Do happy people need therapy, too?

I had a doctor’s appointment this week, the first step in what will eventually be a minor surgical procedure I require (abdominal hernia). I hadn’t been to a doctor in years.

In filling in the paperwork, the nursing assistant asked me the usual questions: Do I smoke (no), do I drink (no), do I have allergies to any medications (no)? Then she asked something I’ve never been asked before: Do I have any history of depression?

I was startled by this question, having never been asked it before. (The answer is “no.”) Later, in mentioning this to our older daughter, she said she had been asked that question as well, the last time she had a doctor’s appointment. Mental health, it seems, is now mainstream.

I applaud psychological counseling. The field has helped endless millions of people cope with trauma, grief, bad behaviors, anxiety, depression and relationships between family members. My understanding is many therapists and counselors enter the discipline to help others cope with issues from which they themselves have suffered, bringing experience and empathy as well as training to the profession.

I’ve never had therapy of any sort, so I’m unfamiliar with the nitty gritty of how these transformations take place. However, this headline startled me when I saw it, because I couldn’t grasp the purpose: “Therapy is Important, Even if You’re Happy.”

The author of this piece, Keah Brown, sought counseling to cope with depression, and outlines the process by which she was able to achieve some measure of relief from this affliction. She also described the maintenance and newly learned techniques required to sustain the strides she had made and avoid relapses.

What startled me about the article was the quote from a social worker and therapist named Brynna Pawlows (not the author’s therapist) who made this stand-alone observation: “I believe people should attend therapy for a significant period of time – typically six to eight months – at some point in their lives, even if they are relatively happy. It’s important to take a real look at ourselves, unpack some maladaptive behaviors or thoughts, and then use the skills taught in therapy to tackle any future issues, adjustments, or lapses in mental health. Therapy isn’t a cure-all, but rather a space to open up, explore, learn new skills, and find the connections to presenting problems and how they connect with early-to-late childhood themes and family dynamics.” [Emphasis added.]

And that’s where my question arises: Is therapy necessary to achieve or maintain happiness if you’ve never experienced anything that would require counseling in the first place? Maybe I’m reading too much into the statement, but that’s sure what it sounds like.

Another therapist quoted in the article, Aimee Lori Garrot, agrees that going to therapy when you’re relatively happy is as important as seeking help in times of distress. “I think if a person is in a good space, they can often work on things in a more successful manner than if they are in the middle of a horrible depression. … There are clear benefits to starting therapy wherever you are in life. There is no need to wait until things get bad before beginning, and there is no reason to wait for them to get better first either; you just have to start.” She also notes that therapy is just as much about learning all the coping skills that you weren’t taught.

I don’t mean to make it sound like I’m mocking or making light of therapy, because I’m not. I consider it an essential medical procedure, just like repairing an abdominal hernia. But I genuinely want to know how therapy can help someone who is already “relatively happy” maintain that state of mind. What am I missing here?

Part of my confusion stems from my unfamiliarity with mental health issues. In another article entitled “Temperamentally Blessed,” author Elizabeth Svoboda discusses the unusual condition of those who don’t suffer from any mental distress at all.

“I regard such temperamentally blessed people with awe, and I’m more than a little curious about the source of their endurance,” she writes. “Why is it that, after what psychologists call an ‘adverse event,’ I have a near-irresistible urge to wallow and curl into myself, while the temperamentally blessed deploy their emotional stabilizers and sail on blithely? Is it genes, upbringing or something less easily defined? And should we seek to follow their example – or are emotional ups and downs a natural and integral part of a life well-lived? Is it even mentally healthy to stay so even-keeled when chaos descends?”

In an effort to dig deeper into this character trait, Svoboda turned to the work of a then-graduate student in psychology named Jonathan Schaefer (now an assistant professor of psychology at Vanderbilt University). Using data from the famous Dunedin cohort study, Schaefer found that evidence of mental disorders in the general population is shockingly high.

“One thing that jumped out at [Schaefer] was that the vast majority of cohort members had met criteria for a mental illness at some point in their lives,” writes Svoboda. “In the turbulent years leading up to middle age, 83 percent had suffered from either short-lived or longer-lasting mental disorders. ‘Experiencing these conditions is actually the norm,’ Schaefer says. ‘It’s kind of weird not to.'”

Read that again: Having a mental disorder is the norm by a wide margin, not the exception.

Those that didn’t experience mental illness were dubbed “the temperamentally blessed,” and the condition was found to be independent of wealth, physical health, or intelligence, though it does appear to have a genetic component in that first-degree relatives similarly experience solid mental health.

“What does seem clear, though, is that being temperamentally blessed is not the same as being happy in a deeper sense,” adds Svoboda. “However even-keeled they might be, the temperamentally blessed don’t score much higher on life-satisfaction scales than those who are not as blessed. ‘There’s more to life than not experiencing mental disorder,’ Schaefer says. ‘There are some people in the enduring mental-health group who rate their life satisfaction as pretty low.'”

Maybe this is why happy people need therapy?

The writer of the original piece kept going to therapy to maintain the happiness she’d found, which strikes me as a perfectly legitimate reason. But the recommendation to attend therapy even if you’re happy to begin with seems … odd. I can’t imagine what my opening session under such conditions would be. “I’m here because I’m happy. Can you fix me?”

So help me out, dear readers. Is therapy in this context helpful?

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