must lean in harder, modeling persistence until momentum returns.
12. Challenge Can Be More Loving Than Validation
Agreeing with everything isn’t empathy. Honest challenge, delivered gently, sparks real change.
13. Resistance Means the Therapist Hasn’t Found the Way In
If someone keeps showing up, they’re trying. “Resistance” is feedback, not failure.
Learning to Feel Better
Therapy’s effectiveness isn’t defined by one model or method, it’s defined by movement. It’s about helping people find their footing when they’ve forgotten what stability feels like.
Healing happens when empathy meets direction, when reflection leads to action, and when both client and therapist commit to doing the uncomfortable work of change.
In the video below, I share more about these 13 truths, why many “standard” approaches fall flat and what actually helps when you’re depressed, anxious, or barely holding it together.
-Scott
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FAQ
Q: Can anxiety routines be a sign of depression?Yes. Many people with high-functioning depression use anxiety routines as coping strategies. These routines often mask deeper struggles but also keep people stuck.
Q: What’s the difference between healthy preparation and an anxiety routine?Preparation helps you engage with life. Anxiety routines prevent you from living it. The difference is whether the habit expands or shrinks your world.
Q: What if I’ve tried therapy and it hasn’t helped?You’re not broken. Traditional therapy often overlooks people who need practical, science-based strategies. That’s why I share tools that most mental health providers aren’t teaching.