When Therapy Isn’t the Answer—And Why That’s Okay

I recently came across a post from Brown Girl Therapy that really struck a chord. I deeply appreciate how they named systemic barriers that can make therapy feel out of reach or ineffective for many people. They also highlighted something that doesn’t get talked about enough—the vital role of community in healing. Therapy isn’t always the solution, and that truth deserves more space in our conversations about mental health.

But when I first opened the post, I’ll admit—I thought it was going in a different direction. That first slide stirred something in me that I’ve been holding for a while, and I want to share it here.

We don’t talk enough about the iatrogenic effects of therapy—the harm that can come from treatment itself. In medicine, this might look like side effects from medication or complications from surgery. In mental health, the risks are less visible but no less real. Just because we’re not wielding a scalpel or prescribing medication doesn’t mean therapy is inherently harmless.

One of the most subtle yet powerful dynamics of therapy is this: it increases self-consciousness. That’s the whole idea, right? We slow down. We reflect. We tune into our thoughts, our patterns, our past. But what we don’t always name is that increased self-consciousness, in itself, can amplify anxiety and negative emotion.

There’s robust research connecting heightened self-focus with increased symptoms of anxiety and depression. When we’re hyper-aware of our internal experience, it can stir discomfort, dysregulation, and at times, even despair. Therapy invites people into this state deliberately—not to keep them there, but to help them learn from it and, ideally, move through it with more self-awareness and skill.

As a psychologist, I still believe in therapy. I believe in the power of reflection, in building insight, and in the change that can come from being deeply known. But I also believe that therapy isn’t right for everyone, or right for everyone all the time. And that has to be okay.

Sometimes, healing happens in a circle of friends, a faith community, a dance class, or a garden. Sometimes, it comes from rest, or protest, or storytelling. Therapy can be a powerful tool, but it’s not the only one. And for people for whom therapy feels like too much—or not enough—that doesn’t mean they’re doing it wrong. It just means we need to keep expanding our definitions of care. And if we’re using “Hey, you should go to therapy” as a tool to dismiss rather than to examine… then what are we achieving?

So let’s keep making space for that complexity. And let’s keep talking about the parts of therapy that don’t always feel so therapeutic—because the more honest we are, the more healing becomes possible.