Therapy is more than lying on a couch and talking. Here are 5 ways it can boost happiness

(CNN) — Therapy often gets a bad rap.

In old movies, it’s often depicted with a patient lying on a couch, talking to a stony-faced, note-taking analyst who never speaks. Critics sometimes derisively describe it as navel-gazing. Therapists are offhandedly called “shrinks,” a throwback to the ancient practice  of shrinking the head of a conquered enemy.

And let’s face it, the practice still carries a stigma for many; acknowledging you see a therapist is akin to admitting you are weak or “crazy,” especially in some professions.

When it comes to physical health, most of us don’t hesitate too long to get help for injuries such as a broken bone or a burn. But when it comes to emotional health, there often is a delay, possibly resulting in a bigger mental health crisis.

“People don’t come to therapy until they’re having the equivalent of an emotional heart attack,” psychotherapist Lori Gottlieb told CNN Chief Medical Correspondent Dr. Sanjay Gupta on his podcast Chasing Life recently. Gottlieb is the author of “Maybe You Should Talk to Someone,” a cohost of the “Dear Therapists” podcast and the writer of the weekly “Dear Therapist” advice column for The Atlantic.

“We don’t have this hierarchy of pain with our physical health. We don’t say, ‘Oh, I fell down and broke my wrist, but I don’t have stage 4 cancer, so I’m just going to let my wrist hang out there and I’m not going to get a cast.’ And we have a very different attitude about emotional health,” she said.

Hesitancy over therapy may be due to its stigma, a skepticism about its worth, the cost in time and money, or just the uncertainty about how it works — and this reluctance to discuss mental health is pretty widespread.

According to a survey by the Pew Research Center released in May, 31% of respondents said they would only be somewhat comfortable talking to a therapist about their mental health, while 18% said they’d be either not too or not at all comfortable doing so.

“There are so many misconceptions about therapy, and I think that often prevents people from going,” Gottlieb said. “(One) is that you’re going to go in, you’re going to download the problem of the week, and you’re going to leave, and you’re basically just complaining and getting validated for your complaints.

“And that is not what therapy is. We like to say that insight is the booby prize of therapy, that you can have all the insight in the world, but if you don’t make changes out in the world, the insight is useless,” she said, noting that most therapy takes place in the week between sessions “where you are actually taking what you’ve learned and doing something different.”

Taking action not only rewires your brain, but it can ultimately result in a happier you.

“Do they experience joy more? Yes. Are they generally more content in their lives? Do they feel less stressed, less sad, more able to manage when things don’t go well, less reactive when they’re in a situation that maybe is relationally difficult for them, more able to find sort of inner peace? Yes,” Gottlieb said. “That shouldn’t be underestimated. I think that when people say, ‘Oh, I just want to be happy.’ All of the things that I just described bring you happiness.”

You can listen to the full episode here.

How can therapy improve your happiness? Here are Gottlieb’s top five reasons.

1. Therapy offers perspective

Ideally, therapy is impartial.

“Therapy is like getting a really good second opinion on your life, from someone who’s not already in your life,” Gottlieb said. “When we try to get advice or guidance from people who are close to us, it’s hard for them to separate out the relationship they have with us and to be able to see the issue objectively.”

Our friends, she said, give us “idiot compassion” — they loyally validate our feelings often without pointing out our own role in any conflicts. Therapists are trained to give us “wise compassion,” she said.

“We hold up a mirror to you, and we help you to see something about what is getting you stuck, that maybe you haven’t been willing or able to see. We help you to see something that you can actively change,” Gottlieb said. “And I think that there’s something so empowering about that, and it’s so translatable to many different relationships.”

2. Therapy is a safe space

In therapy, you can explore seemingly frivolous subjects.

“Therapy can make you happier because it helps you to really be intentional about what you want in your life. And I don’t think we have a lot of spaces to talk about that,” Gottlieb said, referring to concepts such as life satisfaction.

“Sometimes people think, ‘Well, I have a roof over my head and food on the table. So this whole thing about meaning and fulfillment — I can’t really talk about that,’” she said. “In therapy, you have a space where you can really ask those hard questions, and nobody’s judging you and nobody’s trying to tell you, ‘Well, you have enough already.’”

3. Therapy helps to connect with others

Modern times have created an epidemic of loneliness; the pandemic only made it worse. Therapy can be a bridge.

“We do have this epidemic of loneliness. And I think a lot of people want deeper connections, and they want more meaningful connections, but they don’t know how to go about it,” Gottlieb said. “I think that we all grew up with certain ideas about what relationships look like, what friendships look like. (But) we aren’t always aware of the ways in which we may be preventing ourselves from having more meaningful relationships.”

For example, many people avoid conflict or seek it out, while others have social anxiety or never learned the necessary social skills. “So we don’t know how to reach out even if we want to,” she said. “And I think in therapy, you learn how to create connection in your life, which is one of the most influential factors when it comes to happiness.”

4. Therapy helps us see the big picture

Therapy helps people see that they are part of larger forces, and not simply individuals who formed with no external influences.

“We sometimes feel that the problems are sort of ‘out there’ — we don’t really know that we are part of that dynamic, part of that dance,” Gottlieb said. “(Therapy) helps you to process that unfinished business.”

She pointed out that our parents were human and often did what they learned from their parents. “And (therapy is) a place where you can say, ‘What is some of this old stuff that I’m carrying around with me that I don’t even realize I’m carrying around?’” she said, noting that once you understand how your history influences how you navigate through the world, you can change patterns.

“It makes you happier because you’re not carrying around the burden of something that happened a long time ago,” she said.

5. Therapy helps us control our story

Our life is a narrative, and therapy can help us make sense of it.

“When you think about our lives … they’re really stories. (Therapy) helps you clarify your story and take authorship of your story,” Gottlieb said. “It helps you to take authorship of your own life. … If I’m creating this one limited time that I have here — this one life that I have here — why am I letting all these other people write my story for me, and how can I really take ownership of my story?”

We hope these five tips help you understand the benefits of therapy. Listen to the full episode here. And join us next week on the Chasing Life podcast with an update about the evolving bird flu situation in the country.

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CNN Audio’s Jennifer Lai contributed to this report.