Why People Go To Therapy

Even when they feel like it doesn't work

Folktales tell people to unburden themselves by whispering into tree holes. Christianity offers priests and confessions. Indigenous peoples have Elders and Knowledge Keepers. Girls in their twenties have SSRIs, psychologists, and registered social workers—are you currently seeing someone? they ask each other.

My theory on the popularity of therapy is that it meets the innate desire we have to purge dark secrets.

But why does this desire exist, and what does it say about our nature? And if it’s truly all just a mechanical supply for a psychological demand, what does this say about the true efficacy of therapy? Isn’t it just another form of catharsis?

There’s a unique quality that’s common to these forms of secret-telling: they’re told privately and unidirectionally to a designated secret-holder who is expected to listen gracefully and offer help, all while keeping confidentiality. Above all, this kind of secret-telling functions as a purge, not a currency exchanged for intimacy.

What is being purged?

Purging implies that the body is getting rid of something harmful: People rarely go to therapy to share the highlights of their Mediterranean vacation, they go to talk about their mistakes, regrets, pain, and hatred. They go to cry, to complain, and to say the things they would never say out loud to the person they’re talking about. And then they seek consolation and resolution—in that order.

This pattern happens in other forms of “therapy”. Catholic confession, for example, occurs in a similar order: contrition (sorrow for the sins committed), disclosure of the sins (the confession), then satisfaction (the penance, i.e. doing something to make amends for the sins).

This ritual says something very profound about our innate sense of morality: We have the instinct to keep dark secrets, secrets, because somewhere inside we seem to know when our conscience has been offended. Here’s how I know that: