therapy culture is not the same thing as therapy
can we please stop conflating the two?
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Like many fellow therapists on substack, I’ve been noticing a growing wave of frustration with therapy. Substack posts, social media rants, and personal accounts all seem to echo a common sentiment of disillusionment with the field. Therapy feels like a never-ending cycle of self-improvement, an expensive and exhausting endeavor that never quite delivers on its promise rather than a genuine avenue for healing.
People feel duped.
They feel trapped in an industry that, rather than providing relief, seems to keep them tethered to the very struggles and wounds they seek to escape.
They are tired of fixing themselves, and they are tired of the therapists who seem to profit off their suffering.
I get it.
I’ve heard horror stories of harmful and ineffective therapists. I’ve made my fair share of mistakes as a therapist. And I agree - there are a lot of therapists who, whether consciously or not, are caught up in the same self-help, self-optimization spiral as their clients, perpetuating the very culture that is causing so much distress.
But let’s be super clear with what we are talking about here.
The commodified, surface-level version of therapy that has infiltrated the mental health space is not therapy.
That is therapy culture.
There is a huge difference between therapy culture and therapy. When we conflate the two, we risk losing sight of what therapy is actually meant to be.
So what is therapy culture, and how is it different from actual therapy?
Therapy culture is what we see on social media, in self-help books by authors who have zero training in psychology, in the commodification of mental health. It’s therapy distilled into bite-sized, instagrammable mantras that, while sometimes helpful, often reduce complex healing processes into oversimplified solutions.
It’s the endless discourse about “doing the work,” as if healing were a linear, transactional process. It’s the expectation that therapy should always yield visible, measurable progress, preferably in a neat and timely fashion. (I explored this in more depth in last week’s post “how do you know when you’ve truly healed?”)
Therapy culture is deeply rooted in the wellness industrial complex, a billion dollar industry that thrives on keeping people feeling like they are perpetually not enough and always in need of another tool, retreat, or certification to finally heal.
It is steeped in self-optimization rhetoric that teaches that if you are not constantly working towards a better, more productive version of yourself than you are a failure.
Within the paradigm of therapy culture, there is an expectation that therapists should be all-knowing and able to “fix” their clients, rather than be a relational guide who helps them navigate their own inner world.
This is not therapy.
Therapy is a process, not a product. It is a relational space, not a self-improvement program. It is messy, nonlinear, sometimes frustrating, and when done with integrity, deeply human.
Therapy is not about achieving some perfected version of yourself but about increasing self-awareness, learning to sit with discomfort, and navigating life with a greater sense of agency and self-compassion.
Therapy is a co-created space where the therapeutic relationship itself is part of the healing process, not a one-way street where the therapist constantly gives advice.
Therapy is sticky and challenging. It requires us to confront difficult emotions and experiences, sitting with uncertainty, and resisting the urge to seek immediate relief.
We need to stop conflating therapy culture with therapy.
Much of the critique that I’ve read seems to blame individual therapists for the systemic paradigms under which people are seeking help in the first place. And although there are certainly bad therapists out there, we need to be more discerning about what’s really going on here.
When we conflate therapy culture with therapy itself, we set unrealistic expectations, both for therapy and for ourselves.
Many people enter therapy believing it will “fix” them, that they will eventually “get better” in a way that means their struggles will disappear. When this doesn’t happen, they either blame themselves or their therapist.
Of course that’s not how it works and clients become understandably disillusioned, believing they’ve been sold on false advertising.
And in a way, they have. But this is the fault of therapy culture, not of therapy.
Therapy is often not about feeling better right away. It’s about developing a greater capacity to hold discomfort, and navigate life’s inevitable challenges.
Another risk of conflating therapy culture with therapy is the harm it causes to both therapists and clients alike.
There is often an unconscious desire for therapists to be all-knowing figures, people who have it “all figured out.” Many clients resist acknowledging the humanness of their therapist because it feels safer to believe in an idealized version—someone who has the answers they desperately seek.
Many people are coming to therapy already with a TikTok self-diagnosis and identity that has been carefully crafted by whatever algorithm they’ve found themselves in. This is a super tricky thing to navigate as a therapist.
Therapists, especially those new to the field, feel pressure to meet the unrealistic expectations set by therapy culture, sometimes resorting to giving the client what they want (i.e. instant relief, validation of their self-diagnosis, or surface-level insights that feel congruent with what therapy culture has taught them), rather than what they need (deeper, sometimes uncomfortable work that leads to lasting change).
In all of the training I’ve taken, there is always the inevitable question of how to toe the line between giving a client what they want versus what they need. If we only focus on what a client needs, we run the risk of rupturing the therapeutic relationship to the point of no repair and potentially causing more harm. If we only give them what they want, we are surrendering to therapy culture and wasting everyone’s time, energy, and resources.
This balance has become increasingly difficult to strike as a direct result of therapy culture. And the result is tragic: clients remain stuck, and therapists feel burned out from trying to meet an impossible standard.
The (very real) flaws with therapy
Critics of therapy are not entirely wrong. There are valid concerns about the industry.
Unfortunately there are unskilled and harmful therapists out there. Whether by being dismissive, overly rigid, or too entangled in therapy culture themselves, some therapists do more harm than good.
“Big therapy” is a term that explains the commercialized version of therapy. Many therapy platforms (coughBetterHelpcough) prioritize profit over quality care, leading to watered-down, ineffective therapy experiences.
With the increase in demand of therapists everywhere, the educational and licensing requirements have decreased to meet this demand. This causes ethical problems with how many therapists are operating.
These issues are real. But the solution is not to dismiss therapy altogether—it’s to develop a more discerning approach to choosing a therapist and engaging in the therapeutic process.
Therapy is not broken—but our cultural understanding of it is. If we want therapy to serve its true purpose, we must collectively shift away from the commodified, self-optimization-driven version of therapy and toward a deeper, more relational understanding of what true healing entails.
We must learn to approach therapy with realistic expectations.
We must choose therapists who prioritize depth over quick fixes.
We must recognize when we, as clients and therapists, are falling into therapy culture.
Healing is not a product. Therapy is not a life hack. It is a process, a relationship, and a practice of sitting with the complexities of being human. The sooner we embrace that, the more therapy can actually help us.
See below for tips and reflections on how to know if you’re engaging with therapy or therapy culture.
Xx,
The imperfect therapist trying to change the paradigm